Core Surgical Skills and Postoperative Care Extra Questions Batch A – MCQ
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1. Regarding the use of adhesion prevention agents, which of the following is true?CorrectIncorrect
2. Select the single most appropriate statement with reference to abdominal incisions and preoperative preparations in a gynaecological surgery:CorrectIncorrect
3. A 45-year-old woman undergoes an abdominal hysterectomy for a large fibroid uterus. She is found to have a fibroid in broad ligament, and there is a concern that her ureter may have been damaged during the difficult surgery. Which of the following is the least possible site of ureteric injury in this surgery?CorrectIncorrect
4. Regarding nonabsorbable suture materials, which of the following statements is correct?CorrectIncorrect
5.A patient who underwent an abdominal hysterectomy a few days ago complains of numbness over the skin over the anterior aspect of the upper thigh. This could be attributed to neuropathy of the:CorrectIncorrect
6. Staples are used for wound closure. Which of the following statements about the use of staples in a gynaecological surgery is incorrect?CorrectIncorrect
7. Following massive blood transfusion, what is the recommended dose of fresh frozen plasma to be administered to prevent coagulation problems?CorrectIncorrect
8. Axonotmesis is best described as an iatrogenic nerve injury which involves:CorrectIncorrect
9. Which of the following statements regarding laparoscopic entry in cases of previous abdominal surgery is false?CorrectIncorrect
10. Which of the following is an example of a self-retaining retractor?CorrectIncorrect
11. Ms. XY is a Para 1 who has had an emergency caesarean section for failure to progress. Her epidural catheter was removed at 8:00 AM today, 6 h after her CS. She is written up to have prophylactic LMWH daily, commencing today for 10 days. Her postnatal check is satisfactory. Which of the following times is most appropriate for her to have the LMWH?CorrectIncorrect
12. Ms. XY, 48 years old, para 3, is due to undergo a NovaSure endometrial ablation in theatre for heavy menstrual bleeding. A WHO surgical safety checklist is in progress. Which of the following is not a component to the sign out?CorrectIncorrect
13. A surgical position which involves the patient in supine position of the body with hips flexed at 15° as the basic angle and with a 30° head-down tilt is known as:CorrectIncorrect
14. Ms. XY is 35 years old. She is a para 3 with 2 previous caesarean sections and desires permanent contraception. She has opted to have a laparoscopic tubal occlusion/ sterilisation procedure. Her BMI is 33. She has had a successful Veress needle insufflation (first pass). What level of pressure must be obtained before passing the trocar?CorrectIncorrect
15. Intraoperative cell salvage is a strategy to reduce the use of banked blood. If IOCS is done for nonsensitised rhesus negative women at the term of a term caesarean section, which of the following statements is true regarding the minimum dose of anti-D to be administered?CorrectIncorrect
16. All of the following are true about surgical needles except:CorrectIncorrect
17. Which of the following is correct regarding synthetic tissue adhesives?CorrectIncorrect
18. A downward and inward muscle-splitting incision from the McBurney point that allows extraperitoneal drainage of abscesses is called:CorrectIncorrect
19. The ilioinguinal and iliohypogastric nerves can be injured during a gynaecological surgery. Which of the following describes these nerves the best?CorrectIncorrect
20. Which of the following is not a known risk factor for nerve injury during a gynaecological surgery?CorrectIncorrect
21. The inferior epigastric artery originates from:CorrectIncorrect
22. A 34-year-old woman had a caesarean section after 24 h of labour due to secondary arrest of cervical dilatation and maternal exhaustion. Two hours post-LSCS, she complained of acute-onset left-sided chest pain radiating to the left shoulder and arm along with breathlessness. She had no previous known medical conditions or family history of cardiac disease. Which of the following statements is true regard- ing investigations planned to rule out acute myocardial infarction?CorrectIncorrect
23. While operating on a patient in lithotomy position, the padding between the lateral fibular heads and the stirrup prevents injury to:CorrectIncorrect
24. Ms. XY is in theatre for repair of a 3C tear. She has been given spinal anaesthetic and antibiotics. Which suturing technique is most suited for the torn IAS (internal anal sphincter)?CorrectIncorrect
25. Ms. XY is in theatre for repair of a 3C tear. She has been given spinal anaesthetic and antibiotics. What structures are torn in a 3C tear?CorrectIncorrect
26. A medical student asks you how to measure blood pressure. What maximum pressure should you inflate the cuff to measure systolic blood pressure in pregnancy?CorrectIncorrect
27. A healthy 39-year-old woman with no significant past medical history attends a preoperative assessment clinic. She is due to undergo a total abdominal hysterectomy for heavy menstrual bleeding following a local anaesthetic endometrial ablation that was unsuccessful. She is fit and well. What preoperative investigation is required?CorrectIncorrect
28. On deciding where to place your secondary lateral ports at laparoscopy, care should be taken to avoid the inferior epigastric vessels. Where can these be found?CorrectIncorrect
29. Your hospital has recently had an increase in postoperative infections. As a result, you are formulating a new guideline that includes information on skin preparation and hair removal prior to surgery. What is the most appropriate method of hair removal prior to surgery?CorrectIncorrect
30. Following delivery, a woman is found to have a third degree tear and a trainee wishes to do the repair under supervision.CorrectIncorrect
31. A 45-year-old woman is undergoing an abdominal hysterectomy for a history of heavy menstrual bleeding that has not responded to medical treatment. The patient has a past history of pelvic pain and the operation notes from a previous laparoscopy comments that the patient had ‘pelvic adhesions’
What is the most appropriate action in terms of protecting the ureter?CorrectIncorrect
32. What is the preferred distension medium for outpatient diagnostic hysteroscopy? GTG 59 Best Practice in Outpatient Hysteroscopy Uterine distension with normal saline allows improved image quality and allows outpatient diagnostic hysteroscopy to be completed more quickly as compared with uterine distension with carbon dioxideCorrectIncorrect
33. At what pressure should the pneumoperitoneum be maintained during the insertion of secondary ports for a laparoscopic procedure?CorrectIncorrect
34. What is the background rate of venous thromboembolism in healthy non-pregnant non-contraceptive using women?CorrectIncorrect
35. What proportion of patients having a surgical procedure will develop a surgical site infection?CorrectIncorrect
36. What is the most common source of microorganisms causing surgical site infection?CorrectIncorrect
37. A 54-year-old patient has had an insertion of a mid-urethral retropubic tape and following the procedure there was a significant fall in the haemoglobin levels from 12.3 g/dl to 7.8 g/dl. Imaging investigations show the presence of retropubic hematoma. A decision is made to evacuate the hematoma. The most appropriate incision would be:CorrectIncorrect
38. Apostoperativepatientwhohadahysterectomyreceivedmorphine in recovery and then again in the gynaecology ward. Her respiratory rate is suppressed; she is drowsy and has pinpoint pupils.
What medication would you give to reverse this potential morphine overdose?CorrectIncorrect
39. A patient who is frail, old and overweight has undergone a midline laparotomy and pelvic clearance for an endometrial cancer.
On postoperative day 4, the nursing staff notice that she has a pressure ulcer with full thickness skin loss, but the bone, tendon and muscle are not exposed.
What type of pressure ulcer grade is this?CorrectIncorrect
40. A woman had an emergency caesarean section for a pathological CTG and pyrexia in labour. She was discharged on postoperative day 4 but re-admitted on day 6 with pyrexia, tachypnoea, tachycardia and hypotension. Haemoglobin is 105 g/l.
Septic shock is the main differential diagnosis.
Following the Sepsis 6 bundle, along with antibiotics and blood cultures, which other important blood test needs to be taken?CorrectIncorrect
41. A patient undergoes a challenging hysterectomy. A drain is left in the pelvis. You are called to review the patient eight hours later as the nurses have noted a high serous drain output and poor urinary output.
What finding would identify if the drain fluid is urine (suggestive of a bladder/ureteric injury) or normal peritoneal fluid?CorrectIncorrect
42. A patient has ventouse delivery Two days later she reports general malaise, fever and feeling unwell. With sepsis, which is the first clinical sign to deteriorate, which can be detected through the use of early warning scores?CorrectIncorrect
43. Oral fluids and food are often delayed following major gynaecological surgery. Which gastrointestinal complication is improved by early postoperative feeding?CorrectIncorrect
44. Following a difficult hysterectomy, a 65-year old woman has returned to the gynaecology ward. She had large amounts of morphine in the recovery area for pain relief and is also connected to a patient-controlled analgesia device.
The nurses note that she is drowsy and her respiratory rate is low. The anaesthetist decides to perform arterial blood gas sampling. What disturbance of acid–base balance is this most likely to show?CorrectIncorrect
45.A 31-year-old para 1 undergoes radical vaginal trachelectomy and laparoscopic bilateral lymph node dissection for early cervical cancer. She presents with paraesthesia over the mons pubis, labia majora and the femoral triangle.
Her symptoms are most likely caused by injury to which of the following?CorrectIncorrect
46. A 57-year-old para 4 undergoes vaginal hysterectomy and sacrospinous ligament xation. She complains of postoperative gluteal pain that worsens in the seated position.
Her symptoms are most likely caused by injury to which of the following?CorrectIncorrect
47. The enhanced recovery approach to preoperative, perioperative and postoperative care has major benefits for many patients in relation to quicker recovery following major surgery. It facilitates shorter hospital stay with no increase in readmission rates. This has clear benefits for patients and their families and for healthcare services.
Which of the following is not a component of the enhanced recovery pathways?CorrectIncorrect
48.A 65-year-old diabetic patient with a BMI of 35 kg/m2 had a AH+BSO for complex endometrial hyperplasia with atypia. What is the best pharmacologic thromboprophylaxis regimen for this patient?CorrectIncorrect
49. Myomectomy for large uterine fibroids can be associated with massive blood loss, blood transfusion and conversion from myomectomy to hysterectomy.
Which of the following is not a recognized intervention to reduce blood loss at the time of open myomectomy?CorrectIncorrect
50. You are asked to prepare a talk for your colleagues on laparoscopic electrosurgical complications. Which of the following is not one of the safety measures to prevent such laparoscopic complications?CorrectIncorrect