Surgery – AMBOSS Exam Questions
and Answers 100% Pass
How treat new sclerotic lesion at L5 vertebral body in pt w bilateral orchiectomy after
prostate cancer dx - ✔✔local radiation
Pt has RUQ abdominal pain plus XR showing air in biliary tree and dilated transverse
colon - dx - ✔✔cholecystoenteric fistula
Pt has hoarse voice, sore throat, difficulty opening mouth. Swelling of R tonsillar pillar
w uvula deviation to L - dx, tx - ✔✔Peritonsillar abscess
- treat with incision and drainage w IV ampicillin-sulbactam
After stab wound, pt has hypotension, muffled heart sounds, JVD. Dx, what other exam
findings will see - ✔✔cardiac tamponade
- also see pulsus paradoxus (drop in SBP by 10 mmHg during inspiration)
40 yo pt has watery diarrhea, episodic crampy abdominal pain, WL, episodic cutaneous
flushing, asthma, systolic murmur at LSB 4th intercostal - dx? What at risk for, why -
✔✔carcinoid syndrome
- at risk for dementia from pellagra (dermatitis, diarrhea, glossitis) from niacin
deficiency from decreased tryptophan
Pt has enlarged bluish veins above dentate line, mass that prolapses but reduces when
breathes normally. Dx? what tx - ✔✔internal hemorrhoids; docusate therapy
COPYRIGHT © 2025 BY BRITTIE DONALD, ALL RIGHTS RESERVED 1
,How dx Zenker diverticulum - ✔✔barium esophagram w continuous fluoroscopy
Pt has retrosternal chest pain, single punched out ulcer seen on endoscopy w normal
mucosa at GE junction. Takes a bunch of meds including insulin, amlodipine, ASA,
metformin, beclomethasone, albuterol, alendronate. Dx. What next step? - ✔✔Drug
induced esophagitis, discontinue alendronate
Why discontinue alendronate in pt w drug induced esophagitis - ✔✔Alendronate can
cause drug-induced esophagitis
- other meds that can cause it include abx, NSAIDs, KCl
After ORIF of LS femur fracture after MVA, pt has pain and paresthesia in arm. Has
decreased brachial and radial pulses, pale and cold skin. Platelets are 60k, PTT is 55s.
Doppler shows occlusion of R brachial artery. Dx? - ✔✔arterial thrombosis from HIT
Pt has fever, chills, plus indurated tender, warm, erythematous skin lesion w sharply
demarcated margins. Also has toe web intertrigo. Dx? what do - ✔✔Erysipelas; treat w
IV cefazolin
3 yo has cough, SOB for 12 hrs. Repeat asthma exacerbations. Decreased breath sounds,
expiratory wheezing, hyperlucency of R lung field w decreased pulm markings. What
do, why - ✔✔Bronchoscopy to remove foreign body
37 yo male has itching in genitals for 7 days, atrophic white papules on glans and
prepuce w erythema. Narrowed, sclerotic urinary meatus. Dx, what do - ✔✔biopsy
lesion; lichen sclerosus but may become SCC
7 mo boy has palpable testicle in R hemiscrotum w palpable mass in L inguinal canal.
What do, why - ✔✔Orchidopexy - spontaneous descent is unlikely as boy is already 4-6
mo of age
By when do you want to perform orchidopexy - ✔✔before 1 year of age
COPYRIGHT © 2025 BY BRITTIE DONALD, ALL RIGHTS RESERVED 2
,After AAA repaid, pt has absent bowel sounds, TTP in 4 quads. Dx - ✔✔ischemic colitis
Homeless pt, IVDU has warmth, erythema neck pain. Palpation causes pain.
inflammation on MRI. Dx, what do, why - ✔✔osteomyelitis
- must cover for MRSA, strep, gram negatives (Pseudomonas)
- give vancomycin and fluoroquinolone (cipro) or cephalosporin (cefepime)
Pt has diarrhea for 2 weeks, urge to defecate 15 min after meal plus palpitations,
sweating after eating. Had distal gastrectomy performed. What do, dx - ✔✔dietary
modifications - early dumping syndrome
4 week old girl has yellowing of eyes, skin for 2 weeks. Can palpate liver 2 cm below
margin. Has very high direct bilirubin and alkaline phosphatase. Dx? - ✔✔biliary
atresia
What are signs of biliary atresia - ✔✔elevated direct hyperbilirubinemia, ALP levels w
post-hepatic jaundice
22 yo has pain of L knee. L tibia is displaced posteriorly when force applied to proximal
tibia after flexing knee. Dx - ✔✔PCL injury
42 yo has 2 episodes of LoC, SOB, palpitations, chest tightness, JVD, pitting edema.
From India. Has diastolic murmur in 5th L intercostal space at midclavicular line. Dx?
What is mechanism of findings? - ✔✔Increased LA pressure from mitral stenosis
(rheumatic fever)
68 yo M has sclerotic lesions in thoracic and lumbar vertebra. Normal DRE. Dx? -
✔✔prostate cancer mets
- can have normal prostate exam
COPYRIGHT © 2025 BY BRITTIE DONALD, ALL RIGHTS RESERVED 3
, Describe lesions that occur from prostate cancer v RCC - ✔✔osteoblastic bone mets
(sclerotic lesions)
- not osteolytic lesions (RCC)
Pt has pulsatile abdominal mass w severe abdominal pain radiating to flank for 30 min.
Low BP, high pulse. What do - ✔✔ruptured AAA - open emergency surgery
19 yo M has blood-speckled stools, protruding rectal mass w 4 cm pedunculated polyp
w superficial excoriations. Colonoscopy shows 14 polyps dx as hamartomatous polyps.
What dx, what associated with - ✔✔Peutz-Jeghers syndrome - increased risk of
pancreatic, breast, ovarian cancer
How treat communicating hydrocele in 6 mo old baby - ✔✔reassurance - should resolve
within 1 year
79 yo W has non-productive cough, fatigue, WL. Worked as seamstress in textile factory
plus smoked for 47 years. Has exudative pleural effusion w nodular pleural lesions on
R side. Dx - ✔✔Mesothelioma
23 yo W has R adnexal tenderness after N/V develop suddenly after sex. Dx, what
findings - ✔✔ovarian torsion - see decreased ovarian blood flow on doppler
68 yo W loses control of bladder when walking or standing. Failed Kegel exercises,
continence pessary. What tx - ✔✔urethral sling - 1st line for stress incontinence if Kegel,
pessary, lifestyle changes fail
52 yo M has 3 mo of upper abdominal pain after eating w improvement w eating. Dark
stools. Epigastric tenderness. Normal vitals. How prevent further cx of disease -
✔✔Triple therapy for H pylori - amoxicillin, clarithromycin, omeprazole
Pt scheduled for cholecystectomy tomorrow but has elevated K+ of 6.1. How manage,
why - ✔✔administer IV saline w furosemide - not emergency
COPYRIGHT © 2025 BY BRITTIE DONALD, ALL RIGHTS RESERVED 4
and Answers 100% Pass
How treat new sclerotic lesion at L5 vertebral body in pt w bilateral orchiectomy after
prostate cancer dx - ✔✔local radiation
Pt has RUQ abdominal pain plus XR showing air in biliary tree and dilated transverse
colon - dx - ✔✔cholecystoenteric fistula
Pt has hoarse voice, sore throat, difficulty opening mouth. Swelling of R tonsillar pillar
w uvula deviation to L - dx, tx - ✔✔Peritonsillar abscess
- treat with incision and drainage w IV ampicillin-sulbactam
After stab wound, pt has hypotension, muffled heart sounds, JVD. Dx, what other exam
findings will see - ✔✔cardiac tamponade
- also see pulsus paradoxus (drop in SBP by 10 mmHg during inspiration)
40 yo pt has watery diarrhea, episodic crampy abdominal pain, WL, episodic cutaneous
flushing, asthma, systolic murmur at LSB 4th intercostal - dx? What at risk for, why -
✔✔carcinoid syndrome
- at risk for dementia from pellagra (dermatitis, diarrhea, glossitis) from niacin
deficiency from decreased tryptophan
Pt has enlarged bluish veins above dentate line, mass that prolapses but reduces when
breathes normally. Dx? what tx - ✔✔internal hemorrhoids; docusate therapy
COPYRIGHT © 2025 BY BRITTIE DONALD, ALL RIGHTS RESERVED 1
,How dx Zenker diverticulum - ✔✔barium esophagram w continuous fluoroscopy
Pt has retrosternal chest pain, single punched out ulcer seen on endoscopy w normal
mucosa at GE junction. Takes a bunch of meds including insulin, amlodipine, ASA,
metformin, beclomethasone, albuterol, alendronate. Dx. What next step? - ✔✔Drug
induced esophagitis, discontinue alendronate
Why discontinue alendronate in pt w drug induced esophagitis - ✔✔Alendronate can
cause drug-induced esophagitis
- other meds that can cause it include abx, NSAIDs, KCl
After ORIF of LS femur fracture after MVA, pt has pain and paresthesia in arm. Has
decreased brachial and radial pulses, pale and cold skin. Platelets are 60k, PTT is 55s.
Doppler shows occlusion of R brachial artery. Dx? - ✔✔arterial thrombosis from HIT
Pt has fever, chills, plus indurated tender, warm, erythematous skin lesion w sharply
demarcated margins. Also has toe web intertrigo. Dx? what do - ✔✔Erysipelas; treat w
IV cefazolin
3 yo has cough, SOB for 12 hrs. Repeat asthma exacerbations. Decreased breath sounds,
expiratory wheezing, hyperlucency of R lung field w decreased pulm markings. What
do, why - ✔✔Bronchoscopy to remove foreign body
37 yo male has itching in genitals for 7 days, atrophic white papules on glans and
prepuce w erythema. Narrowed, sclerotic urinary meatus. Dx, what do - ✔✔biopsy
lesion; lichen sclerosus but may become SCC
7 mo boy has palpable testicle in R hemiscrotum w palpable mass in L inguinal canal.
What do, why - ✔✔Orchidopexy - spontaneous descent is unlikely as boy is already 4-6
mo of age
By when do you want to perform orchidopexy - ✔✔before 1 year of age
COPYRIGHT © 2025 BY BRITTIE DONALD, ALL RIGHTS RESERVED 2
,After AAA repaid, pt has absent bowel sounds, TTP in 4 quads. Dx - ✔✔ischemic colitis
Homeless pt, IVDU has warmth, erythema neck pain. Palpation causes pain.
inflammation on MRI. Dx, what do, why - ✔✔osteomyelitis
- must cover for MRSA, strep, gram negatives (Pseudomonas)
- give vancomycin and fluoroquinolone (cipro) or cephalosporin (cefepime)
Pt has diarrhea for 2 weeks, urge to defecate 15 min after meal plus palpitations,
sweating after eating. Had distal gastrectomy performed. What do, dx - ✔✔dietary
modifications - early dumping syndrome
4 week old girl has yellowing of eyes, skin for 2 weeks. Can palpate liver 2 cm below
margin. Has very high direct bilirubin and alkaline phosphatase. Dx? - ✔✔biliary
atresia
What are signs of biliary atresia - ✔✔elevated direct hyperbilirubinemia, ALP levels w
post-hepatic jaundice
22 yo has pain of L knee. L tibia is displaced posteriorly when force applied to proximal
tibia after flexing knee. Dx - ✔✔PCL injury
42 yo has 2 episodes of LoC, SOB, palpitations, chest tightness, JVD, pitting edema.
From India. Has diastolic murmur in 5th L intercostal space at midclavicular line. Dx?
What is mechanism of findings? - ✔✔Increased LA pressure from mitral stenosis
(rheumatic fever)
68 yo M has sclerotic lesions in thoracic and lumbar vertebra. Normal DRE. Dx? -
✔✔prostate cancer mets
- can have normal prostate exam
COPYRIGHT © 2025 BY BRITTIE DONALD, ALL RIGHTS RESERVED 3
, Describe lesions that occur from prostate cancer v RCC - ✔✔osteoblastic bone mets
(sclerotic lesions)
- not osteolytic lesions (RCC)
Pt has pulsatile abdominal mass w severe abdominal pain radiating to flank for 30 min.
Low BP, high pulse. What do - ✔✔ruptured AAA - open emergency surgery
19 yo M has blood-speckled stools, protruding rectal mass w 4 cm pedunculated polyp
w superficial excoriations. Colonoscopy shows 14 polyps dx as hamartomatous polyps.
What dx, what associated with - ✔✔Peutz-Jeghers syndrome - increased risk of
pancreatic, breast, ovarian cancer
How treat communicating hydrocele in 6 mo old baby - ✔✔reassurance - should resolve
within 1 year
79 yo W has non-productive cough, fatigue, WL. Worked as seamstress in textile factory
plus smoked for 47 years. Has exudative pleural effusion w nodular pleural lesions on
R side. Dx - ✔✔Mesothelioma
23 yo W has R adnexal tenderness after N/V develop suddenly after sex. Dx, what
findings - ✔✔ovarian torsion - see decreased ovarian blood flow on doppler
68 yo W loses control of bladder when walking or standing. Failed Kegel exercises,
continence pessary. What tx - ✔✔urethral sling - 1st line for stress incontinence if Kegel,
pessary, lifestyle changes fail
52 yo M has 3 mo of upper abdominal pain after eating w improvement w eating. Dark
stools. Epigastric tenderness. Normal vitals. How prevent further cx of disease -
✔✔Triple therapy for H pylori - amoxicillin, clarithromycin, omeprazole
Pt scheduled for cholecystectomy tomorrow but has elevated K+ of 6.1. How manage,
why - ✔✔administer IV saline w furosemide - not emergency
COPYRIGHT © 2025 BY BRITTIE DONALD, ALL RIGHTS RESERVED 4
