FLS EXAM QUESTIONS AND ANSWERS
ALL CORRECT
If the laparoscopic view of the operative field is reduced in size, thus compromising proper exposure of the operative field, which of the following should be immediately checked? - Answer-check the insufflator control panel to determine the cause of the loss of working space in the operative field
All of the following are pre-operative checks except? - Answer-check for adequate muscle relaxation. Correct answers include checking that a spare CO2 tank is in the OR, availability of ancillary equipment, and all power sources are connected and appropriate units are switched on
During monopolar electrosurgery, the method of heating tissue quickly, converting all water to steam and causing the cell to explode is descriptive of which of the following: - Answer-cutting mode
Click on the point that is in danger of thermal burn if a monopolar electrode is applied to the end of the appendiceal stump? - Answer-the diameter at the ligature is half that at the stump, so the current density will be 16X greater
The use of all plastic or all metal trocars can avoid which problem during electrosurgery? - Answer-capacitative coupling is a result of using a metal tracer with a plastic screw anchor, which prevents the tracer from draining its charge (instrument can store the charge and then transmit to tissue next time it touches something)
When using the ultrasonic shears, the entire portion of the active blade is exposed. In order to avoid inadvertent delivery of energy to tissue in contact with the bottom portion of the active blade, one should do the following: - Answer-be aware of the contact points the blade is engaging, grab the target tissue and elevate it, and keep the active blade upwards in view of the surgeon
ASA class 3 - Answer-severe systemic disease that limits the patient's activity and may or may not be related to the reason for surgery
initial consultation should include which of the following? - Answer-possibility of conversion to open surgery
which of the following is a relative contraindication to laparoscopic surgery? - Answer- previous abdominal surgery 1 / 2
which of these is NOT an absolute contraindication to laparoscopic surgery? - Answer- bowel obstruction (contraindications include uncorrectable hypovolemic shock, lack of proper surgical training, and inability to tolerate laparotomy)
which procedure may be performed using local anesthesia alone or with mild sedation?
- Answer-diagnostic laparoscopy
important features in patient positioning for laparoscopic surgery include: - Answer- avoidance of position related complications, prevention of DVT, and location of target organ
the most commonly used anesthetic for laparoscopic procedures is general anesthesia.all of the following are true EXCEPT - Answer-there are fewer hemodynamic changes compared to a local anesthetic (true answers are it allows for complete neuromuscular relaxation, it provides good control of ventilation, an tit allows for more flexibility of patient positioning)
what is the most common site for initial trocar insertion? - Answer-umbilicus
When checking placement of Veress needle, which of the following is the most accurate method to detect proper intraperitoneal placement? - Answer-insufflator display revealing flow of CO2 and low initial pressure
smaller tissue area, greater current density and faster heating - Answer-e.g. Bovie tip
Cut mode - Answer-- Low voltage
- High frequency
- Continuous waveform
- Heats tissue quickly; cell water converts to steam and causes cell to explode
Coagulation mode - Answer-- High voltage
- Low frequency
- Intermittent waveform
- Rapid tissue heating, shallow depth of necrosis
- Non-contact: relies on sparking to tissue
Capacitive coupling - Answer-Transfer current from active electrode through insulation to passive electrode- electrode to plastic part another LSC instrument
- if constant contact w/ tissue will not store energy and no injury
Direct coupling - Answer-monopolar instrument in direct contact w/ metal portion of another instrument
Besides capacitative coupling and direct coupling, other hazards of electrocautery - Answer-- Current diversion
- / 2