Jordanian Medical Licensing Examination (JMLE) · Clinical Medicine and General Surgery

General Surgery and Acute Trauma Management

64 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 64 questions

  1. A 24-year-old male presents with 12 hours of periumbilical pain that has migrated to the right lower quadrant, accompanied by anorexia, nausea, and low-grade fever. Physical examination reveals tender…
  2. A 45-year-old female presents with severe colicky right upper quadrant pain radiating to the right scapula, triggered after eating a high-fat meal. Abdominal ultrasound demonstrates acoustic shadowing…
  3. A 65-year-old male with a history of prior open abdominal surgery presents with crampy generalized abdominal pain, bilious vomiting, obstipation, and abdominal distension. Abdominal radiography reveal…
  4. A 70-year-old male presents with sudden-onset tearing chest pain radiating to his interscapular back. Blood pressure is 190/105 mmHg in the right arm and 135/80 mmHg in the left arm. Contrast CT angio…
  5. A 28-year-old unrestrained driver is brought to the trauma center following a high-speed motor vehicle collision. He is cyanotic and in severe respiratory distress. Vital signs: BP 75/40 mmHg, HR 140…
  6. A 60-year-old female presents with fever, jaundice, and right upper quadrant abdominal pain (Charcot's triad). Laboratory testing shows marked leukocytosis and elevated alkaline phosphatase and total…
  7. A 32-year-old male presents with acute severe pain in the left hemiscrotum that began abruptly 2 hours ago. Physical examination demonstrates an elevated, transversely oriented left testis, absent cre…
  8. A 55-year-old male with a history of alcohol abuse presents with severe, unrelenting epigastric pain that radiates directly through to his back, accompanied by persistent vomiting. Serum lipase is 125…
  9. An 80-year-old male with severe constipation presents with massive painless abdominal distension, nausea, and failure to pass flatus. Abdominal radiography reveals a huge, dilated, inverted U-shaped l…
  10. A 25-year-old construction worker falls 4 meters onto his feet, sustaining severe bilateral heel pain. Radiographs demonstrate calcaneal fractures. What additional screening radiographs are mandatory…
  11. A 62-year-old female presents with a non-healing ulcer on the medial aspect of her lower calf, superior to the medial malleolus. The surrounding skin displays brown hemosiderin hyperpigmentation, indu…
  12. A 72-year-old male presents with a painless pulsatile abdominal mass noted on physical examination. Abdominal ultrasonography reveals an infrarenal abdominal aortic diameter of 5.8 cm. What is the sta…
  13. A 20-year-old male sustains a stab wound to the left 5th intercostal space just lateral to the sternum. He is hypotensive (BP 80/50 mmHg), has distended jugular veins, and exhibits muffled heart sound…
  14. A 40-year-old male undergoes a total thyroidectomy for multinodular goiter. On postoperative day 1, he complains of tingling in his fingertips and perioral numbness. Tapping on the facial nerve anteri…
  15. A 35-year-old male presents with severe burns over his entire anterior torso (18%) and both anterior and posterior surfaces of both upper extremities (18%). Total body surface area (TBSA) burned is 36…
  16. A 68-year-old male presents with jaundice, weight loss, and painless enlargement of the gallbladder palpable in the right upper quadrant (Courvoisier's sign). What is the most likely diagnosis?
  17. A 30-year-old male sustains a deep laceration across the volar aspect of his right wrist. On examination, he is unable to oppose his thumb to his little finger and has lost sensation over the palmar a…
  18. A 48-year-old female presents with severe pain in her right leg 6 hours after an open reduction and internal fixation of a tibial plateau fracture. The pain is out of proportion to exam findings and i…
  19. A 52-year-old male with long-standing gastroesophageal reflux disease (GERD) undergoes surveillance endoscopy. Biopsies of the distal esophagus demonstrate replacement of normal stratified squamous ep…
  20. A 28-year-old male presents with fever, exquisite anal pain that is worsened by sitting, and painful defecation. Physical examination reveals an indurated, fluctuant, erythematous, tender mass at the…
  21. A 65-year-old female presents with alternating constipation and diarrhea, fatigue, and unintentional weight loss. Complete blood count reveals microcytic hypochromic anemia (hemoglobin 8.2 g/dL, ferri…
  22. A 38-year-old female presents with acute pain and swelling in her right submandibular region that noticeably worsens during and immediately after eating meals. Bimanual palpation along the floor of th…
  23. A 60-year-old male with heavy alcohol consumption presents with severe mid-epigastric pain and shock. Two days into hospitalization, physical examination reveals bluish-purple ecchymosis around the um…
  24. A 23-year-old male is involved in a motorcycle collision and sustains a pelvic ring fracture. In the trauma bay, he is unable to void. Physical examination reveals blood at the external urethral meatu…
  25. A 50-year-old female presents with a 2 cm solitary thyroid nodule. Fine needle aspiration biopsy reveals malignant follicular cells arranged in papillary architecture with ground-glass nuclei (Orphan…
  26. A 45-year-old male with chronic liver cirrhosis presents with massive upper gastrointestinal bleeding. Vital signs show BP 85/50 mmHg and HR 125 bpm. Following intravenous fluid resuscitation, blood t…
  27. A man has colicky loin pain radiating to the groin with haematuria. Which test is best to detect a ureteric stone?
  28. The most common type of thyroid cancer is:
  29. A patient weighing 90 kg is to receive an infusion at 2 mcg/kg/min. The solution contains 2400 mcg/mL. What infusion rate is needed in mL/h?
  30. A 90 kg adult has burns over 10% of the body surface. Using the Parkland formula (4 mL × kg × %TBSA), how much fluid is given in the first 8 hours?
  31. A 60 kg adult has burns over 10% of the body surface. Using the Parkland formula (4 mL × kg × %TBSA), how much fluid is given in the first 8 hours?
  32. A 55 kg adult needs a minimum urine output of 0.5 mL/kg/h. What is the minimum expected urine volume over 8 hours?
  33. A patient after a road accident has hypotension, tracheal deviation, absent breath sounds on the left and distended neck veins. What is the immediate treatment?
  34. A patient weighs 77 kg and is 1.55 m tall. According to the WHO classification (underweight below 18.5, normal 18.5–24.9, overweight 25–29.9, obese 30 or more), which category is this?
  35. A 80 kg adult needs a minimum urine output of 0.5 mL/kg/h. What is the minimum expected urine volume over 8 hours?
  36. A 60 kg adult has burns over 40% of the body surface. Using the Parkland formula (4 mL × kg × %TBSA), how much fluid is given in the first 8 hours?
  37. A 80 kg adult has burns over 30% of the body surface. Using the Parkland formula (4 mL × kg × %TBSA), how much fluid is given in the first 8 hours?
  38. A 76 kg adult needs a minimum urine output of 0.5 mL/kg/h. What is the minimum expected urine volume over 12 hours?
  39. A 50 kg adult needs a minimum urine output of 0.5 mL/kg/h. What is the minimum expected urine volume over 4 hours?
  40. A 83 kg adult needs a minimum urine output of 0.5 mL/kg/h. What is the minimum expected urine volume over 12 hours?
  41. A man with a painful, pale, pulseless, cold leg 3 hours after atrial fibrillation began has which condition?
  42. A 70 kg adult has burns over 40% of the body surface. Using the Parkland formula (4 mL × kg × %TBSA), how much fluid is given in the first 8 hours?
  43. A patient weighing 90 kg is to receive an infusion at 10 mcg/kg/min. The solution contains 1000 mcg/mL. What infusion rate is needed in mL/h?
  44. A patient weighs 92 kg and is 1.85 m tall. According to the WHO classification (underweight below 18.5, normal 18.5–24.9, overweight 25–29.9, obese 30 or more), which category is this?
  45. A patient weighs 81 kg and is 1.5 m tall. According to the WHO classification (underweight below 18.5, normal 18.5–24.9, overweight 25–29.9, obese 30 or more), which category is this?
  46. A patient with a pulsatile abdominal mass and sudden severe back pain with hypotension has what?
  47. A patient weighing 70 kg is to receive an infusion at 10 mcg/kg/min. The solution contains 3000 mcg/mL. What infusion rate is needed in mL/h?
  48. Which test is the investigation of choice for suspected acute ischaemic stroke before treatment?
  49. A 98 kg adult needs a minimum urine output of 0.5 mL/kg/h. What is the minimum expected urine volume over 4 hours?
  50. A 70 kg adult has burns over 30% of the body surface. Using the Parkland formula (4 mL × kg × %TBSA), how much fluid is given in the first 8 hours?
  51. A 50 kg adult has burns over 10% of the body surface. Using the Parkland formula (4 mL × kg × %TBSA), how much fluid is given in the first 8 hours?
  52. Which sign is classically positive in acute cholecystitis?
  53. A patient weighs 86 kg and is 1.55 m tall. According to the WHO classification (underweight below 18.5, normal 18.5–24.9, overweight 25–29.9, obese 30 or more), which category is this?
  54. A patient weighs 123 kg and is 1.85 m tall. According to the WHO classification (underweight below 18.5, normal 18.5–24.9, overweight 25–29.9, obese 30 or more), which category is this?
  55. A patient weighs 82 kg and is 1.6 m tall. According to the WHO classification (underweight below 18.5, normal 18.5–24.9, overweight 25–29.9, obese 30 or more), which category is this?
  56. A 98 kg adult needs a minimum urine output of 0.5 mL/kg/h. What is the minimum expected urine volume over 8 hours?
  57. A 82 kg adult needs a minimum urine output of 0.5 mL/kg/h. What is the minimum expected urine volume over 4 hours?
  58. A patient weighs 110 kg and is 1.75 m tall. According to the WHO classification (underweight below 18.5, normal 18.5–24.9, overweight 25–29.9, obese 30 or more), which category is this?
  59. A patient weighing 70 kg is to receive an infusion at 10 mcg/kg/min. The solution contains 1200 mcg/mL. What infusion rate is needed in mL/h?
  60. A 90 kg adult has burns over 50% of the body surface. Using the Parkland formula (4 mL × kg × %TBSA), how much fluid is given in the first 8 hours?
  61. A patient weighs 53 kg and is 1.55 m tall. According to the WHO classification (underweight below 18.5, normal 18.5–24.9, overweight 25–29.9, obese 30 or more), which category is this?
  62. What is the most common cause of small bowel obstruction in adults in developed countries?
  63. A patient weighs 60 kg and is 1.65 m tall. According to the WHO classification (underweight below 18.5, normal 18.5–24.9, overweight 25–29.9, obese 30 or more), which category is this?
  64. A patient weighing 80 kg is to receive an infusion at 10 mcg/kg/min. The solution contains 1200 mcg/mL. What infusion rate is needed in mL/h?

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