SPEX Surgery 2

Question 1

A patient undergoes a Whipple procedure (pancreaticoduodenectomy). Which structure is NOT routinely resected during this operation?

Accepted Answer

Splenic flexure of the colon

Answer

The Whipple procedure removes the pancreatic head, duodenum, common bile duct, gallbladder, and often the distal stomach, but the splenic flexure is not part of this resection.

Question 2

Which nerve injury during thyroid surgery results in hoarseness and is the most common laryngeal nerve complication?

Accepted Answer

Recurrent laryngeal nerve

Answer

Recurrent laryngeal nerve injury causes hoarseness (unilateral) or aphonia/airway compromise (bilateral) and is the most feared complication of thyroidectomy.

Question 3

A 65-year-old presents with a pulsatile abdominal mass and abdominal pain radiating to the back. BP is 90/60 mmHg. What is the most appropriate next step?

Accepted Answer

Immediate operative intervention

Answer

A hemodynamically unstable patient with suspected ruptured AAA requires immediate surgical intervention without delay for imaging studies.

Question 4

Which of the following is the preferred initial treatment for acute calculous cholecystitis in a surgically fit patient?

Accepted Answer

Early laparoscopic cholecystectomy (within 72 hours)

Answer

Early laparoscopic cholecystectomy within 72 hours of symptom onset is now the preferred treatment for acute calculous cholecystitis in fit patients, with lower morbidity than delayed surgery.

Question 5

In Hartmann's procedure for perforated sigmoid diverticulitis, which of the following best describes the operation?

Accepted Answer

Sigmoid resection, end colostomy, and oversewn rectal stump

Answer

Hartmann's procedure involves sigmoid resection, creation of an end colostomy, and closure of the rectal stump, avoiding a primary anastomosis in an unstable, contaminated field.

SPEX Exam Practice Test

SPEX Exam Practice Test

SPEX Surgery 2