1 | P a g e PAEA GENERAL SURGERY EOR EXAM NEWEST 2024 ACTUAL EXAM 300 QUESTIONS AND CORRECT DETAILED ANSWERS (VERIFIED ANSWERS) |ALREADY GRADED A+ When evaluating a 65-year-old man with scleral icterus, you note a positive Courvoisier sign on abdominal examination. What is the most likely diagnosis? A) Acute cholangitis B) Alcoholic hepatitis C) Cholecystitis D) Pancreatic malignancy - ANSWER- D) Pancreatic malignancy Rationale: Courvoisier sign = painless, palpable gallbladder in the RUQ A 32-year-old woman presents to the emergency department reporting nausea, vomiting, and intermittent, cramping abdominal pain. There is abdominal tenderness to palpation of the right upper quadrant and epigastric areas but no other abnormalities on physical exam. A pulse of 112 beats per minute, blood pressure 158/94 mm Hg, and temperature 98.6°F are noted. Mildly elevated serum amylase, lipase, alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, and conjugated bilirubin are noted on lab analysis. Ultrasound reveals a dilated common bile duct of 0.6 cm but normal gallbladder wall 2 | P a g e thickness and no gallstones in the lumen. What is the most likely diagnosis? A) Cholangitis B) Choledocholithiasis C) Cholelithiasis D) Perihepatitis - ANSWER- B) Choledocholithiasis A 70-year-old man with hypertension presents to the ED with sudden onset of sharp stabbing pain in the middle of his chest radiating to his back for the past two hours. Vital signs are pulse 100 beats per minute, blood pressure 150/60 mm Hg, oxygen saturation 98%, temperature 98.8°F, and 20 respirations per minute. Exam reveals a decrescendo diastolic murmur at the right sternal border. Electrocardiogram does not show any ischemic changes and chest X-ray reveals a widened mediastinum. Which of the following is the most likely diagnosis? A) Acute pericarditis B) Aortic dissection C) Myocardial infarction D) Pulmonary embolism - ANSWER- B) Aortic dissection A 64-year-old woman presents to the emergency department complaining of a yellow tint to her eyes and skin. She states that this began approximately one month prior and has become progressively worse. She also has constant gnawing upper abdominal pain, which is worse at night. Additionally, she reports a 15-pound weight loss over the past few months, generalized weakness, dark urine, and pruritus. Physical exam confirms the presence of diffuse jaundice, scleral icterus, 3 | P a g e and pain on palpation of the epigastrium and right upper quadrant. Laboratory tests reveal elevated serum bilirubin and alkaline phosphatase levels. Bedside transabdominal ultrasound is performed and reveals a pancreatic mass. Which of the following is the most appropriate next step to assess disease extent and resectability? A) Contrast-enhanced abdominal computed tomography B) Echoendoscope-guided fine needle aspiration biopsy C) Endoscopic retrogra - ANSWER- A) Contrast-enhanced abdominal computed tomography A 64-year-old man presents for evaluation of a lesion on the face. It has been present for the past six months. He has tried treating it with various over-the-counter ointments without any success. Physical examination reveals a flesh-colored papule that has a pearly quality. Telangiectatic vessels are noted within the papule. Which of the following is the most likely diagnosis? A) Basal cell carcinoma B) Melanoma C) Molluscum contagiosum D) Squamous cell carcinoma - ANSWER- A) Basal cell carcinoma A 40 year-old-man presents to the emergency department reporting continuous, severe pain in the left groin for four hours. He has vomited three times since the onset of pain. On exam, he has a tender left inguinal hernia with slight erythema of the overlying skin, as well as abdominal tenderness and guarding. His temperature is 101.1°F. What is the best treatment? 4 | P a g e A) Analgesia and antibiotics B) Manual reduction C) Surgical repair D) Truss application - ANSWER- C) Surgical repair A 35-year-old woman presents to the clinic with palpitations, tremors, and diffuse sweating. Which of the following is used in the diagnosis of hyperthyroidism? A) ACTH stimulation test B) Comprehensive metabolic panel C) Plasma cortisol level D) Thyroid-stimulating hormone - ANSWER- D) Thyroid-stimulating hormone Which of the following characterizes acute bowel obstruction in a patient experiencing postoperative complications? A) Mechanical obstruction is rarely caused by postoperative adhesions B) Most postoperative bowel obstructions are partial and resolve spontaneously C) Nearly half of cases are in patients experiencing an acute cholecystectomy D) Strangulation is common early on due to tight adhesive bands - ANSWER- B) Most postoperative bowel obstructions are partial and resolve spontaneously https://learnexams.com/search/study?query=