American Board of Surgical

American Board of Surgical American Board of Surgical Assistants TEST REVIEW - Sutures and Wound Repair/ General Surgery ______ is a life threatening obstruction in which the intestinal lumen is obstructed both proximally and distally, leading to bowel necrosis , perforation and peritonitis - ANSWER-Volvulus .A longitudinal ulcer in anal canal is ____ and _____ is a tubular tract that has its skin opening beside anus - ANSWER-Fissure in ano Fistula in ano .A Roux en Y procedure for common duct repair is - ANSWER-Choledocojujenostomy .Acromegaly is te result of hyper function of the - ANSWER-pituitary .Acute cholecystitis is usually associated with - ANSWER-Gall stone Cystic duct obstruction Bacterial infection Empyema .Adrenocorticotropin (ACTH) , FSH and LH are secreted by - ANSWER-Pituitary only not adrenals, not ovaries and not testes .After completion of anastomosis in colon resection procedures, the mesentery is carefully reapprximated to - ANSWER-Prevent internal hernia with bowel entrapment .All of the following cause intestinal obstruction except: Intussusception Volvulus of cecum Colitis Superior mesenteric embolus - ANSWER-Colitis .All of the following require immediate surgery except: Complete SBO Cecal volvulus Bile peritonitis Massive rectal prolapse - ANSWER-Massive rectal prolapse .Amount of weight or pull necessary to break suture or ligature material is called - ANSWER-Tensile strength .Ampulla of water is dilated for - ANSWER-Common duct stones .An abd incision made parallel and about four cm lateral to midline is a - ANSWER-Paramedium rectus .An interrupted suture, which is placed through tissue from one side of the wound to the other and then back through tissue again is called - ANSWER-Matress .Anastomosis between small intestine and colon is a - ANSWER-Ileocolostomy .Another name for a stick tie or transfixation suture is - ANSWER-Suture ligature .As a consequence of ligating the inferior mesenteric artery and vein, it is necessary to remove the entire _____ colon and anastomose the ____ colon to the ____ colon - ANSWER-LEFT colon and anastomose the TRANSVERSE colon to the Sigmoid colon .Benign intestinal tumor is a _____ while _____ is malignant - ANSWER-Fibromata, lymphosarcoma .Bleeding from the tonsillar bed is controlled with ___ rather than ___ which might damage the ____ - ANSWER-PRESSURE rather than SUTURE LIGATURE which may damage EXTERNAL CAROTID .Bumpers or guards are used on tension sutures to - ANSWER-Prevent heavy suture from cutting into skin .Carcinoma of fun may be confirmed by - ANSWER-Scalene node biopsy Mediastinoscopy Bronchoscopy Not by esophagoscopy .Care must be taken during ligation of the vena cava for pulmonary embolism to prevent injury to" - ANSWER-Lumbar veins Right ureter .Care must be taken not to damage which structures during thyroidectomy - ANSWER-Parathyroids Trachea Recurrent laryngeal nerve .Causes of peritonitis include which of the following: Ruptured spleen Puerperal infection gangrenous obstruction of bowel acute pancreatitis ulcerative colitis - ANSWER-ALL OF THE ABOVE .Cessation of peristalsis - ANSWER-Paralytic ileus .Characteristic symptom of perforated peptic ulcer - ANSWER-Shock .Choledocotomy is a/an: - ANSWER-iNcision into common bile duct .Combine in antrectomy or gastroenterostomy, ____ is the most common op procedure for peptic ulcer: - ANSWER-Vagotomy .Complete removal of _____ glands results in severe tetany - ANSWER-Parathyroid .Dumping syndrome occurs after gastric resection because of the - ANSWER-rapid entry of food into jejunum .Esophageal varices occur when an increase in ____ obstructions forces ____ blood to seek a new avenue of return to the ____ - ANSWER-PORTAL VEIN VENOUS RIGHT ATRIUM .Excessive accumulation of uric acid in blood with disposition of acid crystal in tissue causes - ANSWER-Gout .For a perforated diverticulum of the colon, affected bowel segment is resected followed by a/an: - ANSWER-Two stage operation .Four major sources of blood supply to stomach: - ANSWER-Right and left gastroepiploic Right and left gastric .Halsted Technique consists mainly of - ANSWER-Interrupted silk sutures .Healing process in which a wound is purposely left open and allowed to heal from bottom upward is called - ANSWER-Secondary intention .Hemorrhage occurring during operation on biliary tree is usually result form injury to - ANSWER-Cystic artery .Hormone estrogen is secreted by - ANSWER-Adrenal cortex and ovaries Not by pituitary and not by adrenal medulla .In 2 layer bowel anastomosis, the inner _____ layer is closed with ___ sutures and the outer _____ layer with ____ sutures - ANSWER-Inner MUCOSAL layer with absorbable Outer SEROSAL layer with non absorbable .In gastric bypass for morbid obesity, stapling the ____ portion of the stomach provided a small ____Outlet - ANSWER-PROXIMAL GASTROJUJENOSTOMY .In the presence of infection, the absorption rate of surgical gut is: - ANSWER-Increased .In upper quadrant oblique incision (subcostal) which muscle is retracted / transversely divided? - ANSWER-Rectus .in which of the following is a loop colostomy done? Abdominperineal resection Bowel decompression Total colectomy Hemicolectomy - ANSWER-Bowel decompression .longitudinal ulcer in anal canal is - ANSWER-Fissure in ano .Low levels of adrenocortical hormone in the blood or urine is indicative of _____ dz - ANSWER-Addisons .Many post op patients are in state of _____ due to ____ depletion, a condition that retards wound healing - ANSWER-negative nitrogen balance protein .Most braided or twisted non absorbable sutures should not be used in presence of active infection because - ANSWER-The sutures become breeding place for infection .Pancreas functions as an ___ gland , secreting insulin and ___ directly into the ____ - ANSWER-ENDOcrine gland, secreting insulin and GLUCAGON, directly into BLOOD SERUM .Pancreas secretes hormones: ___ and ___ which are involved in ____ metabolism - ANSWER-Glucagon Insulin Carbohydrate .Partial gastrectomy followed by gastroduodenal anastomosis is a - ANSWER-Billroth I .Place these digestive system structures in correct sequence Pylori sphincter Fundus Diaphragm jejunum Esophagus cardiac sphincter duodenum ampulla of vater - ANSWER-Esophagus Diaphragm Cardiac sphincter Fundus Pyloric sphincter Duodenum Ampulla of vater Jejunum Ileum .Portacval shunt is indicated for: - ANSWER-Esophageal varices Backpressure on portal vein Leunnec's cirrhosis Not indicated for portal HTN .Post op GI bleeding can cause_____ shock while _____ shock is result of failure of arterial pressure - ANSWER-HYPOVOLEMIC NEUROGENIC .Protrusion of bowel through separated edges of abdominal wound closure is - ANSWER-Evisceration .Protrusion of viscera through and incision following surgery is - ANSWER-Evisceration .Purpose of vagotomy is treating patients with peptic ulcers is to - ANSWER-Decrease gastric acid hypersecretion .Radical mastectomy for cancer involves removal of portion of the ____ muscles - ANSWER-Pectorals major and minor .reconstruction of the GI tract in a Whipple procedure is accomplished by the following anastomosis: - ANSWER-Pancreatojejunostomy, choledocojejunostomy, gastrojejunostomy, choledochojejunostomy .Removal of fibrinous deposit or restrictive membrane on the pleural lining that interferes with pulmonary ventilation is a - ANSWER-Cardiac poudrage .Removal of fibroses palmar aponeurosis is done for - ANSWER-Dupuytren's contracture .Saccular dilation leading from lumen of bowel is - ANSWER-Diverticulum .Salivary glands consiste of 1. sublingual 2. Submax 3. parotid 4. stepsons 5. Brunner's - ANSWER-1,2,3 Sublingual Submaxillary Parotid .SBO leads to electrolyte imbalances. First to ____ from loss of ____-, then to _____ due to loss of ____ - ANSWER-First, ALKALOSIS from loss of HYDROCHLORIC ACID Then ACIDOSIS from loss of WATER AND SODIUM .Secreting cells of mammary glands - ANSWER-Alveoli .Select procedure that require isolation of instruments from rest of operative field: 1. Open intest anastomosis 2. Common duct exploration 3. Exteriorization of coostomy 4. esophagomyotomy - ANSWER-1,2,3, Open anastomosis Common duct expo ext of colostomy .Separation of congenital hypertrophied sphincter which prevents tempting of the stomach in an infant is - ANSWER-Pyloromyotomy .Silk is not recommended for use in gallbladder kidney or bladder because - ANSWER-It may become nucleus for stone formation .Space caused by separation of wound edges which have not been closely approximated by sutures is called - ANSWER-Dead Space .Spitting open or gaping of wound is called - ANSWER-Dehiscence .Statement concerning a post hypophysectomy patient is true? Replacement adrenal steroid therapy is required Diabetes insidious may occur Cessation of menstruation and infertility occurs All of the above - ANSWER-ALL of the above .Stay suture does not pass through -Subq -Rectus muscle -Mesentery -Fascia - ANSWER-Mesentery .Structure that must be identified in parotidectomy - ANSWER-Cranial Nerve VII (7 -facial) .Subtotal gastric resection with gastrojejunostomy anterior to transverse colon is a - ANSWER-Billroth II .Surgical bypass procedure for portal HTN is a shunt between ____ and ____ or between ____ and _____ - ANSWER-Portal vein and IVC or Splenic vein and left renal vein .Surgical correction of hiatal hernia - ANSWER-Diaphragm crura is tightened .Surgical gut is made from the - ANSWER-Submucosa layer of sheep's intestines .Surgical procedure for head of pancreas is - ANSWER-Whipple .Surgical removal of endocrine gland affects the - ANSWER-Body metabolism