Name ………………………………………………………………. No……………………………………………….

1- Hypothermic coagulopathy:
A. is associated with prolonged PT and aPTT
B. can be corrected with fresh-frozen plasma transfusion
C. is a complication of massive transfusion
D. is associated with clotting factors depletion
E. none of the above

2- optimal management of mucosa associated lymphoid tissue (MALT) lymphoma is:

A. chemotherapy
B. total gastrectomy
C. partial gastrectomy
D. antibiotics
E. chemoradiation

3- Which of the following about Zenker’s diverticulum is true?

A. Surgical repair is usually successful
B. Large (> 2 cm) diverticula do not need to be resected
C. They are full-thickness diverticula
D. Most successful treatment involves esophageal resection
4- During the workup for epigastric discomfort that began about 6 months ago, you find a 4 cm mass in
the mid-body of the stomach. Biopsy is consistent with low-grade GIST. He otherwise is healthy with no
prior abdominal operations. Which of the following is the next best step in management?
A. Preoperative multiagent chemotherapy and radiation followed by resection 6 weeks after
treatment
B. Wedge resection of the gastric lesion
C. Subtotal gastrectomy with Billroth 2 reconstruction
D. Treatment with Gleevec

5- In relation to perioperative considerations in patients with adrenal tumors, which of the

following is true?
A. In patients with pheochromocytoma, beta blockade should be initiated prior to alpha-adrenergic
blockade.
B. tumor manipulation may stimulate sudden catecholamine release during the surgery.
C. Patients with an aldosterone secreting adrenal tumor will most likely have hyperkalemia.
D. Patients with cortisol producing tumor should not receive heparin due to their hypocoagulability.

6-After performing a total thyroidectomy in a 55-year-old female, the patient develops

Chvostek’s sign and parasthesias on post-operative day one. She is started on calcium and vitamin D
replacement therapy and discharged home with those medications as well as teriparatide shots
(parathyroid hormone replacement therapy). After one year postsurgery, the patient still requires
calcium and vitamin D replacement as well as teriparatide shots. The likely structure injured
during the thyroidectomy was the:
A. Superior thyroid arteries
B. Middle thyroid veins
C. Recurrent laryngeal nerves
D. Inferior thyroid arteries
E. Superior laryngeal nerves
7- A 40-year-old man presents with a 6-month history of dysphagia for both solids and liquids, as
well as regurgitation of undigested food after meals. Esophagram shows a dilated esophagus with
a significant “bird's beak” narrowing at the lower esophageal sphincter (LES). Manometry reveals
poor esophageal peristalsis and a very hypertensive LES. Which of the following statements is true
regarding this patient's condition?
A. Medical treatment with nitrates and calcium channel blockers is successful in most cases
B. The surgical procedure of choice for this disorder is a long esophageal myotomy
C. Although dysphagia is common, regurgitation is unusual in these patients
D. Rigid or pneumatic LES dilation can offer a long-term success rate as high as 80%
E. Manometry is not indicated if the patient has the classic presenting symptoms and esophagram findings
8-A 63-year-old man with no significant past medical history is admitted with an acute abdomen
secondary to gastric perforation. If a definitive ulcer procedure is performed on this patient,
which of the following procedures is associated with the lowest ulcer recurrence rate?
A .Truncal vagotomy
B .Truncal vagotomy and pyloroplasty
C .Vagotomy and antrectomy
D .Parietal cell vagotomy E. Gastric bypass
9-An 85-year-old man presents with a 3-day history of severe abdominal pain. The patient's
temperature is 39.4°C (103°F), he is tachycardic with 130 beats/min, and he has a blood pressure
of 80/40 mm Hg. The patient is becoming more tachypneic, and upon placement of a Foley
catheter no urine is produced. His abdomen is rigid and plain abdominal film demonstrates free
air under the right hemidiaphragm. His past medical history is significant for coronary artery
disease, emphysema, chronic renal insufficiency secondary to insulin-dependent diabetes
mellitus, as well as manic depression. Which of the following is the most appropriate operation to
perform on this patient?

A. Pyloromyotomy B. Omental patching with or without a vagotomy

C. Gastrectomy D. Billroth II E. Vagotomy and antrectomy

Approach to patient with HTN and hypokalemia (the first step) (other steps are bonus) after taking Hx and complete P/E?