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ROSH REVIEW general surgery Questions and Answers (100% Pass)
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ROSH REVIEW general surgery Questions and Answers (100% Pass)
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©PREP4EXAMS@2024 [REAL EXAM DUMPS] Friday, July 19, 2024 6:13 AMROSH REVIEW general surgery Questions and
Answers (100% Pass)
A 24-year-old woman presents to the clinic for preoperative evaluation for a scheduled right
anterior cruciate ligament repair. Preoperative clearance was requested by the surgeon secondary
to the patient complaining of chest pain. Review of systems is positive for a chronic
nonproductive cough, chest pain, fatigue, and weight loss. She denies any history of tobacco use.
A chest radiograph reveals bilateral hilar adenopathy with symmetric enlargement of the hila.
Serum angiotensin-converting enzyme levels are ordered and found to be elevated. Which of the
following is the most likely diagnosis? - ✔️✔️Sarcoidosis
Which of the following options is the best therapy for an ascending aortic dissection? -
✔️✔️Emergent surgical repair
Why must the preoperative preparation for surgical resection of a patient with a diagnosed
pheochromocytoma involve propranolol initiation after a 10-14 day course of
phenoxybenzamine? - ✔️✔️To avoid unopposed alpha-adrenergic receptor stimulation
A 60-year-old man has been bedridden following a stroke several months ago. Urinalysis shows
high levels of protein in the urine and nephrotic syndrome is suspected. On physical exam, where
would the provider likely detect edema? - ✔️✔️Sacrum (peripheral and periorbital edema are
commonly seen in patients with nephrotic syndrome caused by sodium retention and
hypoalbuminemia; lab shows proteinuria > 3.5g/day)
A 78-year-old man undergoes laparoscopic surgery for a small bowel obstruction. Which
metabolic disturbance is he most at risk for postoperatively? - ✔️✔️Metabolic alkalosis
A 30-year-old woman presents to the outpatient clinic for follow-up on her total thyroidectomy
performed six weeks ago. Her incision is well-healed, and there are no signs of infection. The
patient does complain of feeling cold, despite others around her being warm, fatigue, and weight
gain. She has remained on levothyroxine 100 mcg by mouth once daily. Serum thyroid-
stimulating hormone was performed prior to the appointment and was found to be elevated.
Which of the following is the most likely diagnosis? - ✔️✔️Hypothyroidism
1
,©PREP4EXAMS@2024 [REAL EXAM DUMPS] Friday, July 19, 2024 6:13 AM
A 46-year-old man presents to the emergency department reporting abdominal pain, bloating,
nausea, anorexia, and vomiting. His symptoms have been worsening since onset three days ago.
His last bowel movement was four days ago, but he continues to pass flatus. Which of the
following tests has the highest sensitivity for confirming the most likely diagnosis? -
✔️✔️Abdominal CT w/ contrast
Which of the following is appropriate initial treatment for uncomplicated symptomatic Crohn's
disease? - ✔️✔️Immunosuppressant therapy
Parents bring their previously healthy four-week-old boy to the ED due to repeated "projectile
vomiting" immediately after he nurses for the past 24 hours. The parents report the emesis looks
just like breast milk. He has had a normal pattern of wet diapers. The parents deny any rectal
bleeding. He has not had any difficulty nursing before, and attempts at burping him have not
brought any relief. Vital signs include a temperature of 98.8°F. Physical exam reveals an alert,
crying infant with a small, firm right upper quadrant mass. Blood analysis is within normal
limits. Which of the following choices is the best next step for this patient? - ✔️✔️Order
transabdominal ultrasound
A 66-year-old man with hypertension and type II diabetes mellitus presents to the ED
complaining of chest tightness, dyspnea, and dizziness while mowing his lawn earlier that day.
He had similar symptoms two weeks ago. His symptoms resolved within a couple of minutes of
sitting to rest. He is currently pain-free. Vital signs are pulse 88 beats per minute, blood pressure
134/88 mm Hg, temperature 98.8°F, oxygen saturation 97%, and 20 respirations per minute.
Exam reveals an obese man in no acute distress and is otherwise unremarkable.
Electrocardiogram is obtained and shown above. Which of the following is the most likely
diagnosis? - ✔️✔️Angina pectoris
You are evaluating a 48-year-old woman with right lower extremity swelling, pain, and redness.
She is eight days status-post open cholecystectomy. She was on lovenox for two days
postoperatively but is not currently taking any medications except oxycodone for pain. What is
the test of choice to confirm your suspected diagnosis? - ✔️✔️Venous doppler ultrasound
Which of the following is a physical exam finding characterized by pain and inspiratory arrest
during palpation of the right upper quadrant? - ✔️✔️Murphy's sign
2
, ©PREP4EXAMS@2024 [REAL EXAM DUMPS] Friday, July 19, 2024 6:13 AM
A 66-year-old woman with a past medical history of uncontrolled diabetes mellitus, obesity, and
rheumatoid arthritis who is on methotrexate presents to the emergency department complaining
of redness, drainage, and pain at her incision site. She had an umbilical hernia repair
approximately six days prior. On exam, you note the patient has a fever of 100.6°F and the
incision site is erythematous and warm with a small amount of purulent drainage noted. There
are no signs of wound dehiscence and no areas of fluctuance noted. Which of the following is the
most likely diagnosis? - ✔️✔️Cellulitis
Which of the following blood analysis tests is indicated to diagnose anemia? - ✔️✔️Complete
blood count
Which of the following physical exam findings is more indicative of skin abscess than cellulitis?
- ✔️✔️Fluctuance
A 31-year-old man presents to the emergency department after an episode of syncope following
sexual intercourse. Upon regaining consciousness at home, patient began complaining of a
severe headache and started to vomit. Physical examination reveals an uncomfortable man with
positive meningeal signs. Blood pressure is 162/94 mm Hg. CT scan of the head without contrast
reveals no acute pathology. Based on the most likely diagnosis, what would you expect on the
patient's lumbar puncture? - ✔️✔️Hemoglobin degradation products (xanthochromia from
subarachnoid hemorrhage; tx includes supportive and nimodipine)
A 54-year-old man presents to the clinic complaining of difficulty swallowing food for the past
two years, which has been gradually worsening. He has no problem swallowing liquids. He has
had uncontrolled gastroesophageal reflux for several years. He has no history of tobacco use and
has not had any head or neck radiation therapy. Which of the following is the best initial test for
this patient? - ✔️✔️Upper endoscopy (esophageal strictures)
A 32-year-old man presents to the outpatient clinic for follow-up regarding his hypertension.
Despite the use of three antihypertensive agents, he remains hypertensive. He also has episodes
of nonexertional palpitations, diaphoresis, and headache. He recently completed a 24-hour
urinary fractionated metanephrines test, which was positive. A computed tomography of the
abdomen and pelvis is done and reveals a 5 cm tumor of the right adrenal gland. Which of the
following is the most appropriate next step in management? - ✔️✔️Phenoxybenzamine
3
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