General Surgery Board Review Surgical Foundation 4

Question 1

A patient with a known splenic artery aneurysm is 28 weeks pregnant. What is the threshold for repair?

Accepted Answer

Diameter ≥ 2 cm

Answer

Splenic artery aneurysms ≥2 cm in women of childbearing age or pregnant patients warrant repair due to high rupture risk during pregnancy.

Question 2

Which condition is characterized by right lower quadrant pain, CT showing fat stranding at the terminal ileum, and no bowel wall thickening?

Accepted Answer

Mesenteric adenitis

Answer

Mesenteric adenitis presents with RLQ pain, mesenteric lymph node enlargement on CT, and normal bowel wall, often associated with viral illness.

Question 3

The Hartmann's procedure is defined as?

Accepted Answer

End colostomy with oversewn rectal stump

Answer

Hartmann's procedure resects the sigmoid colon, creates an end colostomy, and oversews the rectal stump — used when primary anastomosis is unsafe.

Question 4

Which electrolyte abnormality is most commonly associated with massive blood transfusion?

Accepted Answer

Hyperkalemia and hypocalcemia

Answer

Massive transfusion causes hyperkalemia from RBC lysis and hypocalcemia from citrate chelation in stored blood.

Question 5

A 70-year-old develops fever, tachycardia, and right upper quadrant pain 5 days after laparoscopic cholecystectomy. CT shows a 4 cm fluid collection in the gallbladder fossa. Best next step?

Accepted Answer

Percutaneous CT-guided drainage

Answer

A postoperative biloma or abscess in the gallbladder fossa is best managed with percutaneous image-guided drainage and antibiotics.

General Surgery Board Review Practice Test

General Surgery Board Review Practice Test

General Surgery Board Review Surgical Foundation 4