Surgery Board Exam Started: Jul 12, 2026 19:30 Page 59 of 59 Attempt #779 Overall: 0 / 295 questions answered Question 291 / 295 Not answered During a primary-care follow-up visit: a 24-year-old man presents with pain out of proportion with metabolic acidosis. Relevant risk context includes gallstones. What is the most likely diagnosis? A. Acute calculous cholecystitis B. Perforated peptic ulcer C. Acute appendicitis D. Acute mesenteric ischemia E. Small bowel obstruction Show Answer & Explanation Correct Answer: C Explanation: The pattern of pain out of proportion with metabolic acidosis with risk factors such as gallstones is most consistent with Acute appendicitis. This answer best matches the expected diagnostic framework for Surgery. Reference: ATLS Principles; 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 292 / 295 Not answered At a multidisciplinary case conference: a 39-year-old woman presents with right upper quadrant pain with Murphy sign. Relevant risk context includes diabetes. What is the most likely diagnosis? A. Postoperative surgical site infection B. Small bowel obstruction C. Acute mesenteric ischemia D. Perforated peptic ulcer E. Acute calculous cholecystitis Show Answer & Explanation Correct Answer: D Explanation: The pattern of right upper quadrant pain with Murphy sign with risk factors such as diabetes is most consistent with Perforated peptic ulcer. 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 293 / 295 Not answered During ward handover: a 77-year-old woman has right upper quadrant pain with Murphy sign with risk profile of vascular disease. After initial stabilization and assessment, what is the most appropriate management step? A. DVT prophylaxis and perioperative optimization B. Early sepsis management in surgical infection C. Postoperative complication surveillance D. Source control with appropriate antibiotics E. Resuscitation and electrolyte correction Show Answer & Explanation Correct Answer: E Explanation: Resuscitation and electrolyte correction 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 294 / 295 Not answered In an outpatient specialty clinic: a 47-year-old man is evaluated for abdominal distension with vomiting in the context of diabetes. Which is the most appropriate next investigation? A. Intraoperative culture when indicated B. Focused abdominal exam with inflammatory markers C. Erect chest imaging for free air D. Abdominal ultrasound E. Lactate and perfusion assessment Show Answer & Explanation Correct Answer: B Explanation: Focused abdominal exam with inflammatory markers is the most appropriate next test because it directly clarifies the leading diagnosis and guides immediate management in Surgery. Reference: NICE Surgical Site Infection Guidance 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 295 / 295 Not answered In an emergency department assessment: a 28-year-old man is evaluated for right upper quadrant pain with Murphy sign in the context of diabetes. Which is the most appropriate next investigation? A. Abdominal ultrasound B. Lactate and perfusion assessment C. Erect chest imaging for free air D. Intraoperative culture when indicated E. Contrast-enhanced CT abdomen Show Answer & Explanation Correct Answer: E Explanation: Contrast-enhanced CT abdomen 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 Cancel « ← Previous Page 59 of 59 Submit Exam