Free General Surgery Board Review MCQ Question and Answer

Question 1

A 45-year-old male with HIV has a septoplasty to correct a deviated nasal septum. Which exposure method entails the highest risk of occupational HIV exposure?

Accepted Answer

Needle stick

Answer

Needle stick injuries carry the highest risk of occupational HIV exposure because they involve direct percutaneous inoculation of blood. This allows for efficient transfer of the virus into the bloodstream, bypassing the protective barriers of intact skin or mucous membranes. Other exposure routes, while carrying some risk, are generally less efficient in transmitting the virus.

Question 2

A male patient, 48 years old, is getting a kidney transplant. After the new kidney has been connected to the patient's vascular supply and implanted, the surgeon immediately notices that the organ is not receiving adequate blood flow. The blood type of the donor is B-negative. in contrast to the O-positive receiver.
What is causing the ischemia event, out of the following?

Accepted Answer

Type II hypersensitivity reaction

Answer

This scenario describes an ABO incompatibility, where an O-positive recipient (who has anti-A and anti-B antibodies) receives a B-negative kidney. The recipient's pre-existing antibodies immediately attack the donor kidney's B antigens, leading to hyperacute rejection. This rapid, antibody-mediated destruction of the graft is a classic example of a Type II hypersensitivity reaction.

Question 3

A 25-year-old guy who has mixed internal and exterior hemorrhoids that are refractory to medical therapy has a 3 column excisional hemorrhoidectomy. He experiences suprapubic soreness and the inability to urinate later that evening.
Which of the following factors most likely caused this complication?

Accepted Answer

Performing 3 quadrant hemorrhoidectomy instead of 2

Answer

Postoperative urinary retention is a common complication after hemorrhoidectomy, often exacerbated by the extent of surgical trauma. Performing a 3-quadrant hemorrhoidectomy involves more extensive dissection and tissue manipulation compared to a 2-quadrant procedure. This increased surgical insult can lead to greater pain, inflammation, and reflex spasm of the pelvic floor muscles, thereby increasing the risk of urinary retention.

Question 4

Despite surgical hemostasis and weaning from cardiopulmonary bypass, a patient continues to hemorrhage. After bypass, a thromboelastograph trace demonstrates a prolonged r-time (reaction time).
Which of the following fits this result the best?

Accepted Answer

Coagulation factor deficiency

Answer

A prolonged r-time (reaction time) on a thromboelastograph (TEG) indicates a delay in the initial formation of the clot. This parameter specifically reflects the activity and availability of coagulation factors. Therefore, a prolonged r-time strongly suggests a deficiency or impaired function of these essential factors, which are necessary for initiating the coagulation cascade.

Question 5

Grade 2 hemorrhoids disease with prolapse and sporadic bleeding are present in a 45-year-old female with a known history of ileocolic Crohn's disease. Which of the following should be carried out before suggesting office-based or surgical treatment?

Accepted Answer

Flexible proctosigmoidoscopy

Answer

In a patient with Crohn's disease presenting with hemorrhoidal symptoms, it is crucial to first rule out other perianal manifestations of Crohn's, such as fissures, fistulas, or proctitis. Flexible proctosigmoidoscopy allows for direct visualization of the distal colon and rectum, enabling accurate diagnosis. This prevents misdiagnosis and avoids potentially harmful surgical interventions for hemorrhoids that could complicate underlying inflammatory bowel disease.

General Surgery Board Review Practice Test

General Surgery Board Review Practice Test

Free General Surgery Board Review MCQ Question and Answer