General Surgery Question Bank

General Surgery  Question Bank

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1. A patient develops pancreatic ascites three weeks after splenectomy. The ascitic fluid has a markedly elevated amylase concentration and high protein content. Cross-sectional imaging suggests a pancreatic-tail duct leak, and the ascites persists despite initial supportive treatment. Which procedure can both define and treat the duct disruption?

A. Immediate exploratory laparotomy

B. Mesenteric arteriography

C. Diagnostic paracentesis alone

D. Intravenous somatostatin without duct evaluation

E. Endoscopic retrograde cholangiopancreatography with transpapillary pancreatic-duct stenting

2. Which medication is commonly preferred for primary prevention of hepatic decompensation and variceal hemorrhage in an appropriate patient with compensated cirrhosis and clinically significant portal hypertension?

A. Amlodipine

B. Omeprazole

C. Carvedilol

D. Intravenous octreotide

E. Lisinopril

3. Which is an advantage of performing an open repair of a reducible inguinal hernia under local anesthesia by a team experienced in the technique?

A. It eliminates the need for physiologic monitoring.

B. It is associated with a lower risk of postoperative urinary retention.

C. It eliminates the possibility of hernia recurrence.

D. It prevents all wound infections.

E. It is appropriate for every strangulated hernia.

4. Which amino acid carries carbon and amino nitrogen from skeletal muscle to the liver as part of the glucose–alanine cycle?

A. Alanine

B. Glutamine

C. Glutamic acid

D. Arginine

E. Phenylalanine

5. A patient has undergone successful aortobifemoral bypass for severe peripheral artery disease. Which long-term management is most important for reducing cardiovascular and limb-related events?

A. Anticoagulation with warfarin in every patient

B. High-intensity statin therapy, appropriate antiplatelet therapy, blood-pressure and diabetes management, smoking cessation, and exercise

C. Discontinuation of cardiovascular medications once the graft is patent

D. Routine replacement of the graft every five years

E. Long-term dual-antiplatelet therapy in every patient regardless of bleeding risk

6. What is the leading cause of death among women in the United States?

A. Complications of diabetes

B. Cerebrovascular disease

C. Cancer

D. Septicemia

E. Heart disease

7. A 5-year-old boy has a mildly tender, 3-cm midline neck mass just above the hyoid bone. The mass moves with swallowing, and no normal thyroid gland can be confidently palpated. Which study should be obtained first?

A. CT of the neck

B. Fine-needle aspiration

C. Neck and thyroid ultrasonography

D. MRI of the neck

E. Excisional biopsy without imaging

8. A patient with kidney failure requiring hemodialysis has persistent vomiting caused by gastric outlet obstruction. Laboratory results show a serum chloride level of 72 mEq/L, serum bicarbonate level of 48 mEq/L, PCO₂ of 50 mm Hg, and arterial pH of 7.60. Which of the following is the preferred method for correcting this patient’s severe metabolic alkalosis?

A. Intravenous ammonium chloride

B. Intravenous acetazolamide

C. Intravenous hydrochloric acid

D. Intravenous arginine hydrochloride

E. Hemodialysis using a reduced-bicarbonate dialysate, along with treatment of the ongoing gastric losses

9. Which serum tumor marker is most commonly used to follow treatment response and disease course in epithelial ovarian cancer when it was elevated at diagnosis?

A. Beta-human chorionic gonadotropin

B. Alpha-fetoprotein

C. Squamous cell carcinoma antigen

D. Carcinoembryonic antigen

E. Cancer antigen 125

10. Which hormone is primarily responsible for stimulating ductal proliferation and branching of the breast during pregnancy?

A. Estrogen

B. Prolactin

C. Human chorionic gonadotropin

D. Progesterone

E. Human placental lactogen

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