SURGERY COMAT EXAMINATION TEST FINAL
PAPER FULL SOLUTION 2026 GRADED A+.
⫸ 5 W's of Post-op surgery? Answer: 5 W's
• Wind
○ Pneumonia, PE, Aspiration
• Wound
○ Surgical site infections
• Water
○ Urinary tract infections
§ Increased risk due to indwelling catheters
§ Associated with enteric organisms ie. E. coli, Klebsiella, Proteus
mirabillis
• Walk
○ Deep vein thrombosis
• Wonder Drugs
○ Drug fever, blood products, IV lines
○ Drug fever: diagnosis of exclusion
§ Usually associated with anticonvulsants, antibiotics (beta-lactams,
sulfonamides) and allopurinol
§ Occurs within 1-2 weeks of drug initiation
,⫸ Modified Radial Mastectomy vs. Simple mastectomy? Answer:
MRM includes:
• Includes axillary dissection
• Level I and Level II axillary dissection being the standard procedure
⫸ altnernate name for hidradenitis suppurative Answer: acnes inversa
⫸ What is hidradenitis suppurativa? Answer: hronic skin
inflammatory condition that is associated with:
• Induration
• Abscess
• Sinus tracts
It is similar in character and location as many other conditions but can
be differentiated by careful history and identifying presence of
hyperkeratosis induced follicular occlusion (family history and
reccurrence)
⫸ What is Paraphimosis? Answer: Paraphimosis is considered a
urological emergency and occurs when the retracted foreskin develops
a fixed constriction proximal to the glans
⫸ Treatment of parphimosis? Answer: The glans is first compressed
for several minutes to decrease edema
Followed by application of ice and attempting to push the prepuce
distally while the glans is pushed proximally
,⫸ Balanoposthitis Answer: is an inflammation secondary to an
infection of the glans penis and the surrounding foreskin
The majority of cases are due to poor hygiene or external irritation
with subsequent colonization by a fungus
⫸ Treatment of Balanoposthitis? Answer: Cleaning the region with
soap and water, adequate hygiene, avoiding moist environment and
application of antifungal creams such as nystatin or clotrimazole
⫸ Peyronie's disease Answer: Peyronie's disease is a rare condition
also known as chronic inflammation of the tunica albuginea
Associated with abnormal growth of the fibrous plaques and scar
formation in the sheath of tissue surrounding the corpora cavernosa
(tunica albuginea) of the penis
⫸ Phimosis Answer: Phimosis is the inability to retract the foreskin
proximally to the glans penis
• Can be a result of normal development or may be due to infection
or poor hygiene
⫸ Priapism? Answer: Priapism is another urological emergency but is
not involved with foreskin constriction or retraction difficulties
, • Priapism is a urological emergency and is defined as painful,
involntary and persistent erection in which both corpora cavernosa are
engorged with stagnant blood
• Impotence can result with sustained erection, thus urgent action is
imperative when faced with this condition
⫸ Treatment of priapism? Answer: adequate analgesia, hydration,
stopping the offending agent, administration of terbutaline (beta2-
mimetic), application of ice packs and corporal aspiration of blood
⫸ A-fib complication and acute abdomen? Answer: The patient in the
vignette has A-fib as seen in the exhibit and is reportedly non-
compliant with medical therapy predisposing him to atrial clot
formatiom which can subsequently embolize and cause ischemic
colitis. These patients present with:
• Acute abdominal pain
• Bloody diarrhea
• Vomiting
• Abdominal tenderness
⫸ Other causes of ischemic colitis Answer: • Embolus
• Hypoperfusion from any cause
• Bowel obstruction
⫸ Clinical findings of ischemic colitis? Answer: • Labs show
characteristically elevated WBC count and elevated lactic acid level
because of ischemia
PAPER FULL SOLUTION 2026 GRADED A+.
⫸ 5 W's of Post-op surgery? Answer: 5 W's
• Wind
○ Pneumonia, PE, Aspiration
• Wound
○ Surgical site infections
• Water
○ Urinary tract infections
§ Increased risk due to indwelling catheters
§ Associated with enteric organisms ie. E. coli, Klebsiella, Proteus
mirabillis
• Walk
○ Deep vein thrombosis
• Wonder Drugs
○ Drug fever, blood products, IV lines
○ Drug fever: diagnosis of exclusion
§ Usually associated with anticonvulsants, antibiotics (beta-lactams,
sulfonamides) and allopurinol
§ Occurs within 1-2 weeks of drug initiation
,⫸ Modified Radial Mastectomy vs. Simple mastectomy? Answer:
MRM includes:
• Includes axillary dissection
• Level I and Level II axillary dissection being the standard procedure
⫸ altnernate name for hidradenitis suppurative Answer: acnes inversa
⫸ What is hidradenitis suppurativa? Answer: hronic skin
inflammatory condition that is associated with:
• Induration
• Abscess
• Sinus tracts
It is similar in character and location as many other conditions but can
be differentiated by careful history and identifying presence of
hyperkeratosis induced follicular occlusion (family history and
reccurrence)
⫸ What is Paraphimosis? Answer: Paraphimosis is considered a
urological emergency and occurs when the retracted foreskin develops
a fixed constriction proximal to the glans
⫸ Treatment of parphimosis? Answer: The glans is first compressed
for several minutes to decrease edema
Followed by application of ice and attempting to push the prepuce
distally while the glans is pushed proximally
,⫸ Balanoposthitis Answer: is an inflammation secondary to an
infection of the glans penis and the surrounding foreskin
The majority of cases are due to poor hygiene or external irritation
with subsequent colonization by a fungus
⫸ Treatment of Balanoposthitis? Answer: Cleaning the region with
soap and water, adequate hygiene, avoiding moist environment and
application of antifungal creams such as nystatin or clotrimazole
⫸ Peyronie's disease Answer: Peyronie's disease is a rare condition
also known as chronic inflammation of the tunica albuginea
Associated with abnormal growth of the fibrous plaques and scar
formation in the sheath of tissue surrounding the corpora cavernosa
(tunica albuginea) of the penis
⫸ Phimosis Answer: Phimosis is the inability to retract the foreskin
proximally to the glans penis
• Can be a result of normal development or may be due to infection
or poor hygiene
⫸ Priapism? Answer: Priapism is another urological emergency but is
not involved with foreskin constriction or retraction difficulties
, • Priapism is a urological emergency and is defined as painful,
involntary and persistent erection in which both corpora cavernosa are
engorged with stagnant blood
• Impotence can result with sustained erection, thus urgent action is
imperative when faced with this condition
⫸ Treatment of priapism? Answer: adequate analgesia, hydration,
stopping the offending agent, administration of terbutaline (beta2-
mimetic), application of ice packs and corporal aspiration of blood
⫸ A-fib complication and acute abdomen? Answer: The patient in the
vignette has A-fib as seen in the exhibit and is reportedly non-
compliant with medical therapy predisposing him to atrial clot
formatiom which can subsequently embolize and cause ischemic
colitis. These patients present with:
• Acute abdominal pain
• Bloody diarrhea
• Vomiting
• Abdominal tenderness
⫸ Other causes of ischemic colitis Answer: • Embolus
• Hypoperfusion from any cause
• Bowel obstruction
⫸ Clinical findings of ischemic colitis? Answer: • Labs show
characteristically elevated WBC count and elevated lactic acid level
because of ischemia
