ENAM Practice (Peru National Medical Examination) · Surgery and Emergency Medicine

Abdominal surgery and trauma

16 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 16 questions

  1. A 22-year-old man has periumbilical pain that migrates to the right iliac fossa, with fever and rebound tenderness. What is the next step?
  2. A 45-year-old woman has right upper quadrant pain after fatty meals, fever and a positive Murphy sign. Ultrasound shows gallstones with a thickened gallbladder wall. What is the diagnosis?
  3. A 55-year-old man has jaundice, fever and right upper quadrant pain. What is this triad called?
  4. A 70-year-old man has colicky abdominal pain, vomiting, distension and absolute constipation, with a previous laparotomy. What is the most likely cause?
  5. A 65-year-old man has sudden severe abdominal pain, a rigid abdomen and free air under the diaphragm on an erect chest radiograph. What is the diagnosis?
  6. A 30-year-old man has a painful irreducible lump in the groin that is tender and associated with vomiting. What is the diagnosis?
  7. A 68-year-old man has a pulsatile abdominal mass and sudden back pain with hypotension. What is the most likely diagnosis?
  8. A 50-year-old woman has painless progressive jaundice, weight loss and a palpable non-tender gallbladder. What is the sign called?
  9. A 25-year-old motorcyclist has a closed femoral shaft fracture. What is the most serious early systemic complication?
  10. A 30-year-old man after a stab wound has hypotension, distended neck veins, muffled heart sounds and clear lungs. What is the diagnosis?
  11. A 28-year-old man after a road traffic accident has respiratory distress, tracheal deviation and absent breath sounds on the right. What is the immediate treatment?
  12. In the primary survey of a trauma patient, what is the first priority?
  13. A 35-year-old man has burns involving the whole of his anterior trunk and the whole of both arms. Using the rule of nines, what is the approximate total body surface area burned?
  14. A 40-year-old man has an open fracture of the tibia. Which is the most important early measure to reduce infection?
  15. A 20-year-old footballer has acute knee swelling after a twist, and a positive Lachman test. Which structure is torn?
  16. A 72-year-old woman falls and has a shortened, externally rotated leg. What is the most likely diagnosis?

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