Surgery final

A 40 years old patients came to the Emergency Department complaining of a colicky right hypochondrial pain, radiating to the right scapula. The pain started two days ago. The patient reports vomiting and fever up to 40 degrees Celsius. On physical exam the right hypochondrial area is tender to touch. Lab tests reveal bilirubin level 4.5 mg/dl. The symptoms and signs mentioned above are typical for:

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We describe Leriche’s syndrome as concomitant arterial occlusion of:

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Early gastric cancer is:

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Incidentaloma means:

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Liver metastases are the most common in the malignancy of:

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A 65 year old female patient has been admitted to the Emergency Department following an incident of syncope. On admission she confessed to general weakness, increased heart rate and worse tolerance of exercise, lasting several weeks. Her husband added she had been rather pale for a few days. The patient said that for several months she had no appetite and occasionally felt abdominal pain, mostly in the right lower quadrant. She negated seeing any signs of gastrointestinal bleeding. On physical exam the abdomen is soft, painless, with no peritoneal signs and no palpable masses. Per rectum: normal stool. In lab tests HGB 4,0 g/dl and iron deficiency. The patient was admitted to the Internal Department and after blood transfusion her condition improved. Does she need any further diagnostics?

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A 75 years old patient with a history of chronic atrial fibrillation complains of a sudden onset pain of the right lower limb. On physical exam, pallor and cooling of the right leg is found, along with an absent pulse over the right popliteal artery. The correct management is:

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A 35 year old biker has been brought to the Emergency Department from a road accident. The patient is unconscious. On physical examination: abdomen rigid, HR 140/min, BP 60/40 mmHg, no breath sounds audible over the left chest side. On FAST fluid is present in the peritoneal cavity. Quick blood gas sampling shows HBG 6,5 g/dl. What should be the right sequence of management?

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Acute ischemia of the lower extremities can be caused by:

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A 22 years old pregnant women, first pregnancy, 11th week, has been admitted as an emergency to the surgery department with acute appendicitis confirmed clinically and in lab tests. The best management is:

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Atrial fibrillation is the most common cause of:

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The indication for livertransplantation is not:

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Partial gastric resection with an end-to-end anastomosis of the stomach stump to the duodenum is called:

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Painless, palpable enlarged gallbladder is called:

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A patient with a persistent atrial fibrillation felt a sharp pain in his leg.The called doctor stated that the right lower limb is pale and cool. The patient has limited limb movement and feeling on it. There is no pulse eon his foot. The doctor called an ambulance. Before the patient is in the hospital, the most important for his urgent treatment is:

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In case of bleeding esophageal varices, when endoscopic control was unsuccessful or unavailable, the most effective control of bleeding can be achieved by:

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The 75-year-old man suddenly fainted. He is pale and sweaty, HR is 130/min, BP is 80/40 mmHg. He complains of pain in the epigastric region and in the lumbar region. The first thing to do is:

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In the case of brain death, an absolute contraindication to organs removal for transplantation purposes is:

1. 1)  Fact that the deceased before his death expressed his objection to taking the organs after his death for transplantation purposes

2. 2)  No family consent

3. 3)  Gallbladder cancer

4. 4)  Death as a result of a murder

5. 5)  Death as a result of suicide

   The correct answer is:

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A surgical procedure that consists in resection of a pathological lesion of the distal bowel, followed by closing the proximal rectal stump creating a sigmoidostomy is called:

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A 30 years old male patient has head injury due to a fall from a height. On arrival you find: the patient is disoriented, opens eyes in response to voice, localizes to painful stimuli. Evaluate him according to Glasgow Coma Scale and state indications to endotracheal intubation.

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In case of finding a non-resectable tumor of the pancreatic head, that causes obstructive jaundice and compression of the duodenum, the best palliative surgical management is:

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A 35 years old male patient has been brought to the Emergency Department from a road accident.On admission the patient is conscious, disoriented, GSC 14, reports strong abdominal pain. On physical examination: skin pallor, abdomen tender to touch with no peritoneal signs. BP 80/60, HR 120/min. Quick blood gas sampling shows HGB 7.4 g/dl. On FAST fluid is present in the peritoneal cavity. The patient’s condition is deteriorating. What should be the surgeon’s decision?

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A 50 years old male patient reports vomiting and colicky abdominal pain, lasting two days. On plain abdominal x-ray the radiologist describes multiple air-fluid levels, corresponding to intestinal obstruction. On physical exam the abdomen is tender to touch, distended, no peritoneal signs, metallic bowel sounds audible. The patient has been passing scarce watery stools. The next step in diagnosing should be:

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A 75 years old male patient has been admitted to the Ophthalmology Department to have cataract surgery. On the day before planned eye surgery he reported severe abdominal pain, radiating to the back and scrotum. After several minutes the patient’s condition suddenly deteriorated. On physical exam, hypotension, tachycardia, disturbed consciousness, and skin pallor were found. The ophthalmologist also found abdominal tenderness and bruising of the scrotum. What is the most probable diagnosis?

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Lichtenstein’s inguinal hernia repair means:

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Thyroidectomy may be complicated with:

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Klatskin tumor means:

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Choose the TRUE statement about gastric carcinoma:

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Richter’s hernia means:

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