FLS 3 Exam Questions with correct
Answers
Indications for using local anesthesia in laparoscopy - Correct Answers -no conclusive
evidence that it will prevent visceral pain but can be helpful for tubal ligations, diagnostic
laparoscopies or hernia repairs
Types of local anesthesia - Correct Answers -Bupivacaine, Ropivacaine, Lidocaine
Advantages of epidural anesthesia - Correct Answers -Decreased post-operative
anesthesia and decreased length of post-op ileus as well as improved muscle
relaxation.
What medication can you give to prevent bradyarrhythmias in lap surgery? - Correct
Answers -Prophylactic atropine prevents bradyarrhythmias caused by
pneumoperitoneum but causes excessive dry mouth so better to give intra-op rather
than pre-op. Can give glycopyrrolate
What do you do when you suspect a gas embolus? - Correct Answers -Stop insufflation,
place patient in T-burg in left lateral decubitus position to prevent gas embolus to get to
the right heart system, give fluid bolus to reverse severe hypotension, and place central
line to evacuate or break up the embolus in the right heart chamber.
How do we minimize risk of transmission of infectious particles from patient to OR staff
in laparoscopy - Correct Answers -Use filters for all suction devices, universal protection
(eye protection, gloves, impervious gowns)
What is important to do in a "final look" before removing the camera in laparoscopy? -
Correct Answers -Check the surgical bed for hemostasis, perform survey of abdomen to
rule out occult injury to remote organs, let out some of the pneumoperitoneum for a "low
pressure test."
What are the most common causes of unrecognized bleeding in laparoscopy? - Correct
Answers -Trocar injury of abdominal wall vessels, injury to vessels and organs away
from operative field, tamponade of venous bleeding due to pneumoperitoneum.
, What class of meds are used pre-op for relaxation of patients - Correct Answers -
Benzos. For relaxation and also to give amnesia.
What meds should patient take prior to surgery? - Correct Answers -H2 blocker or non-
particulate antacid sodium citrate to minimize effects of aspiration should it occur. Also
any chronic cardiovascular or pulmonary medications
What components are important for anesthetizing a patient for laparoscopy - Correct
Answers -IV induction + GETA and neuromuscular blockade
Can you use an LMA for laparoscopy? - Correct Answers -controversial
Does the use of nitrous oxide as an insufflating gas cause bowel distension - Correct
Answers -usually not seen (rare) unless patient has a bowel obstruction
Common patient positions in surgery - Correct Answers -Supine, Trendelenburg,
Reverse T-burg, Lithotomy, lateral decubitus
How should you position the arms in a pelvic laparoscopic surgery - Correct Answers -
Arm tucked to the sides. Ensure hands are not near a break in the table to avoid a hand
injury if table is flexed during surgery
How should you position the arms in an upper abdominal surgery - Correct Answers -
Arms abducted to 90 degree angle but not greater than 90 to avoid brachial plexus
stretch injury
What are some key elements to keeping patient safe in a steep reverse Trendelenburg
position - Correct Answers -Foot board to keep patient from sliding, safety belt to keep
patients knees from buckling
Keys to safely positioning a patient in lithotomy position - Correct Answers -Fit the
equipment to the patient, not the patient to the equipment. Allen stirups preferable to
candy cane stirrups given more movements.
In an omentectomy, what level should the knees be placed in the lithotomy position for
optimal positioning? - Correct Answers -For open surgery such as omenectomy it's
important to make sure the knees are level with the torso to keep the instruments from
interfering with the knees
Decubitus position precautions - Correct Answers -avoid stretch in brachial plexus, roll
in the the axilla on the dependent side, with a an arm board for the contralateral arm.
Can use a bean bag but it cannot extend too far anterior or posterior to avoid
interference with port placement and manipulation
Answers
Indications for using local anesthesia in laparoscopy - Correct Answers -no conclusive
evidence that it will prevent visceral pain but can be helpful for tubal ligations, diagnostic
laparoscopies or hernia repairs
Types of local anesthesia - Correct Answers -Bupivacaine, Ropivacaine, Lidocaine
Advantages of epidural anesthesia - Correct Answers -Decreased post-operative
anesthesia and decreased length of post-op ileus as well as improved muscle
relaxation.
What medication can you give to prevent bradyarrhythmias in lap surgery? - Correct
Answers -Prophylactic atropine prevents bradyarrhythmias caused by
pneumoperitoneum but causes excessive dry mouth so better to give intra-op rather
than pre-op. Can give glycopyrrolate
What do you do when you suspect a gas embolus? - Correct Answers -Stop insufflation,
place patient in T-burg in left lateral decubitus position to prevent gas embolus to get to
the right heart system, give fluid bolus to reverse severe hypotension, and place central
line to evacuate or break up the embolus in the right heart chamber.
How do we minimize risk of transmission of infectious particles from patient to OR staff
in laparoscopy - Correct Answers -Use filters for all suction devices, universal protection
(eye protection, gloves, impervious gowns)
What is important to do in a "final look" before removing the camera in laparoscopy? -
Correct Answers -Check the surgical bed for hemostasis, perform survey of abdomen to
rule out occult injury to remote organs, let out some of the pneumoperitoneum for a "low
pressure test."
What are the most common causes of unrecognized bleeding in laparoscopy? - Correct
Answers -Trocar injury of abdominal wall vessels, injury to vessels and organs away
from operative field, tamponade of venous bleeding due to pneumoperitoneum.
, What class of meds are used pre-op for relaxation of patients - Correct Answers -
Benzos. For relaxation and also to give amnesia.
What meds should patient take prior to surgery? - Correct Answers -H2 blocker or non-
particulate antacid sodium citrate to minimize effects of aspiration should it occur. Also
any chronic cardiovascular or pulmonary medications
What components are important for anesthetizing a patient for laparoscopy - Correct
Answers -IV induction + GETA and neuromuscular blockade
Can you use an LMA for laparoscopy? - Correct Answers -controversial
Does the use of nitrous oxide as an insufflating gas cause bowel distension - Correct
Answers -usually not seen (rare) unless patient has a bowel obstruction
Common patient positions in surgery - Correct Answers -Supine, Trendelenburg,
Reverse T-burg, Lithotomy, lateral decubitus
How should you position the arms in a pelvic laparoscopic surgery - Correct Answers -
Arm tucked to the sides. Ensure hands are not near a break in the table to avoid a hand
injury if table is flexed during surgery
How should you position the arms in an upper abdominal surgery - Correct Answers -
Arms abducted to 90 degree angle but not greater than 90 to avoid brachial plexus
stretch injury
What are some key elements to keeping patient safe in a steep reverse Trendelenburg
position - Correct Answers -Foot board to keep patient from sliding, safety belt to keep
patients knees from buckling
Keys to safely positioning a patient in lithotomy position - Correct Answers -Fit the
equipment to the patient, not the patient to the equipment. Allen stirups preferable to
candy cane stirrups given more movements.
In an omentectomy, what level should the knees be placed in the lithotomy position for
optimal positioning? - Correct Answers -For open surgery such as omenectomy it's
important to make sure the knees are level with the torso to keep the instruments from
interfering with the knees
Decubitus position precautions - Correct Answers -avoid stretch in brachial plexus, roll
in the the axilla on the dependent side, with a an arm board for the contralateral arm.
Can use a bean bag but it cannot extend too far anterior or posterior to avoid
interference with port placement and manipulation
