Surgery week 1 quiz Q
Possible Raw Score: 44
# 1 of 44 - 1 Points
Surgery MS | Surgery | Surgical Groups by Area
1. What is the preferred treatment for infantile intestinal obstruction due to
intussusception?
A. Colonoscopy
B. Emergent colon resection
C. Nasogastric decompression
D. Barium or air enema
E. Intravenous fluids only
2. A 1-year-old boy presents with a 1-week history of bloody diapers. The child has been
crying almost constantly. On clinical exam, there is abdominal tenderness. Guaiac test
is positive, hematocrit is 39.0, and hemoglobin is 13.0. What is the most likely
diagnosis?
A. Diverticulitis
B. Meckel's diverticulum
C. Peutz-Jeghers syndrome
D. Ulcerative colitis
E. Crohn's disease
3. Pertaining to the examination of the abdomen, what is borborygmi?
A. The palpable abdominal mass in intestinal intussusception
B. Small intestinal diverticulum
C. The pathognomonic radiologic findings of intestinal obstruction
D. The hyperactive sounds of closed intestinal obstruction
E. The vascular compromise from volvulus
,4. A 12-year-old boy underwent an appendectomy for acute appendicitis. 4 days later, he
developed abdominal distention, absolute constipation, and effortless vomiting. On
examination, the patient is anxious and uncomfortable. The abdomen is distended,
silent, and tender. A plain X-ray of the abdomen shows gas distributed throughout the
small and large gut. Some fluid levels are present. He is diagnosed with advanced
paralytic ileus secondary to generalized peritonitis. In addition to the usual supportive
measures, what is the best treatment?
A. High doses of Ilopan and Prostigmin
B. Prompt reoperation to place multiple drains and search for local abscesses
C. Prompt reoperation to drain the obstructed intestine by ileostomy?
D. Fibrinolysis to ablate adhesions
E. Intestinal intubation and continuous suction
5. The most common benign tumor of the stomach is:
A. Leiomyomas
B. Gastritis cystica profunda
C. Reduplication cyst
D. Pseudolymphoma
E. Adenomyoma
6. A 5-year-old boy is involved in a high speed MVA, and he sustains a blunt trauma to
his head and right leg. On arrival to the emergency department, the patient is boarded
with a c-collar in place. He is moaning incomprehensible sounds, but he is not
responding to verbal stimuli. He does not open his eyes at all. He is exhibiting flexion
of his upper extremities. He has an obvious deformity of his right lower extremity.
, Temp is 37.8, RR is 10 (periodic breathing), pulse is 120, and BP is 100/80. What is
your initial management of the above patient?
A. Assess the airway and intubate the patient
B. Insert 2 large-bore IV's and give large volumes of fluids
C. Splint the right leg
D. Obtain an emergent CT of the head
E. Immediately obtain cervical films to assess for any neck injuries
7. Why is a closed loop obstruction of the intestine so critical?
A. It has one point of obstruction
B. It can rapidly progress to vascular compromise with ischemia and perforation
of the intestine
C. It sequesters fluid
D. It allows food in the bowel to degrade
E. It allows nitrogen to accumulate
8. An 8-month-old male infant is brought to the emergency room with sudden onset of
acute pain and repeated vomiting. The mother states that the infant was eating well
and healthy until a few hours ago. She explains that the pain seems to come into
spasms every 10 - 15 minutes; it is increasing in severity. The boy looks pale and
listless due to exhaustion. Abdominal examination shows a sausage shaped lump in
the right side of the abdomen that hardens on palpation (refer to the image). On rectal
examination, your finger feels a mass that is stained with blood and mucus. What
statement about this condition is true?
A. It is most common around the age of 5 years
B. It is more common in boys
C. Barium swallow is diagnostic
D. The condition subsides on its own
E. It is a very rare condition
, 9. A 23-year-old man presents with a 12-hour history of abdominal pain, nausea, and
vomiting. He recounts that after a long night out with his friends, he went to sleep at 3
am only to be awakened at 4 am by severe abdominal pain. He admits to drinking
heavily the prior evening, which is not unusual during the weekends. His blood
pressure is 100/60, pulse rate is 130, respirations are 14, and his temperature is 39° C.
A chest X-ray taken shortly after admission reveals a substantial amount of free air
under the right hemidiaphragm. What is the most likely diagnosis?
A. Perforated peptic ulcer
B. Alcohol-related gastritis
C. Appendicitis
D. Gastroenteritis
E. Kidney stones
10. What is true regarding acute cholecystitis?
A. Acute cholecystitis occurs most commonly in men older than age 70
B. There is no familial or hereditary component to this disease
C. It most commonly occurs several hours after a large meal, usually late at night or
in the early morning hours, although it may not be related to food intake
D. The initial symptom is a sharp penetrating stabbing pain
E. There is no emesis associated with this disease
11. A 16-year-old pedestrian is brought to the emergency room after being struck by an
automobile traveling at 35 mph. According to bystanders, he was thrown at the scene
a distance of 200 feet. He is brought to the emergency room unresponsive. His vitals
are: blood pressure 140/90 mm Hg, heart rate 45, and respirations 6. The paramedics
report that he has bilateral femur fractures, and a suspected pelvic fracture. He
currently has the mast trousers in place. His eyes open to pain only, and his pupils are
equal and reactive; he responds with incomprehensible sounds. He withdraws from
painful stimuli. What is the patient's initial Glasgow Coma Scale?
A. 3
B. 4
C. 6
D. 8
E. 15
12. A 12-year-old girl presents with a 1-day history of right lower quadrant pain and
fever. She is experiencing nausea, but not vomiting. Physical examination is notable
for right lower quadrant pain and tenderness with guarding. She is taken to the
Possible Raw Score: 44
# 1 of 44 - 1 Points
Surgery MS | Surgery | Surgical Groups by Area
1. What is the preferred treatment for infantile intestinal obstruction due to
intussusception?
A. Colonoscopy
B. Emergent colon resection
C. Nasogastric decompression
D. Barium or air enema
E. Intravenous fluids only
2. A 1-year-old boy presents with a 1-week history of bloody diapers. The child has been
crying almost constantly. On clinical exam, there is abdominal tenderness. Guaiac test
is positive, hematocrit is 39.0, and hemoglobin is 13.0. What is the most likely
diagnosis?
A. Diverticulitis
B. Meckel's diverticulum
C. Peutz-Jeghers syndrome
D. Ulcerative colitis
E. Crohn's disease
3. Pertaining to the examination of the abdomen, what is borborygmi?
A. The palpable abdominal mass in intestinal intussusception
B. Small intestinal diverticulum
C. The pathognomonic radiologic findings of intestinal obstruction
D. The hyperactive sounds of closed intestinal obstruction
E. The vascular compromise from volvulus
,4. A 12-year-old boy underwent an appendectomy for acute appendicitis. 4 days later, he
developed abdominal distention, absolute constipation, and effortless vomiting. On
examination, the patient is anxious and uncomfortable. The abdomen is distended,
silent, and tender. A plain X-ray of the abdomen shows gas distributed throughout the
small and large gut. Some fluid levels are present. He is diagnosed with advanced
paralytic ileus secondary to generalized peritonitis. In addition to the usual supportive
measures, what is the best treatment?
A. High doses of Ilopan and Prostigmin
B. Prompt reoperation to place multiple drains and search for local abscesses
C. Prompt reoperation to drain the obstructed intestine by ileostomy?
D. Fibrinolysis to ablate adhesions
E. Intestinal intubation and continuous suction
5. The most common benign tumor of the stomach is:
A. Leiomyomas
B. Gastritis cystica profunda
C. Reduplication cyst
D. Pseudolymphoma
E. Adenomyoma
6. A 5-year-old boy is involved in a high speed MVA, and he sustains a blunt trauma to
his head and right leg. On arrival to the emergency department, the patient is boarded
with a c-collar in place. He is moaning incomprehensible sounds, but he is not
responding to verbal stimuli. He does not open his eyes at all. He is exhibiting flexion
of his upper extremities. He has an obvious deformity of his right lower extremity.
, Temp is 37.8, RR is 10 (periodic breathing), pulse is 120, and BP is 100/80. What is
your initial management of the above patient?
A. Assess the airway and intubate the patient
B. Insert 2 large-bore IV's and give large volumes of fluids
C. Splint the right leg
D. Obtain an emergent CT of the head
E. Immediately obtain cervical films to assess for any neck injuries
7. Why is a closed loop obstruction of the intestine so critical?
A. It has one point of obstruction
B. It can rapidly progress to vascular compromise with ischemia and perforation
of the intestine
C. It sequesters fluid
D. It allows food in the bowel to degrade
E. It allows nitrogen to accumulate
8. An 8-month-old male infant is brought to the emergency room with sudden onset of
acute pain and repeated vomiting. The mother states that the infant was eating well
and healthy until a few hours ago. She explains that the pain seems to come into
spasms every 10 - 15 minutes; it is increasing in severity. The boy looks pale and
listless due to exhaustion. Abdominal examination shows a sausage shaped lump in
the right side of the abdomen that hardens on palpation (refer to the image). On rectal
examination, your finger feels a mass that is stained with blood and mucus. What
statement about this condition is true?
A. It is most common around the age of 5 years
B. It is more common in boys
C. Barium swallow is diagnostic
D. The condition subsides on its own
E. It is a very rare condition
, 9. A 23-year-old man presents with a 12-hour history of abdominal pain, nausea, and
vomiting. He recounts that after a long night out with his friends, he went to sleep at 3
am only to be awakened at 4 am by severe abdominal pain. He admits to drinking
heavily the prior evening, which is not unusual during the weekends. His blood
pressure is 100/60, pulse rate is 130, respirations are 14, and his temperature is 39° C.
A chest X-ray taken shortly after admission reveals a substantial amount of free air
under the right hemidiaphragm. What is the most likely diagnosis?
A. Perforated peptic ulcer
B. Alcohol-related gastritis
C. Appendicitis
D. Gastroenteritis
E. Kidney stones
10. What is true regarding acute cholecystitis?
A. Acute cholecystitis occurs most commonly in men older than age 70
B. There is no familial or hereditary component to this disease
C. It most commonly occurs several hours after a large meal, usually late at night or
in the early morning hours, although it may not be related to food intake
D. The initial symptom is a sharp penetrating stabbing pain
E. There is no emesis associated with this disease
11. A 16-year-old pedestrian is brought to the emergency room after being struck by an
automobile traveling at 35 mph. According to bystanders, he was thrown at the scene
a distance of 200 feet. He is brought to the emergency room unresponsive. His vitals
are: blood pressure 140/90 mm Hg, heart rate 45, and respirations 6. The paramedics
report that he has bilateral femur fractures, and a suspected pelvic fracture. He
currently has the mast trousers in place. His eyes open to pain only, and his pupils are
equal and reactive; he responds with incomprehensible sounds. He withdraws from
painful stimuli. What is the patient's initial Glasgow Coma Scale?
A. 3
B. 4
C. 6
D. 8
E. 15
12. A 12-year-old girl presents with a 1-day history of right lower quadrant pain and
fever. She is experiencing nausea, but not vomiting. Physical examination is notable
for right lower quadrant pain and tenderness with guarding. She is taken to the
