SMLE Surgery

Question 1

A 25-year-old male presents to the emergency department with right iliac fossa pain, anorexia, and rebound tenderness. His Alvarado score is 8. What is the most appropriate next step?

Accepted Answer

Immediate appendicectomy

Answer

Abdominal ultrasound

Answer

CT abdomen with contrast

Answer

Conservative management with antibiotics

Question 2

A 40-year-old female presents with a painless, mobile, well-circumscribed 2 cm breast lump. Ultrasound shows a solid, homogeneous mass. What is the most likely diagnosis?

Accepted Answer

Fibroadenoma

Answer

Breast carcinoma

Answer

Breast cyst

Answer

Phyllodes tumour

Question 3

A patient undergoes thyroidectomy and develops numbness around the mouth and carpopedal spasm 24 hours postoperatively. What is the most likely cause?

Accepted Answer

Hypocalcaemia from parathyroid damage

Answer

Recurrent laryngeal nerve injury

Answer

Wound haematoma

Answer

Thyroid storm

Question 4

A 60-year-old male presents with painless obstructive jaundice, weight loss, and a palpable non-tender gallbladder. What is the most likely diagnosis?

Accepted Answer

Pancreatic head carcinoma

Answer

Gallstone in the common bile duct

Answer

Hepatocellular carcinoma

Answer

Acute cholangitis

Question 5

What is the most appropriate initial fluid resuscitation for a 70 kg adult with a 40% total body surface area (TBSA) burn according to the Parkland formula?

Accepted Answer

11,200 mL Ringer's lactate in 24 hours

Answer

5,600 mL Ringer's lactate in 24 hours

Answer

5,600 mL normal saline in 24 hours

Answer

2,800 mL Ringer's lactate in 24 hours

Question 6

A 50-year-old man presents with sudden severe abdominal pain. Examination reveals a rigid, board-like abdomen with absent bowel sounds. Erect chest X-ray shows free air under the diaphragm. What is the most likely diagnosis?

Accepted Answer

Perforated peptic ulcer

Answer

Acute pancreatitis

Answer

Acute intestinal obstruction

Answer

Mesenteric ischaemia