Multiple Choice Questions (MCQ)

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Category: Emergency Medicine--->Surgical Emergencies
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Question 1# Print Question

Regarding appendicitis, which ONE of the following statements is most CORRECT?

A. Pain may be localized to the flank or right upper quadrant
B. Obturator sign is positive when pain is elicited on external rotation of the hip
C. A patient with a MANTRELS score of <7 should be referred for surgery
D. The perforation rate is high between the ages of 5 and 60 years

Question 2# Print Question

Which ONE of the following is the MOST LIKELY diagnosis for a 68-year-old male who presents to the emergency department (ED) with a history of left lower quadrant abdominal pain and tenderness, low-grade fever and altered bowel habit?

A. Pyelonephritis
B. Irritable bowel syndrome
C. Sigmoid volvulus
D. Diverticulitis

Question 3# Print Question

An elderly patient with atrial fibrillation presents with acute severe abdominal pain, nausea and vomiting. Which ONE of the following would MOST support the diagnosis of acute mesenteric ischaemia?

A. Generalized abdominal pain, abdominal distension and last bowel movement 5 days ago
B. Fever, generalized abdominal pain that was localized to the right lower quadrant
C. Fever, generalized abdominal pain out of keeping with physical examination and pneumatosis intestinalis on abdominal X-ray
D. Fever, abdominal pain radiating to the back, bruising around the umbilical region and an elevated serum lipase

Question 4# Print Question

A 56-year-old male patient presents to the ED with acute abdominal pain. He is a smoker and takes aspirin for a heart condition. He has severe, constant epigastric pain that radiates to the left shoulder. He has associated vomiting but no haematemesis. On examination his vital signs are HR 104, BP 135/89, RR 22, temp 37.2°. He has rebound tenderness on palpation of the abdomen. Erect chest X-ray (CXR) demonstrates a small amount of free air under the diaphragm.

Which ONE of the following describes the MOST appropriate management?

A. Nil by mouth, IV access, 2 L IV crystalloid stat, analgesia and urgent upper abdominal ultrasound scan (USS)
B. Nil by mouth, IV access, fluid resuscitate to maintain adequate blood pressure, IV analgesia, antiemetic, nasogastric tube (NGT), urgent CT scan and surgical referral
C. Nil by mouth, large bore IV access, IV analgesia, triple antibiotics and transfer to theatre for urgent laparotomy
D. Nil by mouth, IV fluids to maintain adequate BP, NGT insertion, IV analgesia, antiemetic, IV esomeprazole, triple antibiotics and urgent surgical referral

Question 5# Print Question

What ONE of the following is the MOST common cause of small bowel obstruction (SBO) in the adult population?

A. Inflammatory bowel disease
B. Adhesions
C. Intussusception
D. Hernia

Category: Emergency Medicine--->Surgical Emergencies
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