10.2010 surgery

A 32-year-old medical student notes an asymptomatic mass in his right testicle. On examination, the mass cannot be transilluminated. The urologist suspects seminoma. Seminoma is accurately described by which of the following statements?

A 32-year-old man is in a high-speed motorcycle collision and presents with an obvious pelvic fracture. On examination, he has a scrotal hematoma and blood at his urethral meatus. Which of the following is the most appropriate next step in his management?

The most common bening lesion in the liver is:

What percentage of breast cancers are caused by mutation in the BRCA gene?

A 52-year-old woman sees her physician with complaints of fatigue, headache, flank pain, hematuria, and abdominal pain. She undergoes a sestamibi scan that demonstrates persistent uptake in the right superior parathyroid gland at 2 hours. Which of the following laboratory values is most suggestive of her diagnosis?

Approximately 2 weeks after viral respiratory illness, an 18 month old child complains of abdominal pain passes some bloody mucus perrectum. A long, thin mass is palpable in the right upper quadrant of the abdomen. Intussusceptions is suspected. Correctstatements concerning Intussusception in infants include which of the following?

The most appropriate treatment of a woman with lobular carcinoma in situ (LCIS) involving one quadrent is:

A patient with spontanious eye opening,who is conFused and localizes pain has a Glasgow Coma Score (GCS) of:

Which is of the following is a cause of cardiogenic shock in a trauma patient?

Which of the following tumor markers is the best to monitor recurrence of colon cancer?

The most common cause of acute cholecysitits is:

A 24-year-old man is brought into the emergency department after a fall from a ladder. His breathing is labored and he is cyanotic. No breath sounds can be heard, even in the right lung field, which is resonant to percussion. The first step in his management should be

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

The ideal time to give immunizations to patients undergoing elevtive splenectomy is:

A 19-year-old man is admitted to the emergency department with a stab wound just below the right inguinal ligament. There is profuse bleeding from the wound and he is in shock. The first step in local wound control should be to

Which of the following increase the risk of breast cancer:

Spigelian hernias usually occur:

A 72-year-old man undergoes an aortobifemoral graft for symptomatic aortoiliac occlusive disease. The inferior mesenteric artery (IMA) is ligated at its aortic attachment. Twenty-four hours after surgery the patient has abdominal distention, fever, and bloody diarrhea. Which of the following is the most appropriate diagnostic study for this patient?

The most appropriate treatment with DCIS involving 2 quadrents is:

A newborn infant born from a mother with polyhydramnios presents with excessive salivation along with coughing and choking with the first oral feeding. An x-ray of the abdomen shows gas in stomach and a nasogastric tube coiled in the esophagus. Which of the following is the most likely diagnosis?

A 59-year-old woman presents with right lower quadrant pain, nausea, and vomiting. She undergoes an uncomplicated laparoscopic appendectomy. Postoperatively, the pathology reveals a 2.5-cm mucinous adenocarcinoma with lymphatic invasion. Staging workup, including colonoscopy, chest x-ray, and computed tomography (CT) scan of the abdomen and pelvis, is negative. Which of the following is the most appropriate next step in her management?

Which of the following is a true surgical emergency in a newborn:

Which of the following is the most sensitive test for a pheochromocytoma?

A 39-year-old previously healthy male is hospitalized for 2 weeks with epigastric pain radiating to his back, nausea, and vomiting. Initial laboratory values revealed an elevated amylase level consistent with acute pancreatitis. Five weeks following discharge, he complains of early satiety, epigastric pain, and fevers. On presentation, his temperature is 38.9°C (102°F) and his heart rate is 120 beats per minute; his white blood cell (WBC) count is 24,000/mm3 and his amylase level is normal. He undergoes a CT scan demonstrating a 6 cm by 6 cm rim-enhancing fluid collection in the body of the pancreas. Which of the following would be the most definitive management of the fluid collection?

Which of the following is the best predictor of a singnificantly increased operative risk for coronary artery bypass surgery:

A double bubble on an air contrast upper gastrointestinal series in an infant is characteristic of?

A 70-year-old woman has nausea, vomiting, abdominal distention, and episodic crampy midabdominal pain. She has no history of previous surgery but has a long history of cholelithiasis for which she has refused surgery. Her abdominal radiograph reveals a spherical density in the right lower quadrant. Which of the following is the definitive treatment for this patient’s bowel obstruction?

The most effective treatment of achalasia is:

After being injured by a bull on his mother’s farm, a young man is placed in a cast for a supracondylar fracture of his humerus. He begins to experience intense pain and weakness in the ipsilateral hand. Compartment pressures are measured and are markedly elevated. Which of the following statements regarding compartment syndromes following orthopedic injuries is true?

A 47-year-old asymptomatic woman is incidentally found to have a 5-mm polyp and no stones in her gallbladder on ultrasound examination. Which of the following is the best management option?

Dieulafoyw’s lesion most commonly results in:

Appropriate treatment for a single episode of microscopic hematuria is:

The initial diagnostic examination in a 50-year-old patient who is febrile and tender in the left lower quadrent of the abdomen should be:

Transurethral resection of the prostate (TURP) syndrome after endoscopic resection of the prostate occurs because of:

A 40-year-old woman notices a skin rash around her areola. There is an erosive area about the nipple. There is tenderness, itching, and intermittent bleeding. Which of the following statements is true regarding this entity?

Which of the following is the most likely to harbor a colorectal cancer:

A 65-year-old woman has a life-threatening pulmonary embolus 5 days following removal of a uterine malignancy. She is immediately heparinized and maintained in good therapeutic range for the next 3 days, then passes gross blood from her vagina and develops tachycardia, hypotension, and oliguria. Following resuscitation, an abdominal CT scan reveals a major retroperitoneal hematoma. Which of the following is the best next step in management?

A 61-year-old woman with a history of unstable angina complains of hematemesis after retching and vomiting following a night of binge drinking. Endoscopy reveals a longitudinal mucosal tear at the gastroesophageal junction, which is not actively bleeding. Which of the following is the next recommended step in the management of this patient?

The most common site of volvulus is:

A 59-year-old woman undergoes an exploratory laparotomy for peritonitis and is found to have perforated diverticulitis. She undergoes a sigmoid resection with an end colostomy. She is administered a third-generation cephalosporin within 1 hour prior to the incision and the antibiotic is continued postoperatively. One week later, she develops an intra-abdominal abscess, which is percutaneously drained. Bacteroides fragilis is isolated from the cultures. Which of the following statements regarding her perioperative antibiotic regimen is most accurate?

A 55-year-old man presents with fever and pain in the perineal region. Upon further questioning he also complains of frequency, urgency, dysuria, and a decreased urinary stream. On physical examination his abdomen is soft, nondistended, and nontender. Digital rectal examination demonstrates exquisite tenderness on the anterior aspect. Laboratory examination reveals leukocytosis and findings on urinalysis are consistent with a bacterial infection. Which of the following is the most likely diagnosis?

Which of the following is the most commonly confused with appendicitis in children:

The standard surgical treatment of gastrointestinal stromal tumor (GIST) of the stomach is:

A 55-year-old man complains of chronic intermittent epigastric pain. A gastroscopy demonstrates a 2-cm prepyloric ulcer. Biopsy of the ulcer yields no malignant tissue. After a 6-week trial of medical therapy, the ulcer is unchanged. Which of the following is the best next step in his management?