An 80-year-old man is admitted to the hospital complaining of nausea, abdominal pain, distention, and diarrhea. A cautiously performed transanal contrast study reveals an apple-core configuration in the rectosigmoid area. Which of the following is the most appropriate next step in his management?
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Question 2 of 47
2. Question
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?
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Question 3 of 47
3. Question
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?
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Question 4 of 47
4. Question
The most common bening lesion in the liver is:
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Question 5 of 47
5. Question
What percentage of breast cancers are caused by mutation in the BRCA gene?
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Question 6 of 47
6. Question
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?
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Question 7 of 47
7. Question
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?
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Question 8 of 47
8. Question
The most appropriate treatment of a woman with lobular carcinoma in situ (LCIS) involving one quadrent is:
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Question 9 of 47
9. Question
A patient with spontanious eye opening,who is conFused and localizes pain has a Glasgow Coma Score (GCS) of:
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Question 10 of 47
10. Question
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?
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Incorrect
Question 11 of 47
11. Question
Which is of the following is a cause of cardiogenic shock in a trauma patient?
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Question 12 of 47
12. Question
Which of the following tumor markers is the best to monitor recurrence of colon cancer?
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Question 13 of 47
13. Question
The most common cause of acute cholecysitits is:
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Question 14 of 47
14. Question
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
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Question 15 of 47
15. Question
The treatment of choice for a 1.8 cm in diameter,N0,M0 invasive breast cancer is:
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Question 16 of 47
16. Question
The ideal time to give immunizations to patients undergoing elevtive splenectomy is:
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Question 17 of 47
17. Question
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
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Question 18 of 47
18. Question
Which of the following increase the risk of breast cancer:
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Question 19 of 47
19. Question
Spigelian hernias usually occur:
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Question 20 of 47
20. Question
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?
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Question 21 of 47
21. Question
The most appropriate treatment with DCIS involving 2 quadrents is:
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Question 22 of 47
22. Question
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?
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Question 23 of 47
23. Question
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?
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Incorrect
Question 24 of 47
24. Question
Which of the following is a true surgical emergency in a newborn:
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Question 25 of 47
25. Question
Which of the following is the most sensitive test for a pheochromocytoma?
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Incorrect
Question 26 of 47
26. Question
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?
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Question 27 of 47
27. Question
Which of the following is the best predictor of a singnificantly increased operative risk for coronary artery bypass surgery:
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Question 28 of 47
28. Question
A double bubble on an air contrast upper gastrointestinal series in an infant is characteristic of?
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Question 29 of 47
29. Question
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?
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Incorrect
Question 30 of 47
30. Question
The most effective treatment of achalasia is:
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Question 31 of 47
31. Question
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?
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Question 32 of 47
32. Question
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?
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Incorrect
Question 33 of 47
33. Question
Dieulafoyw’s lesion most commonly results in:
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Question 34 of 47
34. Question
Appropriate treatment for a single episode of microscopic hematuria is:
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Question 35 of 47
35. Question
A 39-year-old woman with no significant past medical history and whose only medication is oral contraceptive pills (OCP) presents to the emergency room with right upper quadrant pain. CT scan demonstrates a 6-cm hepatic adenoma in the right lobe of the liver. Which of the following describes the definitive treatment of this lesion?
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Incorrect
Question 36 of 47
36. Question
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:
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Question 37 of 47
37. Question
Transurethral resection of the prostate (TURP) syndrome after endoscopic resection of the prostate occurs because of:
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Question 38 of 47
38. Question
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?
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Incorrect
Question 39 of 47
39. Question
Which of the following is the most likely to harbor a colorectal cancer:
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Question 40 of 47
40. Question
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?
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Incorrect
Question 41 of 47
41. Question
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?
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Incorrect
Question 42 of 47
42. Question
The most common site of volvulus is:
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Question 43 of 47
43. Question
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?
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Question 44 of 47
44. Question
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?
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Question 45 of 47
45. Question
Which of the following is the most commonly confused with appendicitis in children:
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Question 46 of 47
46. Question
The standard surgical treatment of gastrointestinal stromal tumor (GIST) of the stomach is:
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Question 47 of 47
47. Question
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?