Revalida (Brazil Medical Diploma Revalidation Exam) · Clinical Medicine and Surgery

Surgery and Trauma

20 practice questions, each with the answer and an explanation.

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Random questions from this topic, one at a time. You see the answer and the explanation straight after each one.

All 20 questions

  1. In the primary survey of a trauma patient, which step comes first?
  2. A trauma patient is hypotensive with absent breath sounds on the right, distended neck veins and tracheal deviation to the left. What is the immediate action?
  3. Which pain pattern is typical of early acute appendicitis?
  4. A patient has right upper quadrant pain, fever and a positive Murphy sign. Ultrasound shows gallstones and wall thickening. What is the best management?
  5. What is the most common cause of small-bowel obstruction in adults who have had abdominal surgery?
  6. A 70 kg adult has burns over 30% of the total body surface. By the Parkland formula (4 mL x kg x %TBSA), how much crystalloid is given in the first 8 hours?
  7. A trauma patient has heart rate 130, falling blood pressure, respiratory rate 35 and confusion. Which class of haemorrhagic shock is this?
  8. A trauma patient with hypotension has a positive FAST examination with free abdominal fluid. What is the next step?
  9. Which finding on an upright chest radiograph suggests a perforated peptic ulcer?
  10. A patient has a painful irreducible inguinal hernia with vomiting and signs of bowel ischaemia. What is indicated?
  11. A patient opens the eyes to pain (E2), makes incomprehensible sounds (V2) and withdraws from pain (M4). What is the Glasgow Coma Scale score and what does it imply?
  12. Which CT finding is typical of an epidural haematoma?
  13. A patient with atrial fibrillation has severe abdominal pain out of proportion to a soft abdomen. What is the most likely diagnosis and best test?
  14. What is a priority in the management of an open fracture?
  15. After a tibial fracture, a patient has severe pain on passive stretching of the toes and a tense calf. What is the treatment?
  16. A teenager has sudden severe scrotal pain, a high-riding testis and an absent cremasteric reflex. What is the management?
  17. A patient has a pulsatile abdominal mass, hypotension and back pain. Which is the most appropriate approach?
  18. A patient has left iliac fossa pain, fever and CT showing pericolic inflammation of the sigmoid colon. What is the diagnosis?
  19. Which two causes account for most cases of acute pancreatitis?
  20. A patient has a dirty wound and an unknown vaccination status. What is the tetanus prophylaxis?

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