Gastrointestinal Surgeries - QUESTIONS

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Question 1 of 15

1. Question
1) Which of the following instruments is NOT a ‘must have’ in order to properly perform a GI surgery:
- a. Retractors for the abdomen
- b. Doyens
- c. Suction machine
- d. Criles
- e. Laparotomy sponges
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Question 2 of 15

2. Question
2) Proper placement of the Doyen forceps is important to help minimize damage to the bowel and yet still prevent leakage of bowel contents. Choose the CORRECT statement:
- a. Doyens should not be used if an assistant is available.
- b. The loop of bowel should be placed at the tip of the doyen.
- c. The loop of bowel should be placed in the centre of the Doyen where there is an obvious gapping.
- d. Doyens should never be used on bowel as they are a crushing instruments.
- e. The loop of bowel can placed either in the centre or at the tip. There is no difference to the amount of pressure placed on the tissues in either location.
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Question 3 of 15

3. Question
3) You have identified on the ultrasound that your patient has a foreign body in a loop of jejunum. Which statement is FALSE:
- a. There is no need to do an exploration of the abdomen since the diagnosis has been already made.
- b. The enterotomy can be performed by bringing the loop of jejunum “out of the abdomen” to minimize contamination.
- c. The enterotomy site should be leaked tested after it has been sutured.
- d. Gloves and instruments should be changed before lavaging the abdomen.
- e. Minimizing tissue trauma will help with the patient’s recovery.
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Question 4 of 15

4. Question
4) When doing a gastrotomy, contamination can be prevented/minimized by applying a number of methods. Which of the following statements is INCORRECT:
- a. The abdomen should be packed off using moistened laparotomy sponges.
- b. A larger pair of gloves can be placed of your surgical gloves before entering the stomach.
- c. The gastrotomy area of the stomach can be elevated with stay sutures to help prevent spillage.
- d. Gloves should be changed after removal of the foreign body.
- e. The gastrotomy can be performed with the stomach “out of the abdomen”.
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Question 5 of 15

5. Question
5) When performing an enterotomy to remove a foreign body; which of the following statements is INCORRECT:
- a. The enterotomy incision should be aborad to the foreign body if possible.
- b. The enterotomy incision should be orad to the foreign body if necessary.
- c. The enterotomy incision can be made over to the foreign body if necessary.
- d. The enterotomy incision should be made on the mesenteric border.
- e. The enterotomy site can be closed with a 3-0 or 4-0 monofilament.
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Question 6 of 15

6. Question
6) When assessing the bowel for viability, the following criteria are true (select the FALSE statement):
- a. Bowel that is purple in colour is likely viable.
- b. Bowel that demonstrates spontaneous peristalsis is viable.
- c. Bowel that is blue in colour is of questionable viability.
- d. Bowel that demonstrates peristalsis only when pinched is not viable and should be removed.
- e. Bowel that is black/grey in colour is not viable and should be removed.
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Question 7 of 15

7. Question
7) Patient and tissue trauma can be avoided/minimized by applying numerous methods. Select the INCORRECT statement:
- a. Thumb forceps should be used with caution and preferably NOT to grab the bowel with.
- b. Incisions in the bowel should be closed by apposing the tissues and not strangulating them.
- c. Sutures should be placed as close as possible in the bowel; more is better.
- d. The patient’s temperature should be monitored and warming devices should be used.
- e. The surgeon should be mentally prepared and have reviewed the relevant possible surgical techniques before entering the OR.
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Question 8 of 15

8. Question
8) Certain GI case scenarios tend to be more difficult and therefore carry a more guarded prognosis Select the INCORRECT statement:
- a. Duodenal foreign bodies are just as easy to remove as jejunal ones.
- b. A chronic foreign body case is more likely to require a resection anastomosis.
- c. String foreign bodies can be more complicated, especially if they are not peracute.
- d. A patient with a ruptured bowel will require very intense post-operative care and is better served in a hospital with an ICU.
- e. Duodenal tumours can be difficult to excise.
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Question 9 of 15

9. Question
9) Certain GI foreign bodies can managed by. monitoring with a “wait and see” approach. Select the INCORRECT statement:
- a. An acute string foreign body case, where the string could be seen and cut from the base of the tongue.
- b. A cat or puppy whose owners saw it swallow a sewing needle.
- c. A dog with a raw bone in his stomach.
- d. A patient with a foreign body on radiographs in the colon.
- e. A patient with a foreign body on radiographs and an obstructive gas pattern.
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Question 10 of 15

10. Question
10) Which of the following statements is CORRECT regarding the resection and anastomosis (RnA) procedure:
- a. If the bowel is a bluish colour before you remove the foreign body, you should skip the enterotomy and simply do a RnA.
- b. It is helpful to place a suture at the mesenteric and then anti-mesenteric borders first to properly align the bowel then suture the remainder of the circumference.
- c. When suturing the RnA bowel; the knots should be located within the bowel lumen so as not to irritate other abdominal organs.
- d. Doyens are placed on the section of the bowel that is to be excised.
- e. It is best to avoid suturing the mesenteric rent that results from the RnA because one might accidentally catch another mesenteric vessel when suturing.
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Question 11 of 15

11. Question
11) Which of the following gastrointestinal surgeries is the simplest procedure to perform that all veterinarians can perform if called upon to do so.
- a. Resection and anastomosis
- b. Gastrotomy
- c. Biopsy/enterotomy
- d. Bilroth I
- e. Bilroth II
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Question 12 of 15

12. Question
12) Which of the following statements is FALSE regarding closing an enterotomy site:
- a. The suture bites should positioned not too close to the incision edge.
- b. It is easiest to start in the middle of the enterotomy site.
- c. It is best to use a monofilament absorbable suture material.
- d. The suture should pulled tightly to strangulate the tissues.
- e. A simple interrupted suture pattern is a very good choice.
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Question 13 of 15

13. Question
13) Which of the following statements is FALSE regarding closing a gastrotomy incision:
- a. The gastrotomy incision can be closed with a continuous suture pattern.
- b. The Cushing pattern works well to invert the incision.
- c. The Conell pattern works well to invert the incision.
- d. The Lembert pattern works well to invert the incision.
- e. A monofilament absorbable suture material works best for a gastrotomy.
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Question 14 of 15

14. Question
14) Which of the following statements is INCORRECT:
- a. Saline should be warmed to core body temperature for lavaging.
- b. Sponges that have a radio-opaque marker are best for abdominal procedures.
- c. Only saline from a bottle can be used to lavage the abdomen; it is best to avoid the bags.
- d. The bowel should be positioned in the tip of the doyen.
- e. Suction tips such as the Poole or Yankhaur are best for abdominal lavaging.
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Question 15 of 15

15. Question
15) Which of the following statements is INCORRECT GI assessments:
- a. Your clinical acumen is your best tool when deciding if a patient require GI surgery or not.
- b. Survey radiographs can be helpful in determining if there is an obstruction.
- c. Contrast radiographs can be considered if one is unsure whether there is an obstruction or not.
- d. Ultra sound is an excellent tool for diagnosing GI obstructions.
- e. If foreign body is visible within the GI tract on survey radiographs then one can be sure that the patient has a GI obstruction.
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Gastrointestinal Surgeries – QUESTIONS

Gastrointestinal Surgeries – QUESTIONS

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