CST Surgical Procedures & Techniques 3 — Questions and Answers
Question 1: During a carotid endarterectomy, the surgical technologist should have which shunt available to maintain cerebral perfusion while the carotid artery is clamped?
- Javid shunt
- Fogarty catheter
- Pruitt-Inahara shunt (Correct answer)
- Argyle shunt
Correct answer: Pruitt-Inahara shunt
The Pruitt-Inahara shunt has balloon tips that secure within both the common and internal carotid arteries, providing continuous blood flow during endarterectomy.
Question 2: In a Whipple procedure (pancreaticoduodenectomy), which anastomosis is performed last?
- Hepaticojejunostomy
- Pancreaticojejunostomy
- Gastrojejunostomy (Correct answer)
- Choledochojejunostomy
Correct answer: Gastrojejunostomy
The gastrojejunostomy (reconnection of the stomach to the jejunum) is the final anastomosis performed in the Whipple procedure reconstruction phase.
Question 3: When setting up for a radical mastectomy, the scrub technologist should prepare for sentinel lymph node biopsy by having which substance available for injection?
- Isosulfan blue dye (Correct answer)
- Methylene blue
- Indocyanine green
- Technetium-99m sulfur colloid
Correct answer: Isosulfan blue dye
Isosulfan blue (Lymphazurin) is injected peritumorally to visually identify the sentinel lymph node by staining lymphatic channels blue.
Question 4: During spinal fusion surgery, which positioning device is most commonly used to reduce intra-abdominal pressure and minimize surgical bleeding?
- Wilson frame (Correct answer)
- Jackson table
- Andrews frame
- Mayfield headrest
Correct answer: Wilson frame
The Wilson frame allows the abdomen to hang freely, reducing intra-abdominal pressure that would otherwise impede venous return and increase epidural bleeding.
Question 5: A surgeon requests 'Weitlaner' during a deep tissue dissection. What type of instrument should the scrub tech pass?
- Self-retaining retractor (Correct answer)
- Tissue forceps
- Needle holder
- Suction device
Correct answer: Self-retaining retractor
The Weitlaner is a self-retaining retractor with sharp or blunt prongs that lock open to hold tissue apart without an assistant holding it.
Question 6: During a Nissen fundoplication, the scrub tech should anticipate bougie esophageal dilator sizes typically ranging from:
- 52–60 French (Correct answer)
- 16–24 French
- 28–36 French
- 40–48 French
Correct answer: 52–60 French
A 52–60 French bougie is passed transorally into the esophagus to calibrate the wrap tightness and prevent postoperative dysphagia.
Question 7: When performing a femoral-popliteal bypass, the graft of first choice when autologous vein is unavailable is:
- PTFE (polytetrafluoroethylene) graft (Correct answer)
- Dacron graft
- Umbilical vein graft
- Bovine carotid artery graft
Correct answer: PTFE (polytetrafluoroethylene) graft
PTFE grafts are the preferred synthetic conduit for infrainguinal bypass when autologous saphenous vein is unavailable due to their acceptable patency rates.
CST Surgical Procedures & Techniques 3
During a carotid endarterectomy, the surgical technologist should have which shunt available to maintain cerebral perfusion while the carotid artery is clamped?