GAMSAT Clinical Procedures and Protocols 4

Question 1

A patient undergoing peritoneal dialysis develops cloudy effluent with abdominal pain. What is the most likely diagnosis?

Accepted Answer

Peritonitis

Answer

Cloudy peritoneal dialysis effluent with abdominal pain is the hallmark presentation of peritonitis, defined by effluent white cell count >100 cells/μL with >50% neutrophils.

Question 2

During a surgical procedure under general anesthesia, the patient develops sudden hypercapnia, muscle rigidity, and hyperthermia. Which drug should be administered immediately?

Accepted Answer

Dantrolene

Answer

Malignant hyperthermia triggered by volatile anesthetics or succinylcholine is treated with dantrolene, which prevents calcium release from the sarcoplasmic reticulum.

Question 3

When performing a fine needle aspiration of a thyroid nodule, which cytological result requires surgical excision according to the Bethesda classification?

Accepted Answer

Bethesda V (Suspicious for malignancy)

Answer

Bethesda V (suspicious for malignancy) carries a 60–75% malignancy risk and requires surgical excision, typically thyroidectomy.

Question 4

A patient receiving a blood transfusion develops flank pain, fever, and hemoglobinuria within 15 minutes. What is the most appropriate immediate action?

Accepted Answer

Stop the transfusion immediately and send blood samples

Answer

Acute hemolytic transfusion reaction due to ABO incompatibility requires immediate transfusion cessation, IV fluids, and return of blood products to the blood bank for investigation.

Question 5

During colonoscopy, which finding would necessitate immediate withdrawal of the scope and surgical consultation?

Accepted Answer

Sudden loss of air insufflation with patient pain

Answer

Sudden loss of insufflation with patient pain suggests bowel perforation, requiring immediate scope withdrawal and surgical assessment.

(GAMSAT) Graduate Medical School Admissions Test Practice Test

(GAMSAT) Graduate Medical School Admissions Test Practice Test

GAMSAT Clinical Procedures and Protocols 4