GENERAL SURGERY END OF ROTATION EXAM LATEST 2024 ACTUAL EXAM QUESTIONS WITH VERIFIED DETAILED ANSWERS (GRADED A+)

GENERAL SURGERY END OF ROTATION
EXAM LATEST 2024 ACTUAL EXAM
QUESTIONS WITH VERIFIED DETAILED
ANSWERS (GRADED A+)

What is the pathologic mechanism of Hirschsprung's disease?
A Pyloric circular muscle hypertrophy causing gastric outlet obstruction
B Absence of ganglion cells in the mucosal and muscular layers of the
colon
C A defect in the diaphragm leading to protrusion of the abdominal
viscera into the thoracic cavity
D Absence of relaxation of the lower esophageal sphincter and lack of
peristalsis in the esophageal body - ANSWER-B
EXPLANATION
Hirschsprung's disease results from an absence of ganglion cells in the
mucosal and muscular layers of the colon.
A person presenting with bleeding esophageal varicies should be treated
with which of the following while awaiting arrival of endoscopy?
A Carafate (Sucralfate)
B Octreotide (Sandostatin)
C Omeprazole (Prilosec)
D Enoxaparin (Lovenox) - ANSWER-B
2
EXPLANATION
Octreotide is a vasoacctive drug used in the treatment of GI bleeding as
well as somatostatin, vasopressin, and terlipressin. Somatostatin and
octreotide are preferred due to safety and less incidence of serious side
effects.
A pregnant female presents at 32 weeks gestation with painless rectal
bleeding and a bulging perianal mass when straining which goes away.
Which of the following is the most appropriate management of this
patient?
A Hemorrhoidectomy
B Metronidazole (Flagyl)
C Psyllium (Metamucil)
D Sclerotherapy - ANSWER-C
EXPLANATION
Dietary fiber or psyllium bulk laxatives can be used to decrease straining
with defecation.
The main complication with the use of transjugular intrahepatic
portosystemic shunt (TIPS) procedure is which of the following?
A increased portal pressures resulting in further esophageal varices
B increased portal pressures resulting in a worsening of cirrhosis
C Budd-Chiari syndrome
D increased risk of encephalopathy - ANSWER-D
EXPLANATION
3
TIPS procedures involve the placement of a stent in the liver in order to
shunt blood away from the portal vein into the hepatic vein which
bypasses the cirrhotic liver parenchyma. Its main complication is
encephalopathy from the accumulation of toxic substances in the brain
since the liver no longer acts as a filter.
A 65 year-old patient with known history of alcohol and tobacco abuse
presents with solid food dysphagia. The patient also has a 24 lb weight
loss over the past 6 months. Which of the following is the most
appropriate intervention?
A endoscopy with biopsy
B chest x-ray
C barium esophagogram
D CT scan of the thorax - ANSWER-A
EXPLANATION
Endoscopy with biopsy establishes the diagnosis of esophageal cancer
with a high degree of reliability