Oman Medical Specialty Board Examination (OMSB) Ā· Clinical Medicine And Surgery

General Surgery and Emergency Management

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 21-year-old male presents with periumbilical pain that migrated to the right lower quadrant over the past 12 hours. On exam, he has tenderness at McBurney's point and positive Rovsing's sign. What iā€¦
  2. A 46-year-old obese female presents with sudden right upper quadrant pain radiating to the right scapula after a fatty meal. Physical examination reveals Murphy's sign. Ultrasound demonstrates gallblaā€¦
  3. A 28-year-old unrestrained driver involved in a high-speed motor vehicle collision arrives in shock. He has severe respiratory distress, cyanosis, distended neck veins, absent breath sounds on the rigā€¦
  4. A trauma patient presents following multiple gunshot wounds to the abdomen with blood pressure 70/40 mmHg and heart rate 140 bpm. In damage control resuscitation, what is the recommended ratio of packā€¦
  5. An 80-year-old nursing home resident presents with massive abdominal distension, obstipation, and cramping. Abdominal radiograph demonstrates a large, dilated 'coffee bean' shaped loop of colon with iā€¦
  6. A 68-year-old male with a history of heavy NSAID use presents with sudden onset of agonizing, diffuse epigastric pain that started 2 hours ago. On examination, his abdomen is rigid and 'board-like' wiā€¦
  7. A 62-year-old male presents with a tender, irreducible bulge in the right groin below the inguinal ligament. What type of hernia is this and why does it carry the highest risk of strangulation?
  8. A 32-year-old firefighter sustains 40% total body surface area (TBSA) second- and third-degree thermal burns. He weighs 70 kg. Using the Parkland formula (4 mL kg % TBSA burn), what is the total fā€¦
  9. A 50-year-old female presents with a painless, hard 2.5 cm breast mass in the upper outer quadrant with skin tethering. What constitutes the mandatory 'triple assessment' in breast surgical evaluationā€¦
  10. A 65-year-old male underwent open total colectomy 3 days ago. He now develops fever (38.6 degrees Celsius), tachypnea, and decreased breath sounds at both lung bases with dullness to percussion. Whatā€¦
  11. A 72-year-old male presents with sudden onset of severe coldness, pallor, numbness, and agonizing pain in his left lower leg. On exam, left femoral pulse is palpable, but popliteal and pedal pulses arā€¦
  12. A 68-year-old male smoker with hypertension presents with sudden, tearing abdominal and back pain, followed by syncopal collapse. On exam, his blood pressure is 80/50 mmHg, pulse is 125 bpm, and a pulā€¦
  13. A 30-year-old male is struck in the temporal region by a cricket ball. He experiences a brief loss of consciousness, recovers completely for 2 hours (lucid interval), and then rapidly deteriorates intā€¦
  14. During surgical management of a penetrating neck trauma, which anatomical zone extends from the cricoid cartilage to the angle of the mandible (Zone II), and why is it surgically unique?
  15. A 42-year-old female presents with severe anal pain during and after defecation, accompanied by bright red blood on the toilet paper. Physical examination reveals an exquisitely tender linear tear inā€¦
  16. A 52-year-old male with chronic gastroesophageal reflux disease undergoes screening endoscopy. Biopsy of the lower esophagus demonstrates replacement of stratified squamous epithelium by columnar epitā€¦
  17. A 25-year-old motorcyclist sustains a closed fracture of the right mid-shaft tibia. Six hours after splinting, he complains of excruciating pain in the right calf that is completely disproportionate tā€¦
  18. A 60-year-old male presents with painless obstructive jaundice, dark urine, pale stools, and 8 kg unintentional weight loss over 2 months. Physical examination reveals a palpable, non-tender gallbladdā€¦
  19. A 35-year-old male presents with a painful, erythematous, fluctuant 3 cm swelling in the perianal area with fever. Digital rectal exam is intolerable due to pain. What is the definitive initial surgicā€¦
  20. A 40-year-old female presents with right lower quadrant colicky pain radiating to the labia majora, accompanied by gross hematuria. Non-contrast helical CT reveals a 4 mm stone in the distal right ureā€¦
  21. A 75-year-old woman with a history of atrial fibrillation presents with sudden, agonizing diffuse abdominal pain. Physical examination shows a soft, non-distended abdomen with minimal tenderness, compā€¦
  22. On postoperative day 6 following an open sigmoid resection, an obese patient with a persistent cough experiences sudden drainage of large amounts of salmon-colored, serosanguinous fluid from the laparā€¦
  23. A 64-year-old male presents with changes in bowel habits, iron deficiency anemia, and positive fecal occult blood. Colonoscopy reveals an obstructing mass in the sigmoid colon. Biopsy confirms adenocaā€¦
  24. A 30-year-old male is brought to the emergency department after falling 4 meters from scaffolding. He is conscious and alert. Vital signs: BP 124/82 mmHg, HR 88 bpm. What is the first priority of manaā€¦
  25. What is the most common cause of small bowel obstruction in an adult patient with a history of prior open abdominal surgery?
  26. A 50-year-old male presents with chronic heartburn, regurgitation, and hoarseness. 24-hour ambulatory esophageal pH monitoring confirms abnormal acid exposure. If the patient fails optimal medical theā€¦
  27. A 55-year-old female presents with muscle weakness, weight gain, purple abdominal striae, and bruising. 24-hour urinary free cortisol is markedly elevated. A high-dose (8 mg) dexamethasone suppressionā€¦
  28. A 66-year-old male undergoes routine screening colonoscopy, revealing an 8 mm sessile polyp in the sigmoid colon. Histopathology demonstrates tubular adenoma with low-grade dysplasia. Complete resectiā€¦
  29. A 42-year-old woman presents with symmetrical joint pain and morning stiffness lasting > 1 hour in her wrists, MCP, and PIP joints for 3 months. Rheumatoid factor and anti-cyclic citrullinated peptideā€¦
  30. A 30-year-old male presents with acute severe pain, erythema, and marked swelling of the right first metatarsophalangeal joint (podagra). Arthrocentesis reveals cloudy synovial fluid with 45,000 WBC/uā€¦
  31. A 26-year-old male with inflammatory bowel disease is admitted with severe abdominal distension, fever (38.8Ā°C), heart rate 128 bpm, and leukocytosis (WBC 22,000/uL). Plain abdominal radiograph demonsā€¦

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