Kuwait Medical Licensing Examination (KMLE / KIMS) · Clinical Medicine And Surgery

General Surgery, Trauma and Critical Care

31 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 31 questions

  1. A 72-year-old female with long-standing osteoarthritis treated with daily over-the-counter Naproxen presents with severe, sudden-onset epigastric pain that rapidly spread to the entire abdomen 2 hours…
  2. A 24-year-old male presents with a 14-hour history of periumbilical pain that migrated to the right lower quadrant, accompanied by anorexia, nausea, and low-grade fever (38.0°C). Examination reveals l…
  3. A 46-year-old female presents with severe right upper quadrant colicky pain radiating to her right scapula, accompanied by nausea and fever (38.4°C) after eating a fatty meal. Physical examination rev…
  4. A 68-year-old male presents with high fever, jaundice, severe right upper quadrant pain, hypotension (BP 82/50 mmHg), and confusion (Reynolds' pentad). Total serum bilirubin is 6.5 mg/dL and alkaline…
  5. A 52-year-old male presents with severe, constant epigastric pain that radiates directly through to his back, accompanied by persistent vomiting. Serum lipase is 1250 U/L (reference < 60 U/L). Abdomin…
  6. A 60-year-old female with a history of two prior Cesarean sections presents with colicky abdominal pain, vomiting, abdominal distension, and obstipation for 2 days. Abdominal radiograph demonstrates c…
  7. A 78-year-old bedridden nursing home resident presents with massive abdominal distension, obstipation, and mild lower abdominal cramping. Abdominal radiograph reveals an enormous, dilated, inverted U…
  8. A 62-year-old male presents with a painful, non-reducible bulge in his right groin that appeared 6 hours ago. He now complains of crampy abdominal pain and vomiting. Examination reveals an exquisite…
  9. A 28-year-old unrestrained driver is brought to the trauma center following a high-speed motor vehicle collision. He is in extreme respiratory distress and cyanotic. Blood pressure is 70/40 mmHg, hear…
  10. A 35-year-old male sustains a penetrating stab wound to the left chest. In the trauma bay, a 32-French chest tube is placed, immediately draining 1,800 mL of dark red blood, followed by continuous ble…
  11. A 24-year-old male is stabbed in the central anterior chest. On arrival, he is restless and pale. Blood pressure is 80/55 mmHg, heart rate is 130 bpm, neck veins are markedly distended up to the angle…
  12. A 32-year-old male sustains blunt abdominal trauma in a motorcycle crash. On arrival, blood pressure is 80/50 mmHg and pulse is 130 bpm. A Focused Assessment with Sonography for Trauma (FAST) exam rev…
  13. A 22-year-old male sustains a closed comminuted fracture of the right tibial shaft. Six hours after closed reduction and splinting, he complains of severe, excruciating pain in his right leg that is o…
  14. A 30-year-old firefighter weighing 70 kg sustains second- and third-degree thermal burns covering 40% of his total body surface area (TBSA). According to the Parkland formula (4 mL kg % TBSA over…
  15. A 42-year-old male pedestrian is struck by an SUV. Pelvic radiographs demonstrate disruption of the pubic symphysis diastasis > 2.5 cm and widening of the left sacroiliac joint ('open-book' pelvic fra…
  16. A 72-year-old male with long-standing atrial fibrillation and generalized atherosclerosis presents with severe, sudden-onset periumbilical abdominal pain for 4 hours. On physical examination, the abdo…
  17. A 48-year-old woman discovers a painless, firm, non-tender, fixed 2.5 cm solitary mass in the upper outer quadrant of her right breast with subtle skin dimpling. What is the gold standard diagnostic s…
  18. A 65-year-old male undergoes an uncomplicated open sigmoid colectomy for colon adenocarcinoma. On postoperative day 5, he develops a temperature of 38.6°C. The surgical midline incision is erythematou…
  19. In a trauma patient presenting with a 'cannot intubate, cannot oxygenate' (CICO) scenario following extensive maxillofacial trauma and severe pharyngeal bleeding, what is the definitive emergency surg…
  20. According to international patient safety standards and the WHO Surgical Safety Checklist, what mandatory procedure must be performed by the surgical and scrub nursing team prior to closing the fascia…
  21. A 60-year-old male with peripheral artery disease presents with a 6-hour history of acute, severe pain in his right foot. Examination reveals a pale, cold right foot with absent dorsalis pedis and pos…
  22. A 50-year-old male smoker with gastroesophageal reflux disease undergoes surveillance endoscopy. Biopsy of the distal esophagus demonstrates salmon-colored mucosa with specialized intestinal metaplasi…
  23. A 35-year-old male is admitted with severe multiple trauma. On hospital day 4, while receiving total parenteral nutrition (TPN), he develops new tachycardia (120 bpm), tachypnea, and fever (38.9°C). T…
  24. A 58-year-old male with a history of alcohol use presents with painless jaundice, dark urine, pale stools, and weight loss of 8 kg over 2 months. Physical examination reveals a palpable, non-tender ga…
  25. A 28-year-old female presents with a smooth, painless, firm, mobile, rubbery 2 cm breast lump that moves freely beneath the examining fingers ('breast mouse'). Ultrasound shows a well-circumscribed, o…
  26. Which surgical complication is classified as a Grade IV complication under the Clavien-Dindo classification system of surgical complications?
  27. A 70-year-old woman with atrial fibrillation presents with sudden onset of severe generalized abdominal pain out of proportion to physical exam findings. Abdomen is soft without peritoneal signs. Seru…
  28. A 52-year-old male with chronic hepatitis B presents with worsening abdominal distension. Paracentesis yields clear straw-colored fluid with total protein 1.1 g/dL and albumin 0.8 g/dL. Concurrent ser…
  29. A 45-year-old female presents with fatigue, cold intolerance, weight gain, and dry coarse skin. Serum TSH is 28 mIU/L (normal 0.4-4.0) and free T4 is 0.4 ng/dL (normal 0.8-1.8). High titers of anti-th…
  30. A 28-year-old male is admitted after inhaling smoke in an enclosed fire. He presents with cherry-red skin, headache, metabolic acidosis with lactate 9.0 mmol/L, and normal arterial PaO2 with 75% oxyge…
  31. A 68-year-old male smoker presents with painless gross hematuria throughout micturition. Microscopic examination confirms numerous red blood cells without casts or proteinuria. Urine culture is negati…

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