Free FMGE Surgery questions

Explanation

Acute hemorrhage reduces circulating volume and preload, producing tachycardia, hypotension, and peripheral vasoconstriction. Rapid hemorrhage control and resuscitation are priorities.

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In an adult, the anterior trunk accounts for 18% and one entire upper limb for 9%. The estimated total is therefore 27% TBSA.

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Early visceral pain from the appendix is poorly localized around the umbilicus. When parietal peritoneum becomes inflamed, pain localizes to the right iliac fossa.

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Systemic toxicity, persistent pain, focal peritoneal signs, and metabolic acidosis suggest compromised bowel perfusion. Strangulation requires urgent surgical assessment.

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Indirect hernias enter the deep ring lateral to the inferior epigastric vessels. Direct hernias protrude medial to these vessels through Hesselbach triangle.

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Fibroadenoma typically presents in young women as a well-circumscribed, mobile, rubbery or firm mass. Suspicious or atypical lesions still require appropriate evaluation.

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Imaging characterizes a suspicious breast lesion, but histopathologic confirmation requires tissue. Core biopsy provides architecture and permits receptor testing in malignancy.

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FNAC is central to risk stratification of many thyroid nodules with suspicious sonographic features. It distinguishes lesions requiring surgery from many benign nodules.

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Murphy sign is classically associated with acute cholecystitis. Inspiration is abruptly limited because the inflamed gallbladder contacts the examiner’s hand.

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Conjugated hyperbilirubinemia with pale stools, dark urine, pruritus, and disproportionately raised alkaline phosphatase points to cholestasis or biliary obstruction.

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Typical epigastric pain radiating to the back together with significantly elevated pancreatic enzymes strongly supports acute pancreatitis.

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A pancreatic pseudocyst is an organized enzyme-rich fluid collection surrounded by fibrous or granulation tissue rather than a true epithelial wall. It often develops after pancreatitis.

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Internal hemorrhoids classically cause painless bright-red rectal bleeding. Anal fissures usually produce severe pain with defecation.

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Severe defecation-related pain with a linear anal ulcer is typical of fissure-in-ano. Most primary fissures occur in the posterior midline.

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Unexplained iron-deficiency anemia in an older adult may reflect chronic occult bleeding from colorectal malignancy, particularly right-sided lesions.

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Exertional ischemic muscle pain relieved by rest is intermittent claudication and is characteristic of peripheral arterial disease.

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Primary varicose veins arise from valvular incompetence and venous hypertension affecting superficial veins, frequently involving the great saphenous system.

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Colicky loin-to-groin pain with hematuria is characteristic of ureteric stone disease. Patients commonly appear restless rather than lying still with peritonitis.

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Sudden pain, abnormal testicular lie, and absent cremasteric reflex strongly suggest torsion. It is a surgical emergency because testicular viability falls with prolonged ischemia.

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Obstructive shock with unilateral absent breath sounds and hyperresonance is classic for tension pneumothorax. It requires immediate decompression without delaying for routine imaging.