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FLS MODULES 2025 QUESTIONS WITH ALL CORRECT ANSWERS

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FLS MODULES 2025 QUESTIONS WITH ALL CORRECT ANSWERS Desired intraabdominal pressure and how much co2 - Answer-10-15 mmHg 1-3 L Co2 Suggested step if utilizing palmer's point - Answer-NG for gastric decompression Absolute contraindications to blind veress needle insertion points - Answer-...

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  • 16 de enero de 2025
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FLS MODULES 2025 QUESTIONS
WITH ALL CORRECT ANSWERS

Desired intraabdominal pressure and how much co2 - Answer-10-15 mmHg
1-3 L Co2

Suggested step if utilizing palmer's point - Answer-NG for gastric decompression

Absolute contraindications to blind veress needle insertion points - Answer-1. insertion
into abdominal scar from prior open operation
2. through previously placed intraperitoneal mesh for hernia repair

Complications of veress needle insertion (8) - Answer-1. bowel injury
2. mesenteric or omental vascular injury
3. retroperitoneal vascular injury
4. cardiac arrhythmia
5. hypotension
6. high airway pressures
7. pneumothorax
8. gas embolism

Hasson technique - Answer-1. 2 cm skin incision
2. carried down through the skin and subQ
3. expose fascia
4. incise fascia with scalpel or bovie
5. place anchoring sutures in fascia while well exposed
6. dissect through pre-peritoneal fat and identify peritoneum
7. grasp peritoneum , elevate, incise
8. blunt tip trochar is inserted under direct visualization and secured to the fascia with
the stay sutures

Things to monitor with co2 pneumoperitoneum (6) - Answer-1. cardiac rhythm
2. pulse ox
3. end tidal co2
4. heart rate
5. BP
6. urine output

CO2 chemical effects - Answer-1. increases arterial co2 concentration--> drop in serum
pH

, 2. increases end tidal co2 (greatest change In the first 20 minutes)

pulmonary physiology with co2 pneumo - Answer-1. increased minute ventilation to
eliminate absorbed CO2
2. reduced functional residual capacity (because of increased intra-abominal pressure)
3. increased peak airway pressure
4. reduced pulmonary compliance

overview of cardiovascular effects of co2 pneumo - Answer-1. systemic vascular
changes
2. cerebral auto regulation of blood flow
3. vagal responsiveness to reverse trendenenberg
4. increased venous stasis because of pressure in peritoneum (need for use of VTE
ppx)

Alternative gases: NO - Answer-benefits: less acid-base disturbance, increased patient
tolerability in patients with severe cardio pulmonary disease, less post op pain

risks: fire hazard with electrocautery, cannot be used with suspected bowel perf

alternative gases: Argon and Helium - Answer-eliminate the complication of acidosis,
but are much less soluble in blood. Decreased solubility increases the risk of extra-
peritoneal gas extravasation (gas embolus)

cardiovascular effects of pneumo - Answer-1. increased preload
2. increased afterload
3. decreased CO

decrease in CO - Answer-Exacerbated by reverse trendelenburg and hypovolemia. may
be caused by vagally induced bradycardia

what to do if decreased CO intraop (5) - Answer-1. desufflate immediatey
2. check insufflator setting and fuctions
3. check for adequate relaxation
4. check intravascular volume status
5. check for other causes of hypotension

cardiac arrhythmia due to pneumoperitoneum (3) - Answer-1. sinus tach (most
common, self limited)
2. PVCs
3. bradycardia (due to pressure effect, vagally mediated)

Renal effects of pneumoperitoneum - Answer-1. increased intrabdominal pressure
decreases renal blood flow--> intra-op oliguria is common
2. renin and ADH release results in Na and free water resorption
3. post-op oliguria should resolve within a few hours

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