General Surgery-Orthopedics and Trauma medicine

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Q1: A 60-year-old patient with a history of smoking and hypertension presents with abdominal pain and distension. Physical examination reveals rebound tenderness in the lower abdomen. Which of the following interventions is most appropriate for this patient?

A) Immediate laparotomy

B) Intravenous antibiotics

C) Bowel rest and observation

D) Contrast-enhanced CT scan

E) Diagnostic paracentesis

Q2: During a laparoscopic cholecystectomy, the surgeon encounters a bleeding cystic artery. Despite attempts at electrocautery, bleeding persists. What is the most appropriate next step?

A) Convert to an open procedure

B) Apply additional clips to the bleeding vessel

C) Increase insufflation pressure

D) Administer a bolus of intravenous heparin

E) Continue electrocautery with higher power

Q3: A patient with chronic renal failure requires a surgical procedure. Which factor is most important to consider regarding anesthesia management?

A) Maintenance of normothermia

B) Avoidance of neuromuscular blockade

C) Permissive hypercapnia

D) Aggressive fluid resuscitation

E) Rapid sequence induction

Q4: A 45-year-old male with a history of peptic ulcer disease undergoes elective surgery. Postoperatively, he develops melena and hemodynamic instability. What is the most appropriate initial step in management?

A) Upper endoscopy

B) Intravenous proton pump inhibitor

C) Blood transfusion

D) Repeat surgery

E) Angiographic embolization

Q5: A 35-year-old female presents with a painful breast lump. On examination, a mobile, well-defined mass is identified. What is the most appropriate next step in management?

A) Mammogram

B) Fine-needle aspiration (FNA)

C) Core needle biopsy

D) Antibiotic therapy

E) Surgical excision

Q6: A patient with a contaminated open fracture is receiving intravenous antibiotics. Which wound closure method is most appropriate in this scenario?

A) Primary closure

B) Delayed primary closure

C) Secondary closure

D) Healing by secondary intention

E) Tertiary closure

Q7: A patient undergoing elective surgery has a history of keloid formation. Which suture material is most appropriate to minimize the risk of keloid development?

A) Nylon

B) Polyglycolic acid

C) Silk

D) Polypropylene

E) Vicryl

Q8: A diabetic patient undergoes a toe amputation. Which factor is most crucial for successful wound healing in this patient?

A) Strict glycemic control

B) Broad-spectrum antibiotics

C) Frequent dressing changes

D) Hyperbaric oxygen therapy

E) Early ambulation

Q9: A patient with a stab wound to the abdomen is stable and has a wound track that is difficult to assess. What is the most appropriate diagnostic modality to evaluate the trajectory and potential injuries?

A) Contrast-enhanced CT scan

B) Diagnostic peritoneal lavage

C) Exploratory laparotomy

D) Ultrasonography

E) MRI of the abdomen

Q10: A patient with a non-healing wound has been diagnosed with pyoderma gangrenosum. What is the most appropriate initial treatment for this condition?

A) Systemic steroids

B) Broad-spectrum antibiotics

C) Wound debridement

D) Hyperbaric oxygen therapy

E) Topical antiseptics

Q11: During a laparoscopic cholecystectomy, the surgeon notices a bile leak from the cystic duct stump. What is the most appropriate immediate intervention?

A) Apply additional clips to the cystic duct

B) Convert to an open procedure

C) Use electrocautery to seal the leak

D) Place a hemostatic agent on the stump

E) Continue with the planned procedure

Q12: A patient undergoing major abdominal surgery experiences a sudden drop in blood pressure. The surgical team suspects a tension pneumothorax. What is the most appropriate immediate action?

A) Administer a fluid bolus

B) Initiate positive pressure ventilation

C) Perform needle decompression of the chest

D) Increase the depth of anesthesia

E) Complete the surgery quickly

Q13: A patient undergoing surgery for a malignant tumor is at risk of developing postoperative deep vein thrombosis (DVT). Which pharmacological prophylaxis is most appropriate?

A) Aspirin

B) Warfarin

C) Unfractionated heparin

D) Clopidogrel

E) Enoxaparin

Q14: A patient with a history of malignant hyperthermia undergoes elective surgery. What is the most appropriate measure to prevent an episode of malignant hyperthermia during the procedure?

A) Administration of dantrolene

B) Preoperative cooling measures

C) Avoidance of succinylcholine

D) Continuous temperature monitoring

E) Use of volatile anesthetics

Q15: A patient undergoing abdominal surgery has a known allergy to latex. What is the most appropriate measure to prevent an allergic reaction in the operating room?

A) Use latex-free gloves only

B) Administer prophylactic antihistamines

C) Avoidance of all adhesive tapes

D) Ensure a latex-free environment

E) Preoperative desensitization

Q16: A patient undergoing elective surgery has a history of obstructive sleep apnea. What is the most appropriate peri-operative management to minimize the risk of complications?

A) Routine use of continuous positive airway pressure (CPAP)

B) Preoperative administration of sedatives

C) Avoidance of neuromuscular blockade

D) Rapid sequence induction

E) Prolonged postoperative fasting

Q17: A patient with end-stage renal disease is scheduled for surgery. What is the most appropriate adjustment in the peri-operative management of medications?

A) Maintain the usual dose of all medications

B) Skip doses of oral antihypertensives on the day of surgery

C) Hold diuretics for 48 hours before surgery

D) Administer a double dose of erythropoietin on the day of surgery

E) Replace oral hypoglycemics with insulin on the day of surgery

Q18: A patient scheduled for surgery has a history of methicillin-resistant Staphylococcus aureus (MRSA) colonization. What is the most appropriate peri-operative prophylaxis?

A) Cefazolin

B) Vancomycin

C) Clindamycin

D) Gentamicin

E) Ciprofloxacin

Q19: A patient undergoing major surgery develops acute postoperative delirium. What is the most appropriate initial management?

A) Administration of haloperidol

B) Increasing the depth of anesthesia

C) Early ambulation

D) Intravenous fluid bolus

E) Ordering a brain CT scan

Q20: A patient with a history of chronic opioid use is scheduled for elective surgery. What is the most appropriate peri-operative pain management strategy?

A) High-dose opioids for the first 24 hours

B) Scheduled acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs)

C) Patient-controlled analgesia (PCA) with opioids

D) Intravenous ketamine infusion

E) Delayed initiation of analgesia

Q21: A patient presents with sudden-onset severe abdominal pain, nausea, and vomiting. Physical examination reveals abdominal distension and absent bowel sounds. What is the most likely diagnosis?

A) Acute cholecystitis

B) Acute pancreatitis

C) Small bowel obstruction

D) Acute appendicitis

E) Gastroenteritis

Q22: A patient with a history of recurrent abdominal pain is diagnosed with diverticulosis. What is the most appropriate initial management?

A) High-fiber diet

B) Intravenous antibiotics

C) Bowel resection

D) Prophylactic cholecystectomy

E) Antiemetic therapy

Q23: A patient with a history of alcohol abuse presents with hematemesis and melena. What is the most likely source of bleeding?

A) Esophageal varices

B) Peptic ulcer disease

C) Mallory-Weiss tear

D) Gastric cancer

E) Angiodysplasia

Q24: A patient with a family history of colorectal cancer undergoes screening colonoscopy, revealing a 1 cm polyp with dysplasia. What is the most appropriate next step?

A) Repeat colonoscopy in 5 years

B) Immediate polypectomy

C) Referral for genetic testing

D) Initiation of aspirin therapy

E) Bowel resection

Q25: A patient with a history of renal stones presents with sudden-onset colicky flank pain radiating to the groin. What imaging modality is most appropriate for diagnosing the cause of the pain?

A) Abdominal ultrasound

B) Non-contrast CT scan

C) Intravenous pyelogram (IVP)

D) Magnetic resonance imaging (MRI)

E) Retrograde pyelography

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Welcome to your General Surgery Quiz-Orthopedics and Trauma medicine Quiz!!

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