Deck 20: Genitourinary Surgery

Question 1

Simple nephrectomy is routinely performed in which position?

A) lateral
B) low-lithotomy
C) prone
D) supine

Answer 1

A

Question 2

What does the adrenal medulla secrete?

A) catecholamines
B) testosterone
C) insulin
D) urine

Answer 2

A

Question 3

Which structure is ligated and transsected first in a radical nephrectomy or laparoscopic simple nephrectomy, following isolation of the vessels and ureter?

A) renal artery
B) renal vein
C) proximal ureter
D) Gerota's fascia

Answer 3

A

Question 4

Which part of the kidney becomes the proximal ureter?

A) Bowman's capsule
B) cortex
C) medulla
D) renal pelvis

Question 5

Where is the hilum of the kidney located?

A) superior pole
B) inferior pole
C) lateral midsection
D) medial midsection

Question 6

Which incisional approach is used for access to the lower ureter and may be used for donor kidney implantation?

A) flank
B) Gibson
C) inguinal
D) scrotal

Question 7

At approximately what age or period would a patient MOST likely be diagnosed with a Wilms' tumor?

A) second trimester of gestation
B) between ages 3 and 8 years
C) onset of puberty
D) over age 60

Question 8

What measure is taken to reduce the metabolic needs and prevents tubular necrosis of a kidney removed for transplant?

A) cooling with Collins solution or ice slush
B) spraying with reconstituted topical thrombin
C) warming with sterile isotonic saline solution
D) infusion with warmed lactated Ringer's solution

Question 9

What is the name of the basic structure composed of renal corpuscles and tubules and numbers over a million?

A) adrenal
B) hilum
C) nephron
D) psoas

Question 10

Adenocarcinoma has a direct correlation to each of the following EXCEPT:

A) genetic predisposition
B) end-stage renal disease
C) liver cirrhosis
D) tobacco use

Question 11

In which surgical approach would the latissimus dorsi, internal and external oblique muscles be transected for access to the operative site?

A) inguinal oblique
B) suprapubic
C) subcostal flank
D) transverse abdominal

Question 12

Which of the following comparisons of normal or typical kidney anatomy is CORRECT?

A) The left kidney is smaller and slightly lower than the right.
B) The right kidney is larger and slightly lower than the left.
C) The left kidney is larger and slightly higher than the right.
D) The right kidney is smaller and slightly higher than the left.

Question 13

How many suture ligatures or free ties should the surgical technologist have prepared for ligation of the renal artery and vein prior to transsection and removal?

A) one
B) three
C) five
D) seven

Question 14

Suprarenal glands are more commonly known as:

A) adrenal
B) parotid
C) prostate
D) thymus

Question 15

Cryptorchidism is more commonly known as:

A) kidney stones
B) nocturnal bedwetting
C) undescended testicles
D) urinary tract infection

Question 16

Radical nephrectomy is usually performed with the patient in which position?

A) lateral
B) low-lithotomy
C) prone
D) supine

Question 17

Which of the following structures encloses the kidneys and suprarenal glands?

A) Gerota's fascia
B) tunica vaginalis
C) peritoneal sac
D) costal periosteum

Question 18

Which component of the rigid endoscopic system for cystoscopy is blunt ended and minimizes mucosal trauma during insertion?

A) deflecting mechanism
B) obturator
C) sheath
D) telescoping bridge

Question 19

Which of the following studies is a radiologic procedure in which contrast media is injected through a cystoscope?

A) KUB
B) PSA
C) IV urogram
D) retrograde urogram

Question 20

Flank, Gibson, inguinal, and scrotal are examples of:

A) drape sheets
B) operative approaches
C) post-op dressings
D) wound drains

Question 21

Which of the following is given IV after the donor kidney is removed to reverse the heparinization?

A) thrombin
B) furosemide
C) protamine sulfate
D) Ringer's lactate

Question 22

Just before the surgeon clamps the renal vessels of the donor's kidney, what does the anesthesia provider put in the IV?

A) heparin and mannitol
B) protamine sulfate
C) Ringer's lactate
D) furosemide

Question 23

Which of the following is used to ensure patency of the ureters or allow for drainage of urine from the kidneys?

A) Foley catheter
B) suprapubic catheter
C) Jackson-Pratt drain
D) double-J or pigtail stent

Question 24

What anatomical structure is the bladder attached to in males?

A) rectum
B) prostate
C) scrotum
D) symphysis pubis

Question 25

What is the medical term for the procedure of connecting a donor ureter to a recipient bladder?

A) ureteroscopy
B) reimplantation
C) suprapubic cystostomy
D) ureteroneocystostomy

Question 26

Where in the genitourinary system do calculi originate?

A) kidney
B) bladder
C) prostate
D) testicles

Question 27

Which of the following is responsible for emptying of the bladder and closure of the bladder orifice?

A) detrusor muscle
B) external sphincter
C) urogenital diaphragm
D) vesical trigone

Question 28

When is a patient classified as being in end-stage renal failure?

A) when both kidneys are functioning at or below 25% of normal
B) when both kidneys are functioning at or below 10% of normal
C) when one kidney is normal and the other is functioning at or below 25% of normal
D) when one kidney is normal and the other if functioning at or below 10% of normal

Question 29

In what position is the patient placed for proximal pyelolithotomy?

A) lateral
B) lithotomy
C) prone
D) Trendelenburg

Question 30

What device is used through the ureteroscope to capture an intact calculus or fragments if fractured by laser?

A) Babcock forceps
B) basket stone forceps
C) entrapment sack
D) vessel loops

Question 31

What procedure is performed to remove a calculus lodged in the area of the hilum?

A) cystoscopy
B) orchiectomy
C) pyelolithotomy
D) urethrotomy

Question 32

Dialysis and kidney transplant are the only two treatments for which of the following?

A) end-stage renal disease
B) testicular carcinoma
C) type I diabetes mellitus
D) Wilms' tumor

Question 33

Which suture configuration is used to anastomose vessels in transplants?

A) fine, absorbable, single-armed
B) fine, nonabsorbable, double-armed
C) heavy, absorbable, single-armed
D) heavy, nonabsorbable, double-armed

Question 34

What might the donor kidney be placed into to reduce possibility of injury during handling and transplantation?

A) laparoscopic entrapment sack
B) Lahey intestinal bag
C) plastic incise drape
D) woven stockinette

Question 35

Into which anatomical area of the abdomen will a transplated donor kidney be implanted?

A) left lower quadrant
B) left upper quadrant
C) right lower quadrant
D) right upper quadrant

Question 36

Cystoscopy and ureteroscopy procedures are performed in which position?

A) lateral
B) low-lithotomy
C) supine
D) Trendelenburg

Question 37

Which cutting instruments should the surgical technologist have ready for anastomosis of the renal vessels into the recipient?

A) #15 blade and Knight scissors
B) #10 blade and curved Mayo scissors
C) #11 blade and 45° angle Potts scissors
D) #12 blade and straight tenotomy scissors

Question 38

Which of the following items would likely be needed if the pleural cavity is unintentionally entered during nephrectomy?

A) chest tube with drainage system
B) flexible bronchoscope
C) 1-inch Penrose drain
D) fibrin glue

Question 39

Which of the following is NOT a form of polycystic kidney disease?

A) autosomal dominant
B) autosomal recessive
C) acquired
D) traumatic

Question 40

What is the morcellator used for in a laparoscopic simple nephrectomy?

A) excising Gerota's fascia from around the kidney
B) cutting between the ligaclips placed on the renal vessels
C) insufflating the peritoneal cavity after initial port placement
D) chopping the kidney and ureter into small pieces for suctioning

Question 41

Which distention fluid is nonelectrolytic and will lyse malignant tumor cells because of cellular uptake?

A) glycine
B) saline
C) sorbitol
D) water

Question 42

What is done with the edge of the ilium that is brought out through the abdominal wall for stoma creation?

A) The edges are everted and affixed to the skin.
B) A purse-string suture is placed to cinch it shut.
C) It is cut into four sections and tacked to the skin.
D) A Penrose drain is inserted and pulled over the edge.

Question 43

What is a unique feature of the OR table in a cystoscopy suite?

A) It is radiolucent.
B) Stirrups can be attached to rails.
C) It has a mesh drain attachment.
D) It can be adjusted for fluoroscopic exams.

Question 44

Which of the following is a glass or plastic evacuator used to remove tissue and debris during TURP?

A) Ellik
B) Malecot
C) Pezzer
D) Toomey

Question 45

An elevated serum PSA exam might prompt the additional investigation of a(n):

A) intravenous urogram
B) prostate biopsy
C) PAP smear
D) urinalysis

Question 46

What is the name of a continent urinary reservoir that may be performed following cystectomy?

A) hydrocele
B) ileal conduit
C) Koch pouch
D) orchiopexy

Question 47

Vesicourethral suspension and pubovaginal slings are performed to mainly treat moderate to severe:

A) vaginal dryness
B) uterine prolapse
C) stress incontinence
D) urinary tract infections

Question 48

Which instrument is used in TURP or TURBT and includes the sheath, obturator, working element, and ESU loops?

A) cystoscope
B) nephroscope
C) resectoscope
D) ureteroscope

Question 49

What is one of the main objectives of procedures for female stress incontinence?

A) increase overall bladder capacity
B) reduce bladder spasms and irritability
C) restore the posterior urethrovesical angle
D) tighten and enhance bladder sphincter tone

Question 50

What type of light is used for illumination in endoscopic equipment?

A) fiber-optic
B) fluorescent
C) incandescent
D) ultraviolet

Question 51

Which of the following procedures could be done in either a male or female patient?

A) hydrocelectomy
B) orchiectomy
C) TURBT
D) TURP

Question 52

What is the name of the connective tissue that forms the umbilical ligament and is used for traction in radical cystectomy?

A) urachus
B) symphysis
C) vas deferens
D) diastasis recti

Question 53

In radical cystectomy with ileal conduit on a male patient, what tissue will be sent for frozen section to verify clear margins?

A) sections of both testicles
B) segments of bilateral ureters
C) lateral edges of the tunica vaginalis
D) distal segments of the seminal vesicles

Question 54

How is the anesthetic jelly that is inserted into the male urethra prior to cystoscopy kept from leaking out?

A) A cotton-tipped applicator is inserted into the external meatus.
B) A sterile tight-fitting condom is applied to the penis.
C) A flexible penile clamp is applied to the head of the penis.
D) A gloved finger is held firmly against the head of the penis.

Question 55

The vesical arteries that supply the bladder arise from the:

A) ascending aorta
B) external iliac artery
C) internal iliac artery
D) renal arteries

Question 56

Omnipaque, Renografin, and Isovue are used in cystoscopy as:

A) antibiotics
B) contrast media
C) distention fluids
D) topical analgesics

Question 57

What is the more common name for ureteroileocutaneous diversion?

A) colostomy
B) ileal conduit
C) bladder prolapse
D) pubovaginal sling

Question 58

Marshall-Marchetti-Krantz (MMK) is a traditional version of which general type of procedure?

A) inguinal hernia repair
B) repair of cystocele and rectocele
C) shock wave destruction of calculi
D) suprapubic vesicourethral suspension

Question 59

What is the medical term for excision of the urinary bladder?

A) colporrhaphy
B) corpectomy
C) cystectomy
D) cystostomy

Question 60

Which irrigation or distention fluid would be contraindicated during cystoscopy for fulguration of bladder tumor?

A) glycine
B) saline
C) sorbitol
D) water

Question 61

Which self-retaining retractor is used for open suprapubic prostatectomy?

A) Gelpi
B) Judd-Mason
C) Adson-Beckman
D) O'Sullivan-O'Connor

Question 62

What does specialized tissue within the seminiferous tubules produce?

A) mucus
B) sperm
C) testosterone
D) urine

Question 63

What is the medical term for the free fold of skin that covers the glans penis?

A) epididymis
B) prepuce
C) scrotum
D) tunica

Question 64

Which of the following is the term for the inability to retract the foreskin of the penis?

A) balanitis
B) hypospadias
C) phimosis
D) sclerosis

Question 65

What is the MOST serious post-op complication of penile implant surgery?

A) edema
B) impotence
C) premature ejaculation
D) surgical site infection

Question 66

What is the term for an abnormal accumulation of serous fluid around the testis contained within the tunica vaginalis?

A) cystocele
B) hydrocele
C) omphalocele
D) rectocele

Question 67

Which of the following is NOT a type of pubovaginal or suburethral sling?

A) allograft fascia lata
B) autograft fascia lata
C) polypropylene mesh tape
D) radiopaque vaginal packing

Question 68

Baumrucker, Iglesias, Stern-McCarthy, and Nesbit are types of:

A) catheters
B) resectoscopes
C) evacuators
D) incisions

Question 69

Which type of catheter is placed postoperatively following TURP?

A) 2-way 16 Fr. Foley with 5 mL balloon
B) 2-way 22 Fr. Foley with 30 mL balloon
C) 3-way 16 Fr. Foley with 5 mL balloon
D) 3-way 22 Fr. Foley with 30 mL balloon

Question 70

What is the common diagnosis of a patient undergoing transurethral resection of the prostate?

A) benign prostatic hypertrophy
B) carcinoma of the prostate
C) erectile dysfunction
D) stress incontinence

Question 71

What is used to resect the prostate gland tissue through the resectoscope?

A) endoshears
B) wire loop snare
C) ESU loop electrode
D) #11 blade on #7 handle

Question 72

Which signal should alert the surgical team that prostate capsule perforation is imminent and may conclude the procedure?

A) coughing
B) flatulence
C) groaning
D) leg jerking

Question 73

Bonanno, Malecot, and Pezzer are types of :

A) suprapubic catheters
B) urethral catheters
C) active wound drains
D) passive wound drains

Question 74

Diabetes, vascular disorder, nerve damage, and trauma are all possible causes of:

A) epispadias
B) hypospadias
C) impotence
D) prostate cancer

Question 75

Which procedure is performed for testicular cancer, trauma, or necrosis secondary to torsion?

A) circumcision
B) hydrocelectomy
C) orchiectomy
D) penectomy

Question 76

Approximately how many lobules comprise the average prostate gland?

A) 2
B) 4
C) 20
D) 50

Question 77

Which dilating instrument is used to dilate the corpora for placement of penile prosthesis?

A) Bougie
B) Hegar
C) Van Buren
D) Walther

Question 78

What structure of male anatomy is divided into three sections: prostatic, membranous, and spongy?

A) ejaculatory duct
B) spermatic cord
C) urethra
D) ureter

Question 79

What procedure is performed for penile carcinoma resistant to chemotherapy or radiation?

A) hydrocelectomy
B) orchiectomy
C) penectomy
D) vasectomy

Question 80

Which of the following are male urethral dilators or sounds?

A) Hanks
B) Pratt
C) Van Buren
D) Walther