General Surgery Board Review General Surgery Board Review Perioperative Care & Complications 2

Question 1

What is the most appropriate immediate treatment for suspected malignant hyperthermia intraoperatively?

Accepted Answer

Administer dantrolene 2.5 mg/kg IV immediately

Answer

Dantrolene 2.5 mg/kg IV is the specific antidote for malignant hyperthermia; it inhibits ryanodine receptor-mediated calcium release from the sarcoplasmic reticulum.

Question 2

Enhanced Recovery After Surgery (ERAS) protocols reduce surgical stress and hospital length of stay primarily through which mechanism?

Accepted Answer

Multimodal, evidence-based care bundles reducing physiologic stress response

Answer

ERAS bundles combine preoperative, intraoperative, and postoperative evidence-based interventions (early oral feeding, opioid-sparing analgesia, early mobilization) to blunt surgical stress.

Question 3

Intraoperative hypotension following pneumoperitoneum establishment in laparoscopic surgery is most commonly caused by:

Accepted Answer

Decreased venous return from elevated intra-abdominal pressure

Answer

Elevated intra-abdominal pressure from pneumoperitoneum compresses the inferior vena cava, reducing venous return and cardiac preload, causing hypotension.

Question 4

The Pringle maneuver controls hepatic inflow during liver surgery by clamping which structure?

Accepted Answer

Hepatoduodenal ligament containing the portal triad

Answer

The Pringle maneuver involves manual or vascular clamp occlusion of the hepatoduodenal ligament, which contains the portal vein, hepatic artery, and common bile duct, temporarily halting hepatic inflow.

Question 5

Per current Surviving Sepsis Campaign guidelines, which fluid is recommended as first-line resuscitation in septic shock?

Accepted Answer

Crystalloid (balanced solutions or normal saline) as first line

Answer

Crystalloids (30 mL/kg IV) are the first-line resuscitation fluid in septic shock per SSC guidelines; balanced crystalloids like lactated Ringer's are preferred over normal saline to reduce hyperchloremic acidosis.

General Surgery Board Review Practice Test

General Surgery Board Review Practice Test

General Surgery Board Review General Surgery Board Review Perioperative Care & Complications 2