2025 ABSITE Pharmacology Breakdown– High-Yield
Drug Profiles, Mechanisms of Action, Side Effects, and
Commonly Tested Clinical Scenarios for Surgical Exam
Success
In a patient with Crohn's disease who presents with intractable small bowel obstruction and is
found to have strictures during ex-lap, stricturoplasty should NOT be considered when?
a.) Several semi-evenly spaced strictures are present in a 10cm segment
b.) Diffuse small disease with a short fibrotic stricture is found
c.) The patient has rapid symptomatic recurrence within 12 months of a previous resection
d.) A > 100cm resection was performed
e.) There is evidence of short gut already - -CORRECT ANS- -(a)
This should only be considered if there is not much gut left or there is a short segment of
fibrotic stirctures present.
According to Goodsall's rule the site of the internal opening of a fistula in ano can be predicted
by
a.) The position of the external opening
b.) The distance of the external opening from the anal verge
c.) The absence of in-duration
d.) None of the above - -CORRECT ANS- -(a)
,Goodsall's rule relates the external opening of an anal fistula to its internal opening. It states
that the external opening situated behind the transverse anal line will open into the anal canal
in the midline posteriorly. An anterior opening is usually associated with a radial tract
The extraintestinal manifestation LEAST likely to improve after total proctocolectomy for UC is
which of the following?
a.) Uveitis
b.) Iritis
c.) Sclerosing cholangitis
d.) Erythema nodosum
e.) Pyoderma gangrenosum - -CORRECT ANS- -(c)
In Ulcerative Colitis, proctocolectomy does not help sclerosing cholangitis, may help skin,
anemia; rarely helps arthritis. HLA B27 associated with sacroiliitis
After formation of an ileo-anal pouch for Crohn's disease a patient presents with urgency and
pain. Treatment for suspected pouchitis would include:
a.) EUA & biopsy
b.) Vanco enemas
c.) Short chain fatty acid enemas
d.) Short chain fatty acid enemas & Flagyl
e.) IV Flagyl alone - -CORRECT ANS- -(d)
For suspected pouchitis (infectious or stump) Rx with flagyl or short chain fatty acid enemas
, A 32yr old patient presents with pruritus over the past 2 weeks. He has a history of UC for the
past 7 years, which has remained well controlled on sulfasalazine and cortisone enemas. His
exam is remarkable for diffuse excoriations on his extremities & trunk. Laboratory studies reveal
an iron deficiency anemia & normal electrolytes. LFTs are normal, except for an alkaline
phosphatase of 322 U/L (normal, <110 U/L). Which of the following is the most likely
explanation for his symptoms?
a.) Erythema nodosum
b.) Hepatitis C
c.) Primary biliary cirrhosis
d.) Primary sclerosing cholangitis
e.) Pyoderma gangrenosum - -CORRECT ANS- -(e)
Dapsone and/or steroids (topical or systemic)
At an operation for small bowel obstruction, a cecal volvulus is also found. The cecum appears
viable. The procedure of choice is which of the following?
a.) Cecopexy
b.) Tube cecostomy
c.) Right hemicolectomy
d.) Resection, ileostomy and mucus fistula - -CORRECT ANS- -(c)
Cecal volvulus is unlikely to decompress so they must be taken to the OR. Most recommend R
hemicolectomy with ileo-transverse anastomosis if cecum is viable. Cecopexy is alternative with
tube, but both are likely to fail.
What is appropriate management of a 1cm mid-appendiceal carcinoid?
a.) Observation
Drug Profiles, Mechanisms of Action, Side Effects, and
Commonly Tested Clinical Scenarios for Surgical Exam
Success
In a patient with Crohn's disease who presents with intractable small bowel obstruction and is
found to have strictures during ex-lap, stricturoplasty should NOT be considered when?
a.) Several semi-evenly spaced strictures are present in a 10cm segment
b.) Diffuse small disease with a short fibrotic stricture is found
c.) The patient has rapid symptomatic recurrence within 12 months of a previous resection
d.) A > 100cm resection was performed
e.) There is evidence of short gut already - -CORRECT ANS- -(a)
This should only be considered if there is not much gut left or there is a short segment of
fibrotic stirctures present.
According to Goodsall's rule the site of the internal opening of a fistula in ano can be predicted
by
a.) The position of the external opening
b.) The distance of the external opening from the anal verge
c.) The absence of in-duration
d.) None of the above - -CORRECT ANS- -(a)
,Goodsall's rule relates the external opening of an anal fistula to its internal opening. It states
that the external opening situated behind the transverse anal line will open into the anal canal
in the midline posteriorly. An anterior opening is usually associated with a radial tract
The extraintestinal manifestation LEAST likely to improve after total proctocolectomy for UC is
which of the following?
a.) Uveitis
b.) Iritis
c.) Sclerosing cholangitis
d.) Erythema nodosum
e.) Pyoderma gangrenosum - -CORRECT ANS- -(c)
In Ulcerative Colitis, proctocolectomy does not help sclerosing cholangitis, may help skin,
anemia; rarely helps arthritis. HLA B27 associated with sacroiliitis
After formation of an ileo-anal pouch for Crohn's disease a patient presents with urgency and
pain. Treatment for suspected pouchitis would include:
a.) EUA & biopsy
b.) Vanco enemas
c.) Short chain fatty acid enemas
d.) Short chain fatty acid enemas & Flagyl
e.) IV Flagyl alone - -CORRECT ANS- -(d)
For suspected pouchitis (infectious or stump) Rx with flagyl or short chain fatty acid enemas
, A 32yr old patient presents with pruritus over the past 2 weeks. He has a history of UC for the
past 7 years, which has remained well controlled on sulfasalazine and cortisone enemas. His
exam is remarkable for diffuse excoriations on his extremities & trunk. Laboratory studies reveal
an iron deficiency anemia & normal electrolytes. LFTs are normal, except for an alkaline
phosphatase of 322 U/L (normal, <110 U/L). Which of the following is the most likely
explanation for his symptoms?
a.) Erythema nodosum
b.) Hepatitis C
c.) Primary biliary cirrhosis
d.) Primary sclerosing cholangitis
e.) Pyoderma gangrenosum - -CORRECT ANS- -(e)
Dapsone and/or steroids (topical or systemic)
At an operation for small bowel obstruction, a cecal volvulus is also found. The cecum appears
viable. The procedure of choice is which of the following?
a.) Cecopexy
b.) Tube cecostomy
c.) Right hemicolectomy
d.) Resection, ileostomy and mucus fistula - -CORRECT ANS- -(c)
Cecal volvulus is unlikely to decompress so they must be taken to the OR. Most recommend R
hemicolectomy with ileo-transverse anastomosis if cecum is viable. Cecopexy is alternative with
tube, but both are likely to fail.
What is appropriate management of a 1cm mid-appendiceal carcinoid?
a.) Observation
