National Health Regulatory Authority Licensure Examination (NHRA Bahrain) · Clinical Medicine And Surgery

General Surgery, Trauma and Emergency Resuscitation

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

A 22-year-old male presents with periumbilical abdominal pain that has migrated to the right lower quadrant over the past 12 hours. Examination reveals focal tenderness at McBurney's point with guardi…
A 35-year-old unrestrained driver arrives at the emergency department following a high-speed motor vehicle collision. He is cyanotic and gasping for air. Blood pressure is 70/40 mmHg, heart rate 140 b…
A 45-year-old female presents with fever, jaundice, and severe right upper quadrant abdominal pain (Charcot's triad). Laboratory studies show total bilirubin 85 micromol/L, alkaline phosphatase 450 U/…
A 68-year-old male with a history of bilateral inguinal hernias presents with acute severe groin pain and vomiting. Examination reveals a tense, tender, irreducible swelling in the right groin with ov…
In the primary survey of a trauma patient according to Advanced Trauma Life Support (ATLS), what does the 'A' step prioritize?
A 72-year-old male presents with sudden-onset severe mid-abdominal pain out of proportion to physical examination findings. He has a history of coronary artery disease and atrial fibrillation. Abdomin…
What is the first-line diagnostic imaging modality for a patient presenting with suspected acute cholecystitis?
A 28-year-old male sustained deep partial-thickness burns involving the entire anterior torso (18%) and the entire right arm (9%). What is the Total Body Surface Area (TBSA) percentage according to th…
A 60-year-old male smoker presents with a 2-month history of painless, progressive jaundice, pale clay-colored stools, and dark urine. On palpation, a non-tender, distended gallbladder is felt in the…
A 25-year-old male is brought to the resuscitation room after a stab wound to the left chest. Blood pressure is 80/50 mmHg, heart rate is 130 bpm, neck veins are distended, and heart sounds are distan…
A 50-year-old male with chronic peptic ulcer disease presents with sudden severe epigastric pain that rapidly became generalized. Abdominal examination reveals board-like rigidity and absent bowel sou…
A 75-year-old male with a history of chronic constipation presents with massive abdominal distension, obstipation, and cramping pain. Abdominal radiograph shows a dilated, inverted U-shaped loop of co…
Which of the following is considered the primary, most common pathogen implicated in post-operative surgical site infections (SSIs) following clean orthopedic or vascular procedures?
A 32-year-old male falls 4 meters from scaffolding landing on his feet. He complains of severe back pain. Plain lumbar radiographs show an L2 burst fracture. Physical examination demonstrates loss of…
A 40-year-old female presents with a painless, firm, solitary 2.5 cm nodule in the right thyroid lobe. Serum TSH is normal. Ultrasound demonstrates solid hypoechoic architecture with irregular margins…
A 55-year-old female presents with a high-pitched mechanical small bowel obstruction 5 years after an uncomplicated open hysterectomy. Abdominal imaging shows transition point with dilated proximal lo…
A 20-year-old male sustains a closed mid-shaft fracture of the right humerus in a wrestling match. On physical examination, he is unable to extend his right wrist or fingers, and has sensory loss over…
In a patient with severe polytrauma who has received 10 units of packed red blood cells, what metabolic and coagulation complication is commonly monitored and countered with fresh frozen plasma, plate…
A 64-year-old male presents with intermittent claudication in his calves after walking 200 meters, which resolves with rest. Physical examination demonstrates diminished dorsalis pedis pulses. Ankle-b…
Which of the following clinical signs is defined as cessation of inspiration upon deep palpation of the right upper quadrant, characteristic of acute cholecystitis?
A 42-year-old female presents with severe pain on defecation and bright red blood on toilet tissue for 4 weeks. Examination of the anal verge reveals an exquisitely tender linear tear in the posterior…
A 50-year-old male undergoes routine screening colonoscopy. A 1.5 cm pedunculated polyp in the sigmoid colon is completely excised. Histopathological examination demonstrates high-grade dysplasia with…
A 30-year-old male motorcyclist arrives following a crash. He is hemodynamically stable. Focused Assessment with Sonography for Trauma (FAST) is performed. Which four anatomical regions are routinely…
A 65-year-old male presents with acute urinary retention. Examination reveals a smoothly enlarged, non-tender, firm prostate without nodules. Serum PSA is 2.1 ng/mL. What is the most appropriate initi…
What is the most common cause of massive lower gastrointestinal bleeding in patients over 65 years of age?
In a patient presenting with acute scrotal pain and absent cremasteric reflex, which imaging modality is the gold standard diagnostic test to differentiate testicular torsion from epididymitis?
A 60-year-old male smoker with COPD is admitted with septic shock. Blood gas reveals: pH 7.18, PaCO2 62 mmHg, PaO2 55 mmHg, HCO3- 23 mEq/L, and lactate 5.2 mmol/L. What mixed acid-base disorder is pre…
A 35-year-old male presents with a painless ulcer on the shaft of the penis with raised, indurated borders and a clean base. Non-tender bilateral inguinal lymphadenopathy is present. What is the diagn…
A 72-year-old female presents with sudden onset of severe right eye pain, blurred vision, colored halos around lights, nausea, and vomiting. On examination, the cornea is steamy and the right pupil is…
A 48-year-old male with hereditary hemochromatosis is admitted with sudden severe right upper quadrant pain, ascites, and hepatomegaly. Serum alpha-fetoprotein (AFP) is 850 ng/mL. Contrast-enhanced CT…
A 22-year-old male presents with profound bloody diarrhea, tenesmus, and cramping for 4 weeks. Flexible sigmoidoscopy shows continuous erythematous, friable mucosa with superficial ulcerations extendi…

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