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Minimally Invasive Surgery Fundamentals

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All of the following are contraindications to the use of pneumoperitoneum during laparoscopy EXCEPT:

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a. Acute glaucoma

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b. Peritoneal shunt

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c. Second-trimester pregnancy

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d. Increased intracranial pressure

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Which of the following parameters is NOT increased during laparoscopy?

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a. Blood pressure

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b. Intraabdominal pressure

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c. Glomerular filtration rate

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d. Systemic vascular resistance

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What is a consequence of hypercarbia?

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a. Acidemia

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b. Arrhythmia

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c. Tachycardia

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d. All of the above

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Which of the following favors better oxygenation during laparoscopy?

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a. Thin patient

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b. Upward displacement of the diaphragm

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c. Diminished functional residual capacity

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d. Stiffening of the diaphragm and chest wall during insufflation

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A woman with a history of coronary artery disease presents with an adnexal mass. After thorough review, she is determined to be an appropriate candidate for a laparoscopic procedure. What measures can you take to minimize the risk of cardiovascular morbidity?

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a. Lay the patient on a gel pad

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b. Use steeper Trendelenburg

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c. Increase the intraabdominal pressure

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d. Decrease the intraabdominal pressure and flatten the degree of Trendelenburg

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To effectively compensate for difficulties encountered during laparoscopy in an obese patient, a surgeon may use all of the following EXCEPT:

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a. Steeper Trendelenburg position to improve patient ventilation

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b. Veress needle insertion at an angle that is nearly perpendicular to the skin

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c. Placement of additional ancillary ports to assist in lifting a fattier omentum from the operating field

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