Qatar Healthcare Practitioner Licensing Exam (QCHP / DHP) Ā· Clinical Medicine and Surgery

General Surgery, Trauma and Critical Care

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

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  1. A 34-year-old male is brought to the trauma bay following a high-speed motor vehicle collision. He is tachypneic, cyanotic, and tracheal deviation to the right is noted. Left hemithorax is hyper-resonā€¦
  2. A 28-year-old male presents with acute periumbilical pain that migrated over 12 hours to the right lower quadrant, accompanied by anorexia and low-grade fever. On examination, palpation of the left loā€¦
  3. A 56-year-old woman presents with severe epigastric and right upper quadrant abdominal pain radiating to her right infrascapular area, accompanied by fever (38.8 Ā°C) and leukocytosis (16,000/uL). Ultrā€¦
  4. A 40-year-old male presents with sudden-onset excruciating epigastric abdominal pain described as a 'bursting sensation'. Abdominal exam reveals board-like rigidity, involuntary guarding, and diffuseā€¦
  5. In the primary survey of a trauma patient according to Advanced Trauma Life Support (ATLS), what is the mandatory immediate step to execute while assessing and managing the Airway (A)?
  6. A 68-year-old male with an 8 cm abdominal aortic aneurysm undergoes successful open repair. On postoperative day 2, he develops worsening oliguria, generalized abdominal distension, and respiratory diā€¦
  7. A 72-year-old male presents with obstipation, severe crampy lower abdominal pain, and massive asymmetrical abdominal distension. Plain abdominal radiograph reveals a hugely dilated, inverted U-shapedā€¦
  8. What is the most common histological type of thyroid carcinoma, characterized by psammoma bodies, ground-glass 'Orphan Annie eye' nuclei, and an excellent overall 10-year prognosis?
  9. A 24-year-old female presents with a firm, non-tender, highly mobile, rubbery breast lump measuring 2 cm in her upper outer quadrant. Overlying skin is normal without nipple discharge. Core needle bioā€¦
  10. A 45-year-old male sustains a second-degree burn over his entire anterior torso (18%) and both anterior thighs (9% each = 18%), totaling 36% total body surface area (TBSA). Weight is 70 kg. Using theā€¦
  11. During a laparoscopic cholecystectomy, the surgeon must carefully identify and dissect the 'Triangle of Calot' to ensure safe ligation of the cystic artery and cystic duct. What anatomical structuresā€¦
  12. A 60-year-old male with an irreducible groin bulge presents with severe groin pain, vomiting, and tachycardia. Examination reveals an exquisitely tender, erythematous, non-reducible swelling in the riā€¦
  13. A 55-year-old female presents with persistent deep right upper quadrant pain, low-grade fever, and progressive jaundice. Total bilirubin is 12 mg/dL. Abdominal ultrasound shows marked intrahepatic bilā€¦
  14. A 30-year-old male presents with severe throbbing perianal pain that is constant, worse with sitting and coughing, and accompanied by fever. Physical exam reveals a fluctuant, exquisitely tender, erytā€¦
  15. A 22-year-old construction worker falls from scaffolding, sustaining an open fracture of the right tibial shaft with a 4 cm clean skin wound and minimal periosteal stripping. According to the Gustiloā€¦
  16. What is the classic diagnostic triad of cardiac tamponade (Beck's triad)?
  17. A 65-year-old male presents with painless rectal bleeding and change in bowel habits over 4 months. Colonoscopy reveals an ulcerating adenocarcinoma 6 cm from the anal verge. Preoperative pelvic MRI dā€¦
  18. A 38-year-old male is brought to the trauma center after a motorcycle collision. Focused Assessment with Sonography for Trauma (FAST) is positive for fluid in the hepatorenal space (Morison's pouch).ā€¦
  19. A 45-year-old female presents with episodic palpitations, diaphoresis, and pounding headaches. Blood pressure during an episode is 210/120 mmHg. 24-hour urinary fractionated metanephrines are elevatedā€¦
  20. A 50-year-old male with chronic alcoholism undergoes a total thyroidectomy for multinodular goiter. On postoperative day 1, he complains of tingling around his mouth (circumoral paresthesia) and musclā€¦
  21. What is the most common cause of early small bowel obstruction (SBO) in adults with a history of prior abdominal surgery?
  22. A 62-year-old male with peripheral artery disease presents with severe left calf and foot pain at rest, especially when elevating the leg in bed. The foot is cool, pale, with a non-healing 1 cm ulcerā€¦
  23. A 32-year-old male is admitted with severe acute gallstone pancreatitis. On day 3, he develops severe tachypnea and hypoxemia refractory to 100% oxygen. Chest X-ray demonstrates diffuse bilateral pulmā€¦
  24. A 28-year-old unrestrained driver involved in a head-on collision is found to have a Glasgow Coma Scale (GCS) score of 6 at the scene (Eyes: 1, Verbal: 2, Motor: 3). According to neurotrauma guidelineā€¦
  25. What is the first and most sensitive clinical indicator of an impending acute lower extremity compartment syndrome following a closed tibial shaft fracture?
  26. A 60-year-old male with long-standing gastroesophageal reflux disease undergoes surveillance endoscopy. Biopsy of the distal esophagus reveals columnar epithelium replacing normal stratified squamousā€¦
  27. A 72-year-old female presents with 4 hours of right-sided hemiparesis and motor aphasia. Blood glucose is 120 mg/dL, BP 172/96 mmHg, and non-contrast head CT reveals no hemorrhage or early infarctionā€¦
  28. A 28-year-old male with persistent severe asthma exacerbation remains dyspneic despite continuous nebulized albuterol, ipratropium, and IV methylprednisolone. Arterial blood gas shows pH 7.34, PaCO2 4ā€¦
  29. A 62-year-old male with acute anterior myocardial infarction undergoes successful PCI. On day 4, he suddenly develops severe dyspnea, pulmonary edema, and a new harsh holosystolic murmur loudest at thā€¦
  30. A 48-year-old female presents with recurrent epistaxis, microscopic hematuria, cough, and bilateral cavitary pulmonary nodules on chest CT. Serum testing reveals positive c-ANCA (anti-proteinase 3). Wā€¦
  31. A 58-year-old male with chronic alcoholism presents with tremor, visual hallucinations, diaphoresis, and hypertension 48 hours after his last drink. Heart rate is 128 bpm, BP 168/102 mmHg, temperatureā€¦
  32. A patient scores eye opening 4, verbal response 5 and motor response 6 on the Glasgow Coma Scale. What is the total score?
  33. A patient scores eye opening 3, verbal response 4 and motor response 5 on the Glasgow Coma Scale. What is the total score?
  34. A patient scores eye opening 2, verbal response 3 and motor response 4 on the Glasgow Coma Scale. What is the total score?
  35. A patient scores eye opening 4, verbal response 4 and motor response 6 on the Glasgow Coma Scale. What is the total score?
  36. A patient scores eye opening 3, verbal response 5 and motor response 6 on the Glasgow Coma Scale. What is the total score?
  37. A patient scores eye opening 1, verbal response 2 and motor response 3 on the Glasgow Coma Scale. What is the total score?
  38. A patient scores eye opening 4, verbal response 5 and motor response 5 on the Glasgow Coma Scale. What is the total score?
  39. Using the rule of nines in an adult, what percentage of body surface area is the whole of one arm and the head?
  40. Using the rule of nines in an adult, what percentage of body surface area is both legs (front and back)?
  41. Using the rule of nines in an adult, what percentage of body surface area is the whole of the front of the trunk?
  42. Using the rule of nines in an adult, what percentage of body surface area is the whole of one leg (front and back)?
  43. Using the rule of nines in an adult, what percentage of body surface area is the head and both arms?
  44. According to ATLS, an adult has lost about 10% of blood volume. Which class of haemorrhagic shock is this?
  45. According to ATLS, an adult has lost about 20% of blood volume. Which class of haemorrhagic shock is this?
  46. According to ATLS, an adult has lost about 35% of blood volume. Which class of haemorrhagic shock is this?
  47. According to ATLS, an adult has lost about 45% of blood volume. Which class of haemorrhagic shock is this?
  48. A trauma patient has absent breath sounds on the right, distended neck veins, tracheal deviation to the left and hypotension. What is the immediate management?
  49. In the ATLS primary survey, which step comes first?
  50. What is the most appropriate fluid for initial resuscitation of a patient in haemorrhagic shock from trauma, after the first 1 litre crystalloid?
  51. A young man develops severe testicular pain of sudden onset with a high-riding testis and absent cremasteric reflex. What is the management?
  52. A patient has right iliac fossa pain, anorexia, nausea and fever. Which is the most likely diagnosis?
  53. A patient has fever, jaundice and right upper quadrant pain. Which diagnosis do these form Charcot's triad for?
  54. What is the best initial imaging test for suspected acute cholecystitis?
  55. A patient has absolute constipation, colicky pain, vomiting and a distended abdomen. Plain X-ray shows dilated small bowel loops with air-fluid levels. What is the likely diagnosis?
  56. What is the most common cause of small bowel obstruction in adults who have had previous abdominal surgery?
  57. A 65-year-old with known abdominal aortic aneurysm presents with sudden back pain, hypotension and a pulsatile abdominal mass. What is the next step?
  58. Which sign is most specific for acute compartment syndrome?
  59. Which complication is most likely if post-operative wound infection appears on day 5-7 with redness, warmth and purulent discharge?
  60. A patient develops fever, tachycardia and muscle rigidity during general anaesthesia after suxamethonium and a volatile agent. What is the treatment?
  61. What is the correct approach to antibiotic prophylaxis for clean elective surgery?
  62. Which test is part of the WHO Surgical Safety Checklist before skin incision?
  63. A patient with a deep contaminated wound has an unknown tetanus vaccination history. What should be given?
  64. In an adult with an acute upper gastrointestinal bleed, which is the usual first investigation after resuscitation?
  65. What is the first-line treatment for a symptomatic inguinal hernia in an adult man?
  66. A patient has a painful, irreducible groin lump with vomiting and abdominal distension. What is this?
  67. Which condition is suggested by severe epigastric pain radiating to the back with serum lipase more than three times the upper limit?
  68. What is the most common cause of acute pancreatitis worldwide?
  69. A patient has left lower quadrant pain, fever and raised inflammatory markers. CT confirms uncomplicated diverticulitis. How is it usually managed?
  70. A patient with ulcerative colitis has bloody diarrhoea more than six times a day, fever and tachycardia. What is the first-line treatment of severe flare?
  71. Which tumour marker is used mainly for follow-up of colorectal cancer?
  72. Which organ is most commonly injured in blunt abdominal trauma?
  73. A patient is haemodynamically unstable after blunt abdominal trauma with free fluid on FAST. What is the next step?
  74. What is the first-line imaging for a suspected renal colic with a stone in an adult?
  75. Which management is urgent for an obstructed infected kidney with pyonephrosis?
  76. What is the usual first-line treatment of a small uncomplicated breast abscess in lactating women?
  77. Which is the most common type of thyroid cancer?
  78. Which nerve is most at risk during thyroidectomy leading to hoarseness?
  79. What is the immediate management of an adult with a foreign body airway obstruction who cannot speak or cough?
  80. What is the compression-to-ventilation ratio for adult cardiopulmonary resuscitation by a lone rescuer?
  81. What is the target depth of chest compressions in an adult?
  82. Which drug is given every 3-5 minutes in cardiac arrest with a non-shockable rhythm?
  83. A patient has ventricular fibrillation. What is the immediate treatment?
  84. Which acid-base disturbance occurs in vomiting from pyloric stenosis?

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