General Surgery

Question 1

At what age should Hemoccult testing begin?

Answer 1

Annually >50y (Grade A)

Question 2

When should flexible sigmoidoscopy begin in FAP?

Answer 2

Annually at puberty (Grade B)

Question 3

When to begin colonoscopy in HNPCC?

Answer 3

Start at 40y or 10y before index case; repeat q5y

Question 4

What if patient has polyps on colonoscopy?

Answer 4

Repeat at 3y; if normal, q5y

Question 5

Key features of Cholecystitis?

Answer 5

Steady RUQ/epigastric pain, fever, N/V, Murphy’s sign, often post-fatty meal

Question 6

Differential diagnosis for Cholecystitis?

Answer 6

Biliary colic, ascending cholangitis, choledocholithiasis, PUD, pancreatitis, hepatitis, RLL pneumonia, pyelo

Question 7

Common complications of Cholecystitis?

Answer 7

Empyema, perforation, gallbladder ileus, cholangitis, sepsis, pancreatitis

Question 8

Management of Cholecystitis?

Answer 8

Ceftriaxone 1g IV q24h + Metronidazole 500 mg IV q8h → cholecystectomy

Question 9

Best initial investigation for Cholecystitis?

Answer 9

RUQ ultrasound

Question 10

Classic differential diagnosis in a young male construction worker with acute abdomen?

Answer 10

Appendicitis, cholecystitis, SBO

Question 11

Imaging if unsure in acute abdomen?

Answer 11

CT or US

Question 12

If investigations negative but pain persists in acute abdomen?

Answer 12

Admit & monitor; consider exploratory laparoscopy if worsening

Question 13

Differential diagnosis in an 81y with peritonitis?

Answer 13

Perforated viscus, diverticulitis, appendicitis, ischemic colitis, volvulus, splenic rupture

Question 14

Labs & imaging for elderly with surgical abdomen?

Answer 14

CBC, lactate, 3-view abdo x-ray, LFTs, bili

Question 15

4 common causes of Chronic Pelvic Pain?

Answer 15

Adhesions, endometriosis, IBS, interstitial cystitis

Question 16

Helpful therapies for Chronic Pelvic Pain?

Answer 16

GnRH agonists (fibroids/endometriosis), exercise, bulk agents

Question 17

Important differential diagnosis for RLQ Pain in a 25y Female?

Answer 17

Ectopic pregnancy, appendicitis, PID, ovarian torsion, SBO

Question 18

Key labs for RLQ Pain in a 25y Female?

Answer 18

β-hCG, CBC, vaginal swabs, urinalysis