Surgery Board Exam Started: Jul 14, 2026 01:44 Page 29 of 59 Attempt #3036 Overall: 0 / 295 questions answered Question 141 / 295 Not answered During ward handover: a 45-year-old woman presents with pain out of proportion with metabolic acidosis. Relevant risk context includes prior abdominal surgery. What is the most likely diagnosis? A. Acute calculous cholecystitis B. Perforated peptic ulcer C. Small bowel obstruction D. Acute mesenteric ischemia E. Acute appendicitis Show Answer & Explanation Correct Answer: D Explanation: The pattern of pain out of proportion with metabolic acidosis with risk factors such as prior abdominal surgery is most consistent with Acute mesenteric ischemia. This answer best matches the expected diagnostic framework for Surgery. Reference: WSES Guidelines; Surgery topic-specific current guideline update Comments & Discussion No comments yet. Be the first to comment! Your Name * Your Comment * (Max 200 chars) 200 characters remaining Post Comment Comments remaining this hour: 10/10 Question 142 / 295 Not answered During morning rounds: a 69-year-old woman is evaluated for sudden severe epigastric pain with peritonism in the context of NSAID use. Which is the most appropriate next investigation? A. Erect chest imaging for free air B. Contrast-enhanced CT abdomen C. Intraoperative culture when indicated D. Abdominal ultrasound E. Lactate and perfusion assessment Show Answer & Explanation Correct Answer: A Explanation: Erect chest imaging for free air is the most appropriate next test because it directly clarifies the leading diagnosis and guides immediate management in Surgery. Reference: Tokyo Guidelines for Cholecystitis Comments & Discussion No comments yet. Be the first to comment! Your Name * Your Comment * (Max 200 chars) 200 characters remaining Post Comment Comments remaining this hour: 10/10 Question 143 / 295 Not answered In an emergency department assessment: a 70-year-old man has right lower quadrant pain migrating from periumbilical area with risk profile of vascular disease. After initial stabilization and assessment, what is the most appropriate management step? A. Timely operative consultation B. Resuscitation and electrolyte correction C. Early sepsis management in surgical infection D. Source control with appropriate antibiotics E. Postoperative complication surveillance Show Answer & Explanation Correct Answer: E Explanation: Postoperative complication surveillance is preferred because it aligns with guideline-based care priorities, reduces avoidable complications, and supports safe outcomes in Surgery. Reference: WSES Guidelines; Surgery topic-specific current guideline update Comments & Discussion No comments yet. Be the first to comment! Your Name * Your Comment * (Max 200 chars) 200 characters remaining Post Comment Comments remaining this hour: 10/10 Question 144 / 295 Not answered At a preventive-care consultation: a 30-year-old man presents with right upper quadrant pain with Murphy sign. Relevant risk context includes vascular disease. What is the most likely diagnosis? A. Perforated peptic ulcer B. Acute appendicitis C. Postoperative surgical site infection D. Small bowel obstruction E. Acute mesenteric ischemia Show Answer & Explanation Correct Answer: D Explanation: The pattern of right upper quadrant pain with Murphy sign with risk factors such as vascular disease is most consistent with Small bowel obstruction. This answer best matches the expected diagnostic framework for Surgery. Reference: Tokyo Guidelines for Cholecystitis Comments & Discussion No comments yet. Be the first to comment! Your Name * Your Comment * (Max 200 chars) 200 characters remaining Post Comment Comments remaining this hour: 10/10 Question 145 / 295 Not answered During morning rounds: a 82-year-old woman is evaluated for wound erythema with purulent drainage in the context of immunosuppression. Which is the most appropriate next investigation? A. Lactate and perfusion assessment B. Focused abdominal exam with inflammatory markers C. Intraoperative culture when indicated D. Erect chest imaging for free air E. Contrast-enhanced CT abdomen Show Answer & Explanation Correct Answer: A Explanation: Lactate and perfusion assessment is the most appropriate next test because it directly clarifies the leading diagnosis and guides immediate management in Surgery. Reference: WSES Guidelines; Surgery topic-specific current guideline update Comments & Discussion No comments yet. Be the first to comment! Your Name * Your Comment * (Max 200 chars) 200 characters remaining Post Comment Comments remaining this hour: 10/10 Cancel « ← Previous Page 29 of 59 Next → »