EOR: GENERAL SURGERY EXAM
QUESTIONS AND ANSWERS GRADED A+
2025/2026
Presents w/ RUQ pains worse after eating as well as N/V, fever, and a palpable enlarged
gallbladder - ANS Acute Cholecystitis
- Cholecystectomy + NPO, IV fluids, antibiotics (Ceftriaxone, Metronidazole),
RUQ pain or inspiratory arrest with palpation of the gallbladder is known as _________ Sign and
is indicative of..? - ANS Murphy's sign, Cholecystitis
R shoulder pains in cases of cholecystitis is known as _________ Sign. - ANS Boas Sign
Diagnosis of acute cholecystitis (initial and gold) - ANS Initial: U/S
Gold: HIDA
Most common pathogen in acute cholecystitis (and other bile duct disorders) - ANS E. coli
Presents w/ RUQ pains, jaundice, and fevers. May also have hypotension, shock, and AMS. Labs
show leukocytosis, increased alkaline phosphatase & GGT, and increased bilirubin. -
ANS Acute Cholangitis
- ERCP (diagnostic and therapeutic) + abx
1 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
,If ERCP is unable to be done, what surgery is indicated for Cholangitis? -
ANS Cholecystectomy
40y/o female presents w/ episodic, abrupt RUQ pain resolving slowly over minutes as well as
nausea made worse with meals. - ANS Cholelithiasis
- Observation +/- ursodeoxycholic acid, cholecystectomy
What is the key demographic most prone to getting cholelithiasis/choledocholithiasis? -
ANS The "5 Fs"
- Fat, fair, forty, female, fertile
Most common source of cholelithiasis stones - ANS Cholesterol
40y/o female presents w/ prolonged RUQ pain as well as N/V made worse with meals and
jaundice. - ANS Choledocholithiasis
- ERCP -> choledocholithotomy
Bilirubin levels of >_____ will cause neonatal jaundice while bilirubin levels of >_____ will cause
neonatal kernicterus. - ANS >5.0 = Jaundice
>20.0 = Kernicterus
Newborn presents w/ jaundice and cerebral dysfunction and encephalopathy causing seizures,
lethargy, irritability, hearing loss, and mental developmental delays.
- Labs show bilirubin levels >20 mg/dL. - ANS Kernicterus
- Exchange transfusions +/- IVIG
Treatment of neonatal jaundice - ANS Phototherapy +/- exchange transfusions
Hereditary conjugated bilirubinemia is known as _________ while hereditary unconjugated
bilirubinemia is known as _________ - ANS - Dubin-Johnson Syndrome
2 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
,- Crigler-Najjar Syndrome
"Dark liver" on liver biopsy alongside asymptomatic bilirubinemia is likely what diagnosis? -
ANS Dubin-Johnson Syndrome
- does not require treatment
Newborn presents w/ jaundice with severe progression in the second week, leading to
kernicterus. Labs show indirect hyperbilirubinemia of 20-50mg/dL - ANS Crigler-Najjar
Syndrome
- Phototherapy
Transient episodes of jaundice during periods of stress, fasting, alcohol, or illness is likely what
diagnosis? - ANS Gilbert Syndrome
- does not require treatment
Presents w/ epigastric pains radiating to the back made better with leaning forward as well as
N/V and fever. may have flank or periumbilical ecchymoses.
- Labs show 3x lipase/amylase and ALT increase - ANS Acute Pancreatitis
- NPO, IVFs, analgesics
Diagnosis of acute pancreatitis (initial and gold) - ANS Initial: XR ("Sentinel loop" and "Colon
cutoff sign")
Gold: CT
What are the most common causes for pancreatitis? - ANS "BADHITS"
- Biliary (gallstones)
- Alcohol abuse
- Drugs
- Hypertriglyceridemia
- Idiopathic
3 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
, - Traumas/Surgeries
- Scorpions
Which drugs are known to cause pancreatitis? (4) - ANS - Thiazide diuretics
- Protease inhibitors (the "-avir"s)
- Valproic acid
- Exanatide
Patient w/ Hx of T2DM presents w/ weight loss, steatorrhea, and calcifications to the pancreas
noted on XR. No pain noted. - ANS Chronic Pancreatitis
- Oral pancreatic enzyme replacement, symptomatic relief
Presents w/ painless jaundice, weight loss, pruritus, anorexia, acholic stools, dark urine, and
possible epigastric pains radiating to the back. PE reveals a palpable gallbladder. -
ANS Pancreatic Cancer
- Whipple procedure +/- chemotherapy (5-FU, Gemcitabine)
What is the most common form of pancreatic cancer? - ANS Adenocarcinoma
Palpable nontender gallbladder on examination is known as _________ Sign and is indicative
of..? - ANS Courvoisier's Sign
- indicative of pancreatic cancer
Migratory phlebitis is known as _________ Sign and is indicative of..? - ANS Trousseau's Sign
- indicative of malignancy (ex. pancreatic cancer)
Tumor marker for pancreatic cancer - ANS CA 19-9
Diagnosis of pancreatic cancer (initial and gold) - ANS Initial: CT
4 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
QUESTIONS AND ANSWERS GRADED A+
2025/2026
Presents w/ RUQ pains worse after eating as well as N/V, fever, and a palpable enlarged
gallbladder - ANS Acute Cholecystitis
- Cholecystectomy + NPO, IV fluids, antibiotics (Ceftriaxone, Metronidazole),
RUQ pain or inspiratory arrest with palpation of the gallbladder is known as _________ Sign and
is indicative of..? - ANS Murphy's sign, Cholecystitis
R shoulder pains in cases of cholecystitis is known as _________ Sign. - ANS Boas Sign
Diagnosis of acute cholecystitis (initial and gold) - ANS Initial: U/S
Gold: HIDA
Most common pathogen in acute cholecystitis (and other bile duct disorders) - ANS E. coli
Presents w/ RUQ pains, jaundice, and fevers. May also have hypotension, shock, and AMS. Labs
show leukocytosis, increased alkaline phosphatase & GGT, and increased bilirubin. -
ANS Acute Cholangitis
- ERCP (diagnostic and therapeutic) + abx
1 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
,If ERCP is unable to be done, what surgery is indicated for Cholangitis? -
ANS Cholecystectomy
40y/o female presents w/ episodic, abrupt RUQ pain resolving slowly over minutes as well as
nausea made worse with meals. - ANS Cholelithiasis
- Observation +/- ursodeoxycholic acid, cholecystectomy
What is the key demographic most prone to getting cholelithiasis/choledocholithiasis? -
ANS The "5 Fs"
- Fat, fair, forty, female, fertile
Most common source of cholelithiasis stones - ANS Cholesterol
40y/o female presents w/ prolonged RUQ pain as well as N/V made worse with meals and
jaundice. - ANS Choledocholithiasis
- ERCP -> choledocholithotomy
Bilirubin levels of >_____ will cause neonatal jaundice while bilirubin levels of >_____ will cause
neonatal kernicterus. - ANS >5.0 = Jaundice
>20.0 = Kernicterus
Newborn presents w/ jaundice and cerebral dysfunction and encephalopathy causing seizures,
lethargy, irritability, hearing loss, and mental developmental delays.
- Labs show bilirubin levels >20 mg/dL. - ANS Kernicterus
- Exchange transfusions +/- IVIG
Treatment of neonatal jaundice - ANS Phototherapy +/- exchange transfusions
Hereditary conjugated bilirubinemia is known as _________ while hereditary unconjugated
bilirubinemia is known as _________ - ANS - Dubin-Johnson Syndrome
2 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
,- Crigler-Najjar Syndrome
"Dark liver" on liver biopsy alongside asymptomatic bilirubinemia is likely what diagnosis? -
ANS Dubin-Johnson Syndrome
- does not require treatment
Newborn presents w/ jaundice with severe progression in the second week, leading to
kernicterus. Labs show indirect hyperbilirubinemia of 20-50mg/dL - ANS Crigler-Najjar
Syndrome
- Phototherapy
Transient episodes of jaundice during periods of stress, fasting, alcohol, or illness is likely what
diagnosis? - ANS Gilbert Syndrome
- does not require treatment
Presents w/ epigastric pains radiating to the back made better with leaning forward as well as
N/V and fever. may have flank or periumbilical ecchymoses.
- Labs show 3x lipase/amylase and ALT increase - ANS Acute Pancreatitis
- NPO, IVFs, analgesics
Diagnosis of acute pancreatitis (initial and gold) - ANS Initial: XR ("Sentinel loop" and "Colon
cutoff sign")
Gold: CT
What are the most common causes for pancreatitis? - ANS "BADHITS"
- Biliary (gallstones)
- Alcohol abuse
- Drugs
- Hypertriglyceridemia
- Idiopathic
3 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
, - Traumas/Surgeries
- Scorpions
Which drugs are known to cause pancreatitis? (4) - ANS - Thiazide diuretics
- Protease inhibitors (the "-avir"s)
- Valproic acid
- Exanatide
Patient w/ Hx of T2DM presents w/ weight loss, steatorrhea, and calcifications to the pancreas
noted on XR. No pain noted. - ANS Chronic Pancreatitis
- Oral pancreatic enzyme replacement, symptomatic relief
Presents w/ painless jaundice, weight loss, pruritus, anorexia, acholic stools, dark urine, and
possible epigastric pains radiating to the back. PE reveals a palpable gallbladder. -
ANS Pancreatic Cancer
- Whipple procedure +/- chemotherapy (5-FU, Gemcitabine)
What is the most common form of pancreatic cancer? - ANS Adenocarcinoma
Palpable nontender gallbladder on examination is known as _________ Sign and is indicative
of..? - ANS Courvoisier's Sign
- indicative of pancreatic cancer
Migratory phlebitis is known as _________ Sign and is indicative of..? - ANS Trousseau's Sign
- indicative of malignancy (ex. pancreatic cancer)
Tumor marker for pancreatic cancer - ANS CA 19-9
Diagnosis of pancreatic cancer (initial and gold) - ANS Initial: CT
4 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
