SURGERY EOR PRACTICE EXAMINATION
2026 QUESTIONS WITH ANSWERS GRADED
A+
• How is acute pain defined?.
Answer: Sudden onset of discomfort, often associated with surgery, trauma,
or acute medical conditions, typically lasting less than 3 months.
• How is chronic pain defined?.
Answer: Pain lasting longer than 3 to 6 months, persisting beyond normal
tissue healing time, and often resistant to conventional treatments.
• MCC of Cholecystitis.
Answer: E. coli
• What are the main etiological factors of acute pain?.
Answer: Combination of tissue trauma, local/systemic inflammation, and
direct nerve injury.
• What are common risk factors for acute pain?.
Answer: Medical and psychological conditions Concomitant medications
History of chronic pain Substance use disorder Previous postoperative
treatment regimens
• Who is at ↑risk of developing gallstones?.
Answer: 4 F's Fat Female Fertile Forty
• What factors contribute to chronic pain?.
Answer: A combination of biological, psychological, and social factors.
• "Crampy RUQ abdominal pain that is worse after large or fatty meals".
Answer: Cholecystitis
• What are the two main types of chronic pain?.
Answer: Nociceptive pain (tissue damage) and neuropathic pain (nerve
damage).
,• What is Murphy's Sign?.
Answer: Acute RUQ pain and inspiratory arrest when palpating gallbladder
indicative of Cholecystitis
• Imaging for Cholecystitis?.
Answer: US initial HIDA (Cholescintigraphy) gold
• What are the characteristics of nociceptive pain?.
Answer: Involves inflammatory, ischemic, infectious, or
mechanical/compressive injury.
• What are the characteristics of neuropathic pain?.
Answer: Results from central and/or peripheral nerve disorders.
• Tx for Cholecystitis?.
Answer: NPO, IVF, Abx, Analgesia Laparoscopic Cholecystectomy
• Cause of Pancreatitis?.
Answer: Gallstones MCC EtOH 2nd MC
• What are common symptoms of acute pain?.
Answer: Sharp, stabbing, throbbing, burning pain in the affected area.
• Patient presents with a boring epigastric pain that radiates to their back. It
improves when they lean forward..
Answer: Pancreatitis
• "Bluish discoloration around the belly button".
Answer: Cullen's Sign Umbilical Ecchymosis indicative of Pancreatitis
• "Bluish discoloration around the patient's flank".
Answer: Grey Turner Sign Flank Ecchymosis indicative of Pancreatitis
• If a patient presents with abdominal pain and ↑Lipase, MLD?.
Answer: Pancreatitis
• Test of choice for Acute Pancreatitis?.
Answer: Abdominal CT
,• How will Acute Pancreatitis present on Xray? Chronic?.
Answer: Acute = Sentinel Loop Chronic = Calcified Pancreas
• Pancreatitis Tx.
Answer: NPO, NG tube IVF (90% of acute recover) Analgesia For chronic -
address underlying cause (stones or EtOH)
• What are common physical signs of acute pain?.
Answer: Guarding Facial grimacing or frowning Moaning or groaning
Restlessness or agitation Sweating
• Involves the "Anal Verge".
Answer: Anorectal Abscess
• What location/wall is Anal Disease MC?.
Answer: Posterior Midline
• What are common symptoms of chronic pain?.
Answer: Persistent pain with varying intensity, often accompanied by
functional limitations, mood disturbances, and sleep disruption.
• Patient presents with Severe, tearing rectal pain +/- Hematochezia..
Answer: Anal Fissure
• How does somatic pain present?.
Answer: Localized pain that worsens with movement.
• What are common symptoms of neuropathic pain?.
Answer: Tingling Pins and needles sensation Burning Shooting/electric
shock-like pain Allodynia (pain from non-painful stimuli) Hyperalgesia
(increased sensitivity to pain)
• What tool should be used to assess and track pain management
effectiveness?.
Answer: A validated pain assessment tool
• Why is postoperative pain management important?.
Answer: It facilitates recovery, improves mobility, and reduces
complications like atelectasis and deep vein thrombosis (DVT).
, • Tx for Anal Fissure?.
Answer: ↑Fiber and fluids Stool Softeners Sitz If failure of conservative
measures, Lateral Anal Sphincterotomy
• Complication of Lateral Anal Sphincterotomy? (What does it tx?).
Answer: Irreversible fecal incontinence (Anal Fissure
• What other disease process is associated with Anal Disease (abscess/fistula
especially)?.
Answer: Crohn's
• Anorectal abscess/fistula Tx?.
Answer: Abscess without signs of systemic infection = I&D alone Abscess
WITH signs of systemic infection = I&D, Wound Culture, and empiric Abx
• What are nonpharmacologic treatments for acute pain.
Answer: Patient education, compression, elevation, ice/heat as indicated.
• If you believe a patient has Appendicitis, what symptom should make you
reconsider that diagnosis?.
Answer: Appendicitis is closely associated with Anorexia, so if they are
hungry and CAN EAT, it likely is not Appendicitis
• What are first-line pharmacologic treatments for acute pain?.
Answer: Nonopioid analgesics: Acetaminophen, NSAIDs, local anesthetic
wound infiltration, regional anesthesia.
• MC Surgical Emergency.
Answer: Appendicitis
• How is moderate acute pain treated?.
Answer: Gabapentinoids, ketamine, lidocaine infusions, and opioids as
needed.
• How is severe acute pain treated?.
Answer: Gabapentinoids, ketamine, lidocaine infusions, opioids (scheduled
or as needed).
2026 QUESTIONS WITH ANSWERS GRADED
A+
• How is acute pain defined?.
Answer: Sudden onset of discomfort, often associated with surgery, trauma,
or acute medical conditions, typically lasting less than 3 months.
• How is chronic pain defined?.
Answer: Pain lasting longer than 3 to 6 months, persisting beyond normal
tissue healing time, and often resistant to conventional treatments.
• MCC of Cholecystitis.
Answer: E. coli
• What are the main etiological factors of acute pain?.
Answer: Combination of tissue trauma, local/systemic inflammation, and
direct nerve injury.
• What are common risk factors for acute pain?.
Answer: Medical and psychological conditions Concomitant medications
History of chronic pain Substance use disorder Previous postoperative
treatment regimens
• Who is at ↑risk of developing gallstones?.
Answer: 4 F's Fat Female Fertile Forty
• What factors contribute to chronic pain?.
Answer: A combination of biological, psychological, and social factors.
• "Crampy RUQ abdominal pain that is worse after large or fatty meals".
Answer: Cholecystitis
• What are the two main types of chronic pain?.
Answer: Nociceptive pain (tissue damage) and neuropathic pain (nerve
damage).
,• What is Murphy's Sign?.
Answer: Acute RUQ pain and inspiratory arrest when palpating gallbladder
indicative of Cholecystitis
• Imaging for Cholecystitis?.
Answer: US initial HIDA (Cholescintigraphy) gold
• What are the characteristics of nociceptive pain?.
Answer: Involves inflammatory, ischemic, infectious, or
mechanical/compressive injury.
• What are the characteristics of neuropathic pain?.
Answer: Results from central and/or peripheral nerve disorders.
• Tx for Cholecystitis?.
Answer: NPO, IVF, Abx, Analgesia Laparoscopic Cholecystectomy
• Cause of Pancreatitis?.
Answer: Gallstones MCC EtOH 2nd MC
• What are common symptoms of acute pain?.
Answer: Sharp, stabbing, throbbing, burning pain in the affected area.
• Patient presents with a boring epigastric pain that radiates to their back. It
improves when they lean forward..
Answer: Pancreatitis
• "Bluish discoloration around the belly button".
Answer: Cullen's Sign Umbilical Ecchymosis indicative of Pancreatitis
• "Bluish discoloration around the patient's flank".
Answer: Grey Turner Sign Flank Ecchymosis indicative of Pancreatitis
• If a patient presents with abdominal pain and ↑Lipase, MLD?.
Answer: Pancreatitis
• Test of choice for Acute Pancreatitis?.
Answer: Abdominal CT
,• How will Acute Pancreatitis present on Xray? Chronic?.
Answer: Acute = Sentinel Loop Chronic = Calcified Pancreas
• Pancreatitis Tx.
Answer: NPO, NG tube IVF (90% of acute recover) Analgesia For chronic -
address underlying cause (stones or EtOH)
• What are common physical signs of acute pain?.
Answer: Guarding Facial grimacing or frowning Moaning or groaning
Restlessness or agitation Sweating
• Involves the "Anal Verge".
Answer: Anorectal Abscess
• What location/wall is Anal Disease MC?.
Answer: Posterior Midline
• What are common symptoms of chronic pain?.
Answer: Persistent pain with varying intensity, often accompanied by
functional limitations, mood disturbances, and sleep disruption.
• Patient presents with Severe, tearing rectal pain +/- Hematochezia..
Answer: Anal Fissure
• How does somatic pain present?.
Answer: Localized pain that worsens with movement.
• What are common symptoms of neuropathic pain?.
Answer: Tingling Pins and needles sensation Burning Shooting/electric
shock-like pain Allodynia (pain from non-painful stimuli) Hyperalgesia
(increased sensitivity to pain)
• What tool should be used to assess and track pain management
effectiveness?.
Answer: A validated pain assessment tool
• Why is postoperative pain management important?.
Answer: It facilitates recovery, improves mobility, and reduces
complications like atelectasis and deep vein thrombosis (DVT).
, • Tx for Anal Fissure?.
Answer: ↑Fiber and fluids Stool Softeners Sitz If failure of conservative
measures, Lateral Anal Sphincterotomy
• Complication of Lateral Anal Sphincterotomy? (What does it tx?).
Answer: Irreversible fecal incontinence (Anal Fissure
• What other disease process is associated with Anal Disease (abscess/fistula
especially)?.
Answer: Crohn's
• Anorectal abscess/fistula Tx?.
Answer: Abscess without signs of systemic infection = I&D alone Abscess
WITH signs of systemic infection = I&D, Wound Culture, and empiric Abx
• What are nonpharmacologic treatments for acute pain.
Answer: Patient education, compression, elevation, ice/heat as indicated.
• If you believe a patient has Appendicitis, what symptom should make you
reconsider that diagnosis?.
Answer: Appendicitis is closely associated with Anorexia, so if they are
hungry and CAN EAT, it likely is not Appendicitis
• What are first-line pharmacologic treatments for acute pain?.
Answer: Nonopioid analgesics: Acetaminophen, NSAIDs, local anesthetic
wound infiltration, regional anesthesia.
• MC Surgical Emergency.
Answer: Appendicitis
• How is moderate acute pain treated?.
Answer: Gabapentinoids, ketamine, lidocaine infusions, and opioids as
needed.
• How is severe acute pain treated?.
Answer: Gabapentinoids, ketamine, lidocaine infusions, opioids (scheduled
or as needed).
