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Surgery and Emergency Medicine Flashcards

6 cards from real COMLEX-USA practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

Read the first 6 Surgery and Emergency Medicine flashcards as text

  1. A patient with cirrhosis develops upper GI bleeding with hematemesis. Initial management should include:

    Answer: IV access, fluid resuscitation, and octreotide drip

    Initial management of variceal bleeding includes large-bore IV access, volume resuscitation, octreotide (to reduce portal pressure), antibiotics, and blood transfusion as needed before endoscopy.

  2. Which imaging modality is first-line for evaluating suspected acute appendicitis in a pregnant woman?

    Answer: Ultrasound

    Ultrasound is the first-line imaging for suspected appendicitis in pregnancy to avoid fetal radiation exposure; MRI is used if ultrasound is inconclusive.

  3. In damage control surgery for a trauma patient with coagulopathy and hypothermia, the correct sequence is:

    Answer: Initial hemorrhage control → ICU resuscitation → definitive repair

    Damage control surgery limits OR time to control hemorrhage and contamination, followed by ICU resuscitation of the 'lethal triad' (hypothermia, coagulopathy, acidosis), then return to OR for definitive repair.

  4. A patient presents to the ED with anaphylaxis and urticaria after a bee sting. First-line treatment is:

    Answer: Epinephrine 0.3–0.5 mg IM (thigh)

    Epinephrine IM (anterolateral thigh) is the first and most critical treatment for anaphylaxis; antihistamines and steroids are adjuncts but do not replace epinephrine.

  5. Which finding in a patient with blunt abdominal trauma most reliably indicates splenic injury?

    Answer: Kehr's sign (left shoulder tip pain)

    Kehr's sign (referred left shoulder pain from diaphragmatic irritation by blood) is a classic finding in splenic injury due to subdiaphragmatic hemorrhage.

  6. A patient presents with projectile vomiting, visible peristaltic waves, and a palpable olive-shaped mass in the epigastrium at 3 weeks of age. The diagnosis is:

    Answer: Pyloric stenosis

    Hypertrophic pyloric stenosis classically presents at 3–6 weeks with non-bilious projectile vomiting, visible peristalsis, and a palpable pyloric 'olive'; labs show hypochloremic hypokalemic metabolic alkalosis.