SURGERY EOR EXAM PA QUESTIONS
WITH COMPLETE ANSWERS { GRADED
A+}
A 54-year-old man presents to the emergency department with
crampy abdominal pain, nausea, and vomiting. The patient has
not passed gas or had a bowel movement for at least 10 hours.
On examination, the abdomen is distended and there are high-
pitched bowel sounds with rushes. A plain radiograph of the
abdomen reveals cecal distension to 12 cm. What is the most
appropriate definitive management for this patient?
A
Intravenous fluids
B
Nasogastric suction
,C
Observation
D
Surgical exploration - ✔✔The Correct Answer is: D
Massive distention of the cecum, as detected on plain radiograph,
is typically seen in "closed loop" obstructions where the ileocecal
valve is competent. When distention approaches 12 cm, there is
an increased risk of perforation and/or gangrene. Expedient
surgical intervention is indicated. Although observation with
intravenous fluids and nasogastric decompression are important
adjuncts to management, surgical exploration is the only way to
rapidly address this emergent situation.
When a bone is fractured, there are the 3 stages of healing. What
is the proper order in which the healing occurs?
A
Inflammatory, Remodeling, Reparative
B
,Inflammatory, Reparative, Remodeling
C
Remodeling, Inflammatory, Reparative
D
Remodeling, Reparative, Inflammatory
E
Reparative, Inflammatory, Remodeling - ✔✔The Correct Answer
is: B
Inflammatory changes happen after fractures and this is followed
by a reparative phase and ultimately, a remodeling phase. The
healing from acute injuries generally starts with inflammation,.
Once the integrity of the bone has been restored on the macro
level, bone remodeling continues until full healing has occurred.
What is the most common embolic source of acute arterial
occlusion in the lower extremities?
A
Atrial fibrillation
, B
Aortic aneurysm
C
Myocardial infarction
D
Prosthetic cardiac valve
E
Iliac artery thrombus - ✔✔The Correct Answer is: A
The heart accounts for 80% of all emboli, with atrial fibrillation
making up 70% of that. Aortic aneurysms are frequently lined with
thrombus but infrequently embolize; aneurysmal disease only
accounts for 6% of all acute arterial occlusion. Acute myocardial
infarction (especially those associated with left ventricular
thrombus) accounts for 25% of cardioembolism, with peripheral
embolization often the first sign of a previously "silent" MI.
Prosthetic cardiac valves make up a still small but increasingly
WITH COMPLETE ANSWERS { GRADED
A+}
A 54-year-old man presents to the emergency department with
crampy abdominal pain, nausea, and vomiting. The patient has
not passed gas or had a bowel movement for at least 10 hours.
On examination, the abdomen is distended and there are high-
pitched bowel sounds with rushes. A plain radiograph of the
abdomen reveals cecal distension to 12 cm. What is the most
appropriate definitive management for this patient?
A
Intravenous fluids
B
Nasogastric suction
,C
Observation
D
Surgical exploration - ✔✔The Correct Answer is: D
Massive distention of the cecum, as detected on plain radiograph,
is typically seen in "closed loop" obstructions where the ileocecal
valve is competent. When distention approaches 12 cm, there is
an increased risk of perforation and/or gangrene. Expedient
surgical intervention is indicated. Although observation with
intravenous fluids and nasogastric decompression are important
adjuncts to management, surgical exploration is the only way to
rapidly address this emergent situation.
When a bone is fractured, there are the 3 stages of healing. What
is the proper order in which the healing occurs?
A
Inflammatory, Remodeling, Reparative
B
,Inflammatory, Reparative, Remodeling
C
Remodeling, Inflammatory, Reparative
D
Remodeling, Reparative, Inflammatory
E
Reparative, Inflammatory, Remodeling - ✔✔The Correct Answer
is: B
Inflammatory changes happen after fractures and this is followed
by a reparative phase and ultimately, a remodeling phase. The
healing from acute injuries generally starts with inflammation,.
Once the integrity of the bone has been restored on the macro
level, bone remodeling continues until full healing has occurred.
What is the most common embolic source of acute arterial
occlusion in the lower extremities?
A
Atrial fibrillation
, B
Aortic aneurysm
C
Myocardial infarction
D
Prosthetic cardiac valve
E
Iliac artery thrombus - ✔✔The Correct Answer is: A
The heart accounts for 80% of all emboli, with atrial fibrillation
making up 70% of that. Aortic aneurysms are frequently lined with
thrombus but infrequently embolize; aneurysmal disease only
accounts for 6% of all acute arterial occlusion. Acute myocardial
infarction (especially those associated with left ventricular
thrombus) accounts for 25% of cardioembolism, with peripheral
embolization often the first sign of a previously "silent" MI.
Prosthetic cardiac valves make up a still small but increasingly
