General Surgery Board Review Surgical Foundation 5

Question 1

Which phase of wound healing is characterized by collagen synthesis and fibroblast proliferation?

Accepted Answer

Proliferative phase

Answer

The proliferative phase (days 4–21) features fibroblast migration, collagen deposition, angiogenesis, and epithelialization.

Question 2

A patient with a pulsatile abdominal mass and hypotension arrives to the ER. CT confirms a 7 cm ruptured AAA. Next step?

Accepted Answer

Emergent transfer to operating room

Answer

Hemodynamically unstable ruptured AAA requires immediate OR transfer; delaying for imaging in an unstable patient is lethal.

Question 3

Which intraoperative finding mandates conversion from laparoscopic to open cholecystectomy?

Accepted Answer

Inability to achieve the critical view of safety

Answer

Failure to achieve the critical view of safety is the definitive indication to convert, because proceeding without it risks misidentification and bile duct injury.

Question 4

A 45-year-old presents with fever, jaundice, and RUQ pain (Charcot's triad). Blood cultures grow gram-negative rods. The addition of altered mental status and hypotension describes which condition?

Accepted Answer

Reynolds' pentad (acute suppurative cholangitis)

Answer

Reynolds' pentad adds hypotension and altered mental status to Charcot's triad and indicates severe suppurative cholangitis requiring urgent biliary decompression.

Question 5

During a right hemicolectomy, which structure is at highest risk of inadvertent injury when dividing the mesentery at the base?

Accepted Answer

Right ureter

Answer

The right ureter crosses the iliac vessels and runs medially toward the pelvis; it must be identified and protected during right colon mesenteric dissection.

General Surgery Board Review Practice Test

General Surgery Board Review Practice Test

General Surgery Board Review Surgical Foundation 5