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

Emergency medicine, urology and vascular surgery

18 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 18 questions

  1. A 25-year-old man has loin-to-groin colicky pain and haematuria. Which investigation is first-line in the emergency department?
  2. A 17-year-old boy has sudden severe testicular pain, an absent cremasteric reflex and a high-riding testis. What is the diagnosis?
  3. A 70-year-old man has a poor urinary stream, nocturia and a smooth enlarged prostate. What is the most likely diagnosis?
  4. A 60-year-old woman has a cold, pale, painful leg with absent pulses and sudden onset. What is the diagnosis?
  5. A 55-year-old woman has unilateral leg swelling and calf tenderness. What is the first investigation?
  6. A 62-year-old man has calf pain after walking 200 metres that is relieved by rest. What is the diagnosis?
  7. A 30-year-old woman has a painless thyroid nodule with cold uptake on scan. What is the next step?
  8. A 45-year-old woman has a firm, fixed breast lump of 3 cm and an axillary node. What is the best initial diagnostic approach?
  9. A 60-year-old man has rectal bleeding, altered bowel habit and weight loss. What is the investigation of choice?
  10. A 45-year-old has haematemesis and a history of cirrhosis. What is the most likely source of bleeding?
  11. A 50-year-old man with a bleeding peptic ulcer is haemodynamically unstable. What is the first step?
  12. A 30-year-old woman has anaphylaxis after a wasp sting, with stridor and hypotension. What is the first drug?
  13. A 25-year-old man is found unconscious with pinpoint pupils and slow respiration. What is the antidote?
  14. A 35-year-old farmer has salivation, lacrimation, bradycardia and miosis after spraying pesticides. What is the antidote?
  15. A 20-year-old has a blood glucose of 38 mg/dL and is unconscious. What is the immediate treatment?
  16. A 65-year-old man has cardiac arrest with ventricular fibrillation. What is the most important intervention?
  17. A 40-year-old man is bitten by a snake in the Amazon and develops local swelling and bleeding. What is the definitive treatment?
  18. Which agent is the first-line treatment in an adult with severe sepsis after fluids?

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