PAEA GENERAL SURGERY EOR EXAM
NEWEST 2025 ACTUAL EXAM 300 QUESTIONS
AND CORRECT DETAILED ANSWERS
(VERIFIED ANSWERS) ALREADY GRADED A+
A 24-year-old woman presents to the clinic for preoperative evaluation for a
scheduled right anterior cruciate ligament repair. Preoperative clearance
was requested by the surgeon secondary to the patient complaining of
chest pain. Review of systems is positive for a chronic nonproductive
cough, chest pain, fatigue, and weight loss. She denies any history of
tobacco use. A chest radiograph reveals bilateral hilar adenopathy with
symmetric enlargement of the hila. Serum angiotensin-converting enzyme
levels are ordered and found to be elevated. Which of the following is the
most likely diagnosis? - ANSWER>> Sarcoidosis
Which of the following options is the best therapy for an ascending aortic
dissection? -
Emergent
ANSWER>> surgical
repair
Why must the preoperative preparation for surgical resection of a patient
with a diagnosed pheochromocytoma involve propranolol initiation after a
10-14 day course of phenoxybenzamine? - ANSWER>> To avoid
unopposed alpha-adrenergic receptor stimulation
A 60-year-old man has been bedridden following a stroke several months
ago. Urinalysis shows high levels of protein in the urine and nephrotic
syndrome is suspected. On physical exam, where would the provider likely
detect edema? - ANSWER>> Sacrum (peripheral and periorbital edema
are commonly seen in patients with nephrotic syndrome caused by sodium
retention and hypoalbuminemia; lab shows proteinuria > 3.5g/day)
A 78-year-old man undergoes laparoscopic surgery for a small bowel
obstruction.
,Which metabolic disturbance is he most at risk for
postoperatively? -
Metabolic
ANSWER>>
alkalosis
A 30-year-old woman presents to the outpatient clinic for follow-up on her
total thyroidectomy performed six weeks ago. Her incision is well-healed,
and there are no signs of infection. The patient does complain of feeling
cold, despite others around her being warm, fatigue, and weight gain. She
has remained on levothyroxine 100 mcg by mouth once daily. Serum
thyroid-stimulating hormone was performed prior to the appointment and
was found to be elevated. Which of the following is the most likely
diagnosis? - ANSWER>> Hypothyroidism
A 46-year-old man presents to the emergency department reporting
abdominal pain,
bloating, nausea, anorexia, and vomiting. His symptoms have been
worsening since
onset three days ago. His last bowel movement was four days ago, but he
continues to
pass flatus. Which of the following tests has the highest sensitivity for
confirming the
most likely diagnosis? - ANSWER>> Abdominal CT w/
contrast
Which of the following is appropriate initial treatment for uncomplicated
symptomatic
Crohn's
disANSWER>>
ease? -
Immunosuppressa
nt therapy
Parents bring their previously healthy four-week-old boy to the ED due to
repeated "projectile vomiting" immediately after he nurses for the past 24
hours. The parents report the emesis looks just like breast milk. He has had
a normal pattern of wet diapers. The parents deny any rectal bleeding. He
has not had any difficulty nursing before, and attempts at burping him have
not brought any relief. Vital signs include a temperature of 98.8°F. Physical
,exam reveals an alert, crying infant with a small, firm right upper quadrant
mass. Blood analysis is within normal limits. Which of the following choices
is the best next step for this patient? - ANSWER>> Order transabdominal
ultrasound
A 66-year-old man with hypertension and type II diabetes mellitus presents
to the ED complaining of chest tightness, dyspnea, and dizziness while
mowing his lawn earlier that day. He had similar symptoms two weeks ago.
His symptoms resolved within a couple of minutes of sitting to rest. He is
currently pain-free. Vital signs are pulse 88 beats per minute, blood
pressure 134/88 mm Hg, temperature 98.8°F, oxygen saturation 97%, and
20 respirations per minute. Exam reveals an obese man in no acute
distress and is otherwise unremarkable. Electrocardiogram is obtained and
shown above. Which of the following is the most likely diagnosis? -
ANSWER>> Angina pectoris
You are evaluating a 48-year-old woman with right lower extremity swelling,
pain, and redness. She is eight days status-post open cholecystectomy.
She was on lovenox for two days postoperatively but is not currently taking
any medications except oxycodone
for pain. What is the test of choice to confirm your suspected diagnosis? -
ANSWER>> Venous doppler ultrasound
Which of the following is a physical exam finding characterized by pain and
inspiratory
arrest
during ANSWER>>
palpatio
n of the
right
upper
quadran
t? -
Murphy'
s sign
A 66-year-old woman with a past medical history of uncontrolled diabetes
mellitus, obesity, and rheumatoid arthritis who is on methotrexate presents
to the emergency department complaining of redness, drainage, and pain
at her incision site. She had an umbilical hernia repair approximately six
days prior. On exam, you note the patient has a fever of 100.6°F and the
, incision site is erythematous and warm with a small amount of purulent
drainage noted. There are no signs of wound dehiscence and no areas of
fluctuance noted. Which of the following is the most likely diagnosis? -
ANSWER>> Cellulitis
Which of the following blood analysis tests is indicated to diagnose
anemia? -
Complete
ANSWER>> blood
count
Which of the following physical exam findings is more indicative of skin
abscess than
cellulitis? -
Fluctuance ANSWER>>
A 31-year-old man presents to the emergency department after an episode
of syncope following sexual intercourse. Upon regaining consciousness at
home, patient began complaining of a severe headache and started to
vomit. Physical examination reveals an uncomfortable man with positive
meningeal signs. Blood pressure is 162/94 mm Hg. CT scan of the head
without contrast reveals no acute pathology. Based on the most likely
diagnosis, what would you expect on the patient's lumbar puncture? -
ANSWER>> Hemoglobin degradation products (xanthochromia from
subarachnoid hemorrhage; tx includes supportive and nimodipine)
A 54-year-old man presents to the clinic complaining of difficulty swallowing
food for the past two years, which has been gradually worsening. He has
no problem swallowing liquids. He has had uncontrolled gastroesophageal
reflux for several years. He has no history of tobacco use and has not had
any head or neck radiation therapy. Which of the following is the best initial
test for this patient? - ANSWER>> Upper endoscopy (esophageal
strictures)
A 32-year-old man presents to the outpatient clinic for follow-up regarding
his hypertension. Despite the use of three antihypertensive agents, he
remains hypertensive. He also has episodes of nonexertional palpitations,
diaphoresis, and headache. He recently completed a 24-hour urinary
NEWEST 2025 ACTUAL EXAM 300 QUESTIONS
AND CORRECT DETAILED ANSWERS
(VERIFIED ANSWERS) ALREADY GRADED A+
A 24-year-old woman presents to the clinic for preoperative evaluation for a
scheduled right anterior cruciate ligament repair. Preoperative clearance
was requested by the surgeon secondary to the patient complaining of
chest pain. Review of systems is positive for a chronic nonproductive
cough, chest pain, fatigue, and weight loss. She denies any history of
tobacco use. A chest radiograph reveals bilateral hilar adenopathy with
symmetric enlargement of the hila. Serum angiotensin-converting enzyme
levels are ordered and found to be elevated. Which of the following is the
most likely diagnosis? - ANSWER>> Sarcoidosis
Which of the following options is the best therapy for an ascending aortic
dissection? -
Emergent
ANSWER>> surgical
repair
Why must the preoperative preparation for surgical resection of a patient
with a diagnosed pheochromocytoma involve propranolol initiation after a
10-14 day course of phenoxybenzamine? - ANSWER>> To avoid
unopposed alpha-adrenergic receptor stimulation
A 60-year-old man has been bedridden following a stroke several months
ago. Urinalysis shows high levels of protein in the urine and nephrotic
syndrome is suspected. On physical exam, where would the provider likely
detect edema? - ANSWER>> Sacrum (peripheral and periorbital edema
are commonly seen in patients with nephrotic syndrome caused by sodium
retention and hypoalbuminemia; lab shows proteinuria > 3.5g/day)
A 78-year-old man undergoes laparoscopic surgery for a small bowel
obstruction.
,Which metabolic disturbance is he most at risk for
postoperatively? -
Metabolic
ANSWER>>
alkalosis
A 30-year-old woman presents to the outpatient clinic for follow-up on her
total thyroidectomy performed six weeks ago. Her incision is well-healed,
and there are no signs of infection. The patient does complain of feeling
cold, despite others around her being warm, fatigue, and weight gain. She
has remained on levothyroxine 100 mcg by mouth once daily. Serum
thyroid-stimulating hormone was performed prior to the appointment and
was found to be elevated. Which of the following is the most likely
diagnosis? - ANSWER>> Hypothyroidism
A 46-year-old man presents to the emergency department reporting
abdominal pain,
bloating, nausea, anorexia, and vomiting. His symptoms have been
worsening since
onset three days ago. His last bowel movement was four days ago, but he
continues to
pass flatus. Which of the following tests has the highest sensitivity for
confirming the
most likely diagnosis? - ANSWER>> Abdominal CT w/
contrast
Which of the following is appropriate initial treatment for uncomplicated
symptomatic
Crohn's
disANSWER>>
ease? -
Immunosuppressa
nt therapy
Parents bring their previously healthy four-week-old boy to the ED due to
repeated "projectile vomiting" immediately after he nurses for the past 24
hours. The parents report the emesis looks just like breast milk. He has had
a normal pattern of wet diapers. The parents deny any rectal bleeding. He
has not had any difficulty nursing before, and attempts at burping him have
not brought any relief. Vital signs include a temperature of 98.8°F. Physical
,exam reveals an alert, crying infant with a small, firm right upper quadrant
mass. Blood analysis is within normal limits. Which of the following choices
is the best next step for this patient? - ANSWER>> Order transabdominal
ultrasound
A 66-year-old man with hypertension and type II diabetes mellitus presents
to the ED complaining of chest tightness, dyspnea, and dizziness while
mowing his lawn earlier that day. He had similar symptoms two weeks ago.
His symptoms resolved within a couple of minutes of sitting to rest. He is
currently pain-free. Vital signs are pulse 88 beats per minute, blood
pressure 134/88 mm Hg, temperature 98.8°F, oxygen saturation 97%, and
20 respirations per minute. Exam reveals an obese man in no acute
distress and is otherwise unremarkable. Electrocardiogram is obtained and
shown above. Which of the following is the most likely diagnosis? -
ANSWER>> Angina pectoris
You are evaluating a 48-year-old woman with right lower extremity swelling,
pain, and redness. She is eight days status-post open cholecystectomy.
She was on lovenox for two days postoperatively but is not currently taking
any medications except oxycodone
for pain. What is the test of choice to confirm your suspected diagnosis? -
ANSWER>> Venous doppler ultrasound
Which of the following is a physical exam finding characterized by pain and
inspiratory
arrest
during ANSWER>>
palpatio
n of the
right
upper
quadran
t? -
Murphy'
s sign
A 66-year-old woman with a past medical history of uncontrolled diabetes
mellitus, obesity, and rheumatoid arthritis who is on methotrexate presents
to the emergency department complaining of redness, drainage, and pain
at her incision site. She had an umbilical hernia repair approximately six
days prior. On exam, you note the patient has a fever of 100.6°F and the
, incision site is erythematous and warm with a small amount of purulent
drainage noted. There are no signs of wound dehiscence and no areas of
fluctuance noted. Which of the following is the most likely diagnosis? -
ANSWER>> Cellulitis
Which of the following blood analysis tests is indicated to diagnose
anemia? -
Complete
ANSWER>> blood
count
Which of the following physical exam findings is more indicative of skin
abscess than
cellulitis? -
Fluctuance ANSWER>>
A 31-year-old man presents to the emergency department after an episode
of syncope following sexual intercourse. Upon regaining consciousness at
home, patient began complaining of a severe headache and started to
vomit. Physical examination reveals an uncomfortable man with positive
meningeal signs. Blood pressure is 162/94 mm Hg. CT scan of the head
without contrast reveals no acute pathology. Based on the most likely
diagnosis, what would you expect on the patient's lumbar puncture? -
ANSWER>> Hemoglobin degradation products (xanthochromia from
subarachnoid hemorrhage; tx includes supportive and nimodipine)
A 54-year-old man presents to the clinic complaining of difficulty swallowing
food for the past two years, which has been gradually worsening. He has
no problem swallowing liquids. He has had uncontrolled gastroesophageal
reflux for several years. He has no history of tobacco use and has not had
any head or neck radiation therapy. Which of the following is the best initial
test for this patient? - ANSWER>> Upper endoscopy (esophageal
strictures)
A 32-year-old man presents to the outpatient clinic for follow-up regarding
his hypertension. Despite the use of three antihypertensive agents, he
remains hypertensive. He also has episodes of nonexertional palpitations,
diaphoresis, and headache. He recently completed a 24-hour urinary
