Surgery COMAT questions [ACTUAL EXAM] LATEST VERSION
[QUESTIONS AND ANSWERS] WITH PRACTICE EXAM
DETAILED AND VERIFIED FOR GUARANTEED PASS- LATEST
UPDATE 2025 GRADED A
SAVE
5 W's of Post-op surgery? - CORRECT ANSWER 5 W's
• Wind
○ Pneumonia, PE, Aspiration
• Wound
○ Surgical site infections
• Water
○ Urinary tract infections
§ Increased risk due to indwelling catheters
§ Associated with enteric organisms ie. E. coli, Klebsiella, Proteus mirabillis
• Walk
○ Deep vein thrombosis
• Wonder Drugs
○ Drug fever, blood products, IV lines
○ Drug fever: diagnosis of exclusion
§ Usually associated with anticonvulsants, antibiotics (beta-lactams, sulfonamides) and
allopurinol
§ Occurs within 1-2 weeks of drug initiation
Modified Radial Mastectomy vs. Simple mastectomy? - CORRECT ANSWER MRM
includes:
• Includes axillary dissection
• Level I and Level II axillary dissection being the standard procedure
altnernate name for hidradenitis suppurative - CORRECT ANSWER acnes inversa
What is hidradenitis suppurativa? - CORRECT ANSWER hronic skin inflammatory
condition that is associated with:
• Induration
• Abscess
• Sinus tracts
It is similar in character and location as many other conditions but can be differentiated
by careful history and identifying presence of hyperkeratosis induced follicular occlusion
(family history and reccurrence)
,What is Paraphimosis? - CORRECT ANSWER Paraphimosis is considered a
urological emergency and occurs when the retracted foreskin develops a fixed
constriction proximal to the glans
Treatment of parphimosis? - CORRECT ANSWER The glans is first compressed for
several minutes to decrease edema
Followed by application of ice and attempting to push the prepuce distally while the
glans is pushed proximally
Balanoposthitis - CORRECT ANSWER is an inflammation secondary to an infection
of the glans penis and the surrounding foreskin
The majority of cases are due to poor hygiene or external irritation with subsequent
colonization by a fungus
Treatment of Balanoposthitis? - CORRECT ANSWER Cleaning the region with soap
and water, adequate hygiene, avoiding moist environment and application of antifungal
creams such as nystatin or clotrimazole
Peyronie's disease - CORRECT ANSWER Peyronie's disease is a rare condition also
known as chronic inflammation of the tunica albuginea
Associated with abnormal growth of the fibrous plaques and scar formation in the
sheath of tissue surrounding the corpora cavernosa (tunica albuginea) of the penis
Phimosis - CORRECT ANSWER Phimosis is the inability to retract the foreskin
proximally to the glans penis
• Can be a result of normal development or may be due to infection or poor hygiene
Priapism? - CORRECT ANSWER Priapism is another urological emergency but is
not involved with foreskin constriction or retraction difficulties
• Priapism is a urological emergency and is defined as painful, involntary and persistent
erection in which both corpora cavernosa are engorged with stagnant blood
• Impotence can result with sustained erection, thus urgent action is imperative when
faced with this condition
Treatment of priapism? - CORRECT ANSWER adequate analgesia, hydration,
stopping the offending agent, administration of terbutaline (beta2-mimetic), application
of ice packs and corporal aspiration of blood
A-fib complication and acute abdomen? - CORRECT ANSWER The patient in the
vignette has A-fib as seen in the exhibit and is reportedly non-compliant with medical
therapy predisposing him to atrial clot formatiom which can subsequently embolize and
cause ischemic colitis. These patients present with:
,• Acute abdominal pain
• Bloody diarrhea
• Vomiting
• Abdominal tenderness
Other causes of ischemic colitis - CORRECT ANSWER • Embolus
• Hypoperfusion from any cause
• Bowel obstruction
Clinical findings of ischemic colitis? - CORRECT ANSWER • Labs show
characteristically elevated WBC count and elevated lactic acid level because of
ischemia
• Imaging techniques:
○ CT scan can show bowel wall thickening
○ Barium enema may show a "thumb printing"
○ Sigmoidoscopy can reveal bloody and edematous tissue
Treatment of ischemic colitis? - CORRECT ANSWER • Aimed at the cause, in this
case embolization is a possibility
• If treatment is delayed the bowel necroses then surgical resection is indicated
• Patients should get IV fluids, bowel rest, and ab to cover for normal gastrointestinal
bacteria
• The left side of the colon is invlved most of the time in ischemic colitis
what part of the colon is most commonly involved in ischemic colitis? - CORRECT
ANSWER • The left colon is most commonly involved in ischemic colitis
• This portion of the colon is supplied by the IMA
• The IMA supplies the descending colon, the sigmoid colon, and the upper rectum
ileocolic artery - CORRECT ANSWER Arises from the end of the SMA and supplies
the cecum, appendix, and terminal ileum
Marginal artery (artery of Drummond) - CORRECT ANSWER Marginal artery (artery
of Drummond)
Is the connection between the SMA and the IMA found at the splenic flexure
It is considered a watershed area and an area often involved in ischemic colitis
Middle colic artery - CORRECT ANSWER Branch of the SMA that supplies the
transverse colon
It anastamoses with the L. colic artery of the IMA to form the marginal artery
, SMA - CORRECT ANSWER Arises from the anterior portion of the abdominal aorta
just inferior to the celiac artery
It supplies a portion of the duodenum, the small bowel, the right colon, and 2/3 of the
transverse colon
Schatzki ring - CORRECT ANSWER narrowing of the lower esophagus that can
cause difficulty swallowing (dysphagia). The narrowing is caused by a ring of mucosal
tissue (which lines the esophagus) or muscular tissue.
Heller myotomy is treatment for? - CORRECT ANSWER Treatment of achalasia
Treatment for schatzki rings? - CORRECT ANSWER • Initial treatment is dilation with
a bougie or balloon to fracture the ring
• If symptoms recur repeat dilation can be done
• Persistent symptoms can be treated with endoscopic electrocautery incision
• Because GERD is possible cause for esophageal ring aggressive treatment of reflux
should also be done
fundoplication? - CORRECT ANSWER Treatment for persistent GERD
It can be done if persistent esophageal ring is thought to be caused by refractory GERD
but only after dilation has been attempted
zenker's diverticulum presentation? - CORRECT ANSWER ○ Months to years of
dysphagia
○ Halitosis
○ Heartburn
○ Regurgitation
○ Physical examination can reveal borborygmi in the neck
Diagnosis of Zenker's Diverticulum - CORRECT ANSWER • Barium swallow which
will show an outpouching
• Esophagoscopy should be done prior to surgical management to assess the
diverticulum and look for any signs of squamous cell carcinoma or carcinoma in situ
• If a rigid scope is used there is risk of perforation
Indications for treatment of Zenker's diverticulum and treatment? - CORRECT
ANSWER • Diverticulum is greater than 2 cm
• Patient can tolerate
Treatment is diverticulectomy and cricopharyngeal myotomy
Sliding versus paraesophageal hernias? - CORRECT ANSWER
[QUESTIONS AND ANSWERS] WITH PRACTICE EXAM
DETAILED AND VERIFIED FOR GUARANTEED PASS- LATEST
UPDATE 2025 GRADED A
SAVE
5 W's of Post-op surgery? - CORRECT ANSWER 5 W's
• Wind
○ Pneumonia, PE, Aspiration
• Wound
○ Surgical site infections
• Water
○ Urinary tract infections
§ Increased risk due to indwelling catheters
§ Associated with enteric organisms ie. E. coli, Klebsiella, Proteus mirabillis
• Walk
○ Deep vein thrombosis
• Wonder Drugs
○ Drug fever, blood products, IV lines
○ Drug fever: diagnosis of exclusion
§ Usually associated with anticonvulsants, antibiotics (beta-lactams, sulfonamides) and
allopurinol
§ Occurs within 1-2 weeks of drug initiation
Modified Radial Mastectomy vs. Simple mastectomy? - CORRECT ANSWER MRM
includes:
• Includes axillary dissection
• Level I and Level II axillary dissection being the standard procedure
altnernate name for hidradenitis suppurative - CORRECT ANSWER acnes inversa
What is hidradenitis suppurativa? - CORRECT ANSWER hronic skin inflammatory
condition that is associated with:
• Induration
• Abscess
• Sinus tracts
It is similar in character and location as many other conditions but can be differentiated
by careful history and identifying presence of hyperkeratosis induced follicular occlusion
(family history and reccurrence)
,What is Paraphimosis? - CORRECT ANSWER Paraphimosis is considered a
urological emergency and occurs when the retracted foreskin develops a fixed
constriction proximal to the glans
Treatment of parphimosis? - CORRECT ANSWER The glans is first compressed for
several minutes to decrease edema
Followed by application of ice and attempting to push the prepuce distally while the
glans is pushed proximally
Balanoposthitis - CORRECT ANSWER is an inflammation secondary to an infection
of the glans penis and the surrounding foreskin
The majority of cases are due to poor hygiene or external irritation with subsequent
colonization by a fungus
Treatment of Balanoposthitis? - CORRECT ANSWER Cleaning the region with soap
and water, adequate hygiene, avoiding moist environment and application of antifungal
creams such as nystatin or clotrimazole
Peyronie's disease - CORRECT ANSWER Peyronie's disease is a rare condition also
known as chronic inflammation of the tunica albuginea
Associated with abnormal growth of the fibrous plaques and scar formation in the
sheath of tissue surrounding the corpora cavernosa (tunica albuginea) of the penis
Phimosis - CORRECT ANSWER Phimosis is the inability to retract the foreskin
proximally to the glans penis
• Can be a result of normal development or may be due to infection or poor hygiene
Priapism? - CORRECT ANSWER Priapism is another urological emergency but is
not involved with foreskin constriction or retraction difficulties
• Priapism is a urological emergency and is defined as painful, involntary and persistent
erection in which both corpora cavernosa are engorged with stagnant blood
• Impotence can result with sustained erection, thus urgent action is imperative when
faced with this condition
Treatment of priapism? - CORRECT ANSWER adequate analgesia, hydration,
stopping the offending agent, administration of terbutaline (beta2-mimetic), application
of ice packs and corporal aspiration of blood
A-fib complication and acute abdomen? - CORRECT ANSWER The patient in the
vignette has A-fib as seen in the exhibit and is reportedly non-compliant with medical
therapy predisposing him to atrial clot formatiom which can subsequently embolize and
cause ischemic colitis. These patients present with:
,• Acute abdominal pain
• Bloody diarrhea
• Vomiting
• Abdominal tenderness
Other causes of ischemic colitis - CORRECT ANSWER • Embolus
• Hypoperfusion from any cause
• Bowel obstruction
Clinical findings of ischemic colitis? - CORRECT ANSWER • Labs show
characteristically elevated WBC count and elevated lactic acid level because of
ischemia
• Imaging techniques:
○ CT scan can show bowel wall thickening
○ Barium enema may show a "thumb printing"
○ Sigmoidoscopy can reveal bloody and edematous tissue
Treatment of ischemic colitis? - CORRECT ANSWER • Aimed at the cause, in this
case embolization is a possibility
• If treatment is delayed the bowel necroses then surgical resection is indicated
• Patients should get IV fluids, bowel rest, and ab to cover for normal gastrointestinal
bacteria
• The left side of the colon is invlved most of the time in ischemic colitis
what part of the colon is most commonly involved in ischemic colitis? - CORRECT
ANSWER • The left colon is most commonly involved in ischemic colitis
• This portion of the colon is supplied by the IMA
• The IMA supplies the descending colon, the sigmoid colon, and the upper rectum
ileocolic artery - CORRECT ANSWER Arises from the end of the SMA and supplies
the cecum, appendix, and terminal ileum
Marginal artery (artery of Drummond) - CORRECT ANSWER Marginal artery (artery
of Drummond)
Is the connection between the SMA and the IMA found at the splenic flexure
It is considered a watershed area and an area often involved in ischemic colitis
Middle colic artery - CORRECT ANSWER Branch of the SMA that supplies the
transverse colon
It anastamoses with the L. colic artery of the IMA to form the marginal artery
, SMA - CORRECT ANSWER Arises from the anterior portion of the abdominal aorta
just inferior to the celiac artery
It supplies a portion of the duodenum, the small bowel, the right colon, and 2/3 of the
transverse colon
Schatzki ring - CORRECT ANSWER narrowing of the lower esophagus that can
cause difficulty swallowing (dysphagia). The narrowing is caused by a ring of mucosal
tissue (which lines the esophagus) or muscular tissue.
Heller myotomy is treatment for? - CORRECT ANSWER Treatment of achalasia
Treatment for schatzki rings? - CORRECT ANSWER • Initial treatment is dilation with
a bougie or balloon to fracture the ring
• If symptoms recur repeat dilation can be done
• Persistent symptoms can be treated with endoscopic electrocautery incision
• Because GERD is possible cause for esophageal ring aggressive treatment of reflux
should also be done
fundoplication? - CORRECT ANSWER Treatment for persistent GERD
It can be done if persistent esophageal ring is thought to be caused by refractory GERD
but only after dilation has been attempted
zenker's diverticulum presentation? - CORRECT ANSWER ○ Months to years of
dysphagia
○ Halitosis
○ Heartburn
○ Regurgitation
○ Physical examination can reveal borborygmi in the neck
Diagnosis of Zenker's Diverticulum - CORRECT ANSWER • Barium swallow which
will show an outpouching
• Esophagoscopy should be done prior to surgical management to assess the
diverticulum and look for any signs of squamous cell carcinoma or carcinoma in situ
• If a rigid scope is used there is risk of perforation
Indications for treatment of Zenker's diverticulum and treatment? - CORRECT
ANSWER • Diverticulum is greater than 2 cm
• Patient can tolerate
Treatment is diverticulectomy and cricopharyngeal myotomy
Sliding versus paraesophageal hernias? - CORRECT ANSWER
