03.2010 surgery

A patient with a nonobstructing carcinoma of the sigmoid colon is being prepared for elective resection. Which of the following reduces the risk of postoperative infectious complications?

A 36-year-old man presents to the emergency room with renal colic. His vital signs are normal and a urinalysis shows microscopic hematuria. A radiograph reveals a 1.5-cm stone. Which of the following is the most appropriate management of this patient?

A 68-year-old man is admitted to the coronary care unit with an acute myocardial infarction. His postinfarction course is marked by congestive heart failure and intermittent hypotension. On the fourth day in hospital, he develops severe midabdominal pain. On physical examination, blood pressure is 90/60 mm Hg and pulse is 110 beats per minute and regular; the abdomen is soft with mild generalized tenderness and distention. Bowel sounds are hypoactive; stool Hematest is positive. Which of the following is the most appropriate next step in this patient’s management?

25 years old with a painful full penis erection for several hours. Which of the next statements are true?

A 65-year-old man undergoes a low anterior resection for rectal cancer. On the fifth day in hospital, his physical examination shows a temperature of 39°C (102°F), blood pressure of 150/90 mm Hg, pulse of 110 beats per minute and regular, and respiratory rate of 28 breaths per minute. A computed tomography (CT) scan of the abdomen reveals an abscess in the pelvis. Which of the following most accurately describes his present condition?

In 65 years old man what is the best test for differential diagnosis between septic arthritis and gout?

A cirrhotic patient with abnormal coagulation studies due to hepatic synthetic dysfunction requires an urgent cholecystectomy. A transfusion of FFP is planned to minimize the risk of bleeding due to surgery. What is the optimal timing of this transfusion?

A 60 years old male was admitted for severe right abdominal pain,body temperature is 37 c.ultrasounography shows an aconstic shadow in the common bile duct.tis condition is commonly associated with:

A 42-year-old man sustains a gunshot wound to the abdomen and is in shock. Multiple units of packed red blood cells are transfused in an effort to resuscitate him. He complains of numbness around his mouth and displays carpopedal spasm. An electrocardiogram demonstrates a prolonged QT interval. Which of the following is the most appropriate treatment?

When choledocholithiasis is suspected by abdominal ultrasound the next most appropriate test or procedure will be:

A teenage boy falls from his bicycle and is run over by a truck. On arrival in the emergency room (ER), he is awake and alert and appears frightened but in no distress. The chest radiograph suggests an air-fluid level in the left lower lung field and the nasogastric tube seems to coil upward into the left chest. Which of the following is the next best step in his management?

A 70 year old man had abdominal ultrasound for the follow up of an abdominal aortic aneurism .the presence of stones in the gallbladder is indentified.the patient suffers from some low back discomfort only, which is thought to be attributed to the aneurysm. the appropriate next step in managing the gallstones is:

A 65-year-old man who smokes cigarettes and has chronic obstructive pulmonary disease falls and fractures the third, fourth, and fifth ribs in the left anterolateral chest. Chest x-ray is otherwise normal. Which of the following would be the most appropriate next step in his management?

A 49 years old man was the restrained driver in a motor vehicle collision. He decelerated rapidly in order to avoid hitting another car and swerved into a ditch. He complains of chest pain. Which of the following finding on chest X-ray would be most suspicious for an aortic injury?

A 36-year-old man who was hit by a car presents to the ER with hypotension. On examination, he has tenderness and bruising over his left lateral chest below the nipple. An ultrasound examination is performed and reveals free fluid in the abdomen. What is the most likely organ to have been injured in this patient?

The optimal time to give immunization to patients undergoing elective splenectomy is:

An 18-year-old man was assaulted and sustained significant head and facial trauma. Which of the following is the most common initial manifestation of increased intracranial pressure?

Spigelian hernias occur:

What statement is regarding the treatment of pancreatic carcinoma?

A 16 year old girl undergoes total colectomy for familial adenomatous polyposis (FAP).two years later ,there is a 4 cm asymptomatic abdominal wall mass in the incision. the appropriate management is:

A 32-year-old woman undergoes an uncomplicated appendectomy for acute appendicitis. The pathology report notes the presence of a 1-cm carcinoid tumor in the tip of the appendix. Which of the following is the most appropriate management of this patient?

Symptoms of retroperitoneal sarcoma are usually produced by:

An 88-year-old man with a history of end-stage renal failure, severe coronary artery disease, and brain metastases from lung cancer presents with acute cholecystitis. His family wants “everything done”. The best management option in this patient would be

Twelve hours after having undergone a subtotal thyroidectomy ,a 30 year old woman develops agitation and difficulty breathing.examination reveals tachycardia and anterior cervical swelling. the surgical dressing is dry. the most appropriate treatment at this point would be immediate:

What complication is associated with pancreatectomy?

The treatment of choice for a 1.8 cm in diameter N0,M0 invasive breast cancer in 50 years old women is:

What statement is true regarding hepatic hemangioma?

A 75-year-old man is found by his internist to have an asymptomatic carotid bruit. Which of the following is the most appropriate next test?

Five days after an uneventful cholecystectomy, an asymptomatic middle-aged woman is found to have a serum sodium level of 125 mEq/L. Which of the following is the most appropriate management strategy for this patient?

A 64-year-old man presents with a history of a triple coronary artery bypass 2 years ago. His only medication is a thiazide diuretic. You are considering administration of antiplatelet therapy. Which of the following statements concerning antiplatelet therapy is correct?