ABSITE Exam Preparation Version 1 Newest With
Complete 600 Questions And Correct Detailed
Answers| Brand New Version!
ABSITE Exam Prep – Version 1
Questions (Most Tested, Most Difficult, Long)
QUESTION 1
A 62-year-old male presents with acute onset severe right upper quadrant pain, nausea, and vomiting.
Labs show leukocytosis and mild elevation of bilirubin. Ultrasound demonstrates a distended gallbladder
with wall thickening but no stones. What is the next best step?
A. Start IV antibiotics and observe
B. Emergent laparoscopic cholecystectomy
C. Percutaneous cholecystostomy
D. Endoscopic retrograde cholangiopancreatography (ERCP)
Answer :B
Rationale: Acute cholecystitis without gallstones (acalculous) in a surgical patient requires early
laparoscopic cholecystectomy unless unstable, in which case percutaneous cholecystostomy is
considered.
QUESTION 2
A 45-year-old patient presents with sudden-onset severe abdominal pain and hypotension. CT scan
shows a ruptured abdominal aortic aneurysm. What is the initial management step in the emergency
department?
A. Immediate CT-guided intervention
B. Rapid IV crystalloid resuscitation and preparation for emergent surgical repair
C. Start broad-spectrum antibiotics
D. Observe and monitor vital signs
,Answer :B
Rationale: Ruptured AAA is life-threatening, requiring rapid volume resuscitation and immediate
surgical repair; imaging beyond initial diagnosis is unnecessary.
QUESTION 3
A 70-year-old female presents with hematemesis and hypotension. Endoscopy reveals actively bleeding
duodenal ulcer. What is the MOST appropriate next step after initial resuscitation?
A. Start PPI and admit to ward
B. Urgent endoscopic hemostasis
C. Emergent laparotomy
D. Angiography without intervention
Answer :B
Rationale: Endoscopic hemostasis is first-line for bleeding peptic ulcers after initial fluid resuscitation.
QUESTION 4
A 55-year-old male has severe, worsening left leg pain, pallor, and absent distal pulses. Onset was
sudden. What is the next best step?
A. Start IV heparin and obtain CT angiography
B. Observation and analgesia
C. Duplex ultrasound only
D. Immediate thrombolysis at bedside
Answer :A
Rationale: Acute limb ischemia requires rapid anticoagulation and imaging for surgical planning. Delays
increase risk of limb loss.
QUESTION 5
A patient presents with blunt abdominal trauma and hemodynamic instability. FAST exam shows free
fluid in the peritoneum. What is the next best step?
A. Obtain CT scan
B. Immediate exploratory laparotomy
C. Observation in ICU
D. Bedside paracentesis
Answer :B
Rationale: Hemodynamically unstable trauma patients with positive FAST require emergent
laparotomy.
, QUESTION 6
A 65-year-old patient with history of coronary artery disease develops postoperative hypotension and
jugular venous distention after CABG. Pulmonary exam shows clear lungs. What is the MOST likely
cause?
A. Hypovolemic shock
B. Cardiogenic shock
C. Obstructive shock (tamponade)
D. Septic shock
Answer :C
Rationale: Postoperative cardiac tamponade presents with hypotension, JVD, and clear lungs. Emergent
pericardiocentesis or surgical drainage is required.
QUESTION 7
A 35-year-old male presents with penetrating abdominal trauma to the right lower quadrant. He is
hemodynamically stable. Local wound exploration reveals fascial penetration. What is the next step?
A. Immediate laparotomy
B. Observation only
C. Diagnostic laparoscopy
D. Close wound and discharge
Answer :C
Rationale: Diagnostic laparoscopy is appropriate in stable patients with penetrating abdominal trauma
and fascial penetration.
QUESTION 8
A 45-year-old patient presents with acute appendicitis complicated by abscess formation. He is clinically
stable. What is the BEST initial management?
A. Emergent laparoscopic appendectomy
B. Percutaneous drainage with antibiotics
C. Open appendectomy immediately
D. Observation only
Answer :B
Rationale: Non-operative management with percutaneous drainage and antibiotics is preferred for
appendiceal abscess in stable patients.
Complete 600 Questions And Correct Detailed
Answers| Brand New Version!
ABSITE Exam Prep – Version 1
Questions (Most Tested, Most Difficult, Long)
QUESTION 1
A 62-year-old male presents with acute onset severe right upper quadrant pain, nausea, and vomiting.
Labs show leukocytosis and mild elevation of bilirubin. Ultrasound demonstrates a distended gallbladder
with wall thickening but no stones. What is the next best step?
A. Start IV antibiotics and observe
B. Emergent laparoscopic cholecystectomy
C. Percutaneous cholecystostomy
D. Endoscopic retrograde cholangiopancreatography (ERCP)
Answer :B
Rationale: Acute cholecystitis without gallstones (acalculous) in a surgical patient requires early
laparoscopic cholecystectomy unless unstable, in which case percutaneous cholecystostomy is
considered.
QUESTION 2
A 45-year-old patient presents with sudden-onset severe abdominal pain and hypotension. CT scan
shows a ruptured abdominal aortic aneurysm. What is the initial management step in the emergency
department?
A. Immediate CT-guided intervention
B. Rapid IV crystalloid resuscitation and preparation for emergent surgical repair
C. Start broad-spectrum antibiotics
D. Observe and monitor vital signs
,Answer :B
Rationale: Ruptured AAA is life-threatening, requiring rapid volume resuscitation and immediate
surgical repair; imaging beyond initial diagnosis is unnecessary.
QUESTION 3
A 70-year-old female presents with hematemesis and hypotension. Endoscopy reveals actively bleeding
duodenal ulcer. What is the MOST appropriate next step after initial resuscitation?
A. Start PPI and admit to ward
B. Urgent endoscopic hemostasis
C. Emergent laparotomy
D. Angiography without intervention
Answer :B
Rationale: Endoscopic hemostasis is first-line for bleeding peptic ulcers after initial fluid resuscitation.
QUESTION 4
A 55-year-old male has severe, worsening left leg pain, pallor, and absent distal pulses. Onset was
sudden. What is the next best step?
A. Start IV heparin and obtain CT angiography
B. Observation and analgesia
C. Duplex ultrasound only
D. Immediate thrombolysis at bedside
Answer :A
Rationale: Acute limb ischemia requires rapid anticoagulation and imaging for surgical planning. Delays
increase risk of limb loss.
QUESTION 5
A patient presents with blunt abdominal trauma and hemodynamic instability. FAST exam shows free
fluid in the peritoneum. What is the next best step?
A. Obtain CT scan
B. Immediate exploratory laparotomy
C. Observation in ICU
D. Bedside paracentesis
Answer :B
Rationale: Hemodynamically unstable trauma patients with positive FAST require emergent
laparotomy.
, QUESTION 6
A 65-year-old patient with history of coronary artery disease develops postoperative hypotension and
jugular venous distention after CABG. Pulmonary exam shows clear lungs. What is the MOST likely
cause?
A. Hypovolemic shock
B. Cardiogenic shock
C. Obstructive shock (tamponade)
D. Septic shock
Answer :C
Rationale: Postoperative cardiac tamponade presents with hypotension, JVD, and clear lungs. Emergent
pericardiocentesis or surgical drainage is required.
QUESTION 7
A 35-year-old male presents with penetrating abdominal trauma to the right lower quadrant. He is
hemodynamically stable. Local wound exploration reveals fascial penetration. What is the next step?
A. Immediate laparotomy
B. Observation only
C. Diagnostic laparoscopy
D. Close wound and discharge
Answer :C
Rationale: Diagnostic laparoscopy is appropriate in stable patients with penetrating abdominal trauma
and fascial penetration.
QUESTION 8
A 45-year-old patient presents with acute appendicitis complicated by abscess formation. He is clinically
stable. What is the BEST initial management?
A. Emergent laparoscopic appendectomy
B. Percutaneous drainage with antibiotics
C. Open appendectomy immediately
D. Observation only
Answer :B
Rationale: Non-operative management with percutaneous drainage and antibiotics is preferred for
appendiceal abscess in stable patients.
