ABSITE - HERNIAS – QUESTIONS WITH
CORRECT ANSWERS 2025
YouNareNevaluatingNaN55-year-
oldNfemaleNforNaNpainfulNlumpNinNherNrightNgroinNforNseveralNdays.NSheNdeniesNfever,Nchills,NnauseaNorNem
esis,NhasNbeenNhavingNnormalNbowelNandNbladderNfunction,NandNisNinNotherwiseNexcellentNhealth.NPhysica
lNexaminationNrevealsNaNsolitaryN3-
cmNtender,Nfirm,NroundNmassNinNherNrightNgroinNbelowNtheNinguinalNligamentNwithNnoNskinNdiscoloration.N
SheNhasNaNpre-paidNvacationNscheduledNinNthreeNdays.NAtNthisNpoint,NyouNwouldNrecommend:
A.NObservationNwithNreevaluationNafterNherNvacation
B.NUrgentNherniaNrepair
C.NElectiveNherniaNrepairNfollowingNherNvacation
D.NAnalgesicsNandNattemptedNreductionNofNtheNmass
E.NAspirationNofNtheNmassNwithNultrasoundNguidanceN-NCORRECTNANSWERN-UrgentNherniaNrepair
Correct.
TheNpatient'sNhistoryNandNphysicalNexaminationNareNconsistentNwithNanNincarceratedNfemoralNhernia,Nwhi
chNrequiresNimmediateNoperationNtoNavoidNprogressionNtoNstrangulation,NischemiaNandNperforationNofNinv
olvedNbowel.NComplicationsNareNhighlyNlikelyNinNthisNsetting.NAlthoughNattemptedNreductionNunderNanalge
siaNandNsedationNisNreasonable,NthisNisNnotNrecommendedNforNfemoralNhernias.NThereNisNnoNroleNforNneedl
eNaspirationNofNaNgroinNmassNwhenNaNherniaNisNsuspected.
ANhealthyN40-year-
oldNmanNisNconsultingNwithNyouNforNevaluationNofNintermittentNleftNgroinNdiscomfortN(4NoutNofN10NonNpain
Nscale)NwhichNhasNbeenNpresentNforNtheNpastNthreeNweeks.NTheseNsymptomsNhaveNcausedNhimNtoNmissNw
orkNonNoccasion.NHeNdeniesNanyNconstitutionalNsymptoms,NandNhasNnoNotherNcomplaintsNatNthisNtime.NOn
NphysicalNexamination,NyouNcannotNdetectNaNhernia,NevenNwithNprovocativeNmaneuversN(i.e.,NValsalva,Ncou
gh).NYourNrecommendationNatNthisNtimeNwouldNbe:
A.NComputedNtomographyN(CT)NofNtheNabdomenNandNpelvisNwithNoralNandNintravenousNcontrastNforNfurth
erNevaluation
B.NDiagnosticNlaparoscopy
C.NContrastNherniographyN(peritoneography)
D.NLeftNgroinNexplorationNwithNpossibleNinguinalNherniaNrepair
E.NUltrasonographyNofNtheNleftNgroinN-NCORRECTNANSWERN-UltrasonographyNofNtheNleftNgroin
, Correct.
ThisNpatientNmayNhaveNanNoccultNinguinalNherniaNwhichNisNnotNdetectableNonNphysicalNexamination.NUltras
onography,NherniographyNandNCTNareNallNusefulNdiagnosticNstudies,NwithNultrasoundNbeingNtheNleastNinvas
ive,NlessNcostly,NandNwithNhighNsensitivityNandNspecificity.NInNthisNpatientNwithNminimalNsymptoms,NthereNis
NnoNindicationNforNimmediateNlaparoscopyNorNgroinNexploration.
AN60-year-
oldNmaleNpresentsNwithNpersistentNpainNoverNhisNrightNlowerNabdomenNsixNmonthsNafterNaNbilateralNTEPPNl
aparoscopicNinguinalNherniaNrepair.NThereNisNnoNevidenceNofNherniaNrecurrence,NseromaNorNinfectionNonNp
hysicalNexamination.NAsNpartNofNyourNinvestigation,NyouNobtainNaNplainNabdominalNradiograph,NwhichNreve
alsNmultipleNbilateralNspiralNtacksNacrossNtheNlowerNabdomen.NYouNobtainNtheNoperativeNreport,NandNconfi
rmNyourNsuspicionNthatNtheNsurgeonNusedNpermanentNspiralNtacksNforNmeshNfixation.NInjuryNtoNwhichNofNt
heNfollowingNnervesNisNtheNmostNlikelyNcauseNforNhisNpersistentNpain?
A.NIlioinguinalNnerve
B.NIliohypogastricNnerve
C.NGenitalNbranchNofNtheNgenitofemoralNnerve
D.NLateralNfemoralNcutaneousNnerve
E.NFemoralNnerveN-NCORRECTNANSWERN-IliohypogastricNnerve
Correct.
Post-
herniorrhaphyNneuralgiaNhasNbeenNreportedNtoNoccurNinNupNtoN20%NofNcases.NInjuryNtoNanyNofNtheNnervesN
mentionedNcanNresultNinNpost-
herniorrhaphyNneuralgia.NGivenNtheNlocationNofNtheNpatient'sNsymptomsNandNtheNmethodNusedNforNmeshN
fixation,NtheNiliohypogastricNnerveNisNtheNmostNvulnerableNtoNinjuryNduringNlaparoscopicNmeshNfixation.
AN67-year-oldNmanNpresentsNwithNvomitingNandNabdominalNdistension.NAnNabdominalNx-
rayNrevealsNair/fluidNlevelsNsuggestingNsmallNbowelNobstruction.NOnNexam,NherNabdomenNisNdistendedNwit
hNdiffuseNtendernessNandNthereNisNaNtenderNmassNinNtheNrightNgroin.NAtNoperation,NyouNresectNaNstrangula
tedN6-
cmNsegmentNofNsmallNintestineNandNthereNisNmoderateNcontaminationNwithNbowelNcontents.NWhatNshould
NyouNdoNforNtheNhernia?
A.NCompleteNtheNoperationNandNplanNaNsubsequentNherniaNrepair.
B.NPerformNaNrepairNusingNpolypropyleneNmesh.
C.NPerformNaNrepairNusingNbiologicNmesh.
D.NPerformNaNtissue-basedNrepair.N-NCORRECTNANSWERN-PerformNaNtissue-basedNrepair.
CORRECT ANSWERS 2025
YouNareNevaluatingNaN55-year-
oldNfemaleNforNaNpainfulNlumpNinNherNrightNgroinNforNseveralNdays.NSheNdeniesNfever,Nchills,NnauseaNorNem
esis,NhasNbeenNhavingNnormalNbowelNandNbladderNfunction,NandNisNinNotherwiseNexcellentNhealth.NPhysica
lNexaminationNrevealsNaNsolitaryN3-
cmNtender,Nfirm,NroundNmassNinNherNrightNgroinNbelowNtheNinguinalNligamentNwithNnoNskinNdiscoloration.N
SheNhasNaNpre-paidNvacationNscheduledNinNthreeNdays.NAtNthisNpoint,NyouNwouldNrecommend:
A.NObservationNwithNreevaluationNafterNherNvacation
B.NUrgentNherniaNrepair
C.NElectiveNherniaNrepairNfollowingNherNvacation
D.NAnalgesicsNandNattemptedNreductionNofNtheNmass
E.NAspirationNofNtheNmassNwithNultrasoundNguidanceN-NCORRECTNANSWERN-UrgentNherniaNrepair
Correct.
TheNpatient'sNhistoryNandNphysicalNexaminationNareNconsistentNwithNanNincarceratedNfemoralNhernia,Nwhi
chNrequiresNimmediateNoperationNtoNavoidNprogressionNtoNstrangulation,NischemiaNandNperforationNofNinv
olvedNbowel.NComplicationsNareNhighlyNlikelyNinNthisNsetting.NAlthoughNattemptedNreductionNunderNanalge
siaNandNsedationNisNreasonable,NthisNisNnotNrecommendedNforNfemoralNhernias.NThereNisNnoNroleNforNneedl
eNaspirationNofNaNgroinNmassNwhenNaNherniaNisNsuspected.
ANhealthyN40-year-
oldNmanNisNconsultingNwithNyouNforNevaluationNofNintermittentNleftNgroinNdiscomfortN(4NoutNofN10NonNpain
Nscale)NwhichNhasNbeenNpresentNforNtheNpastNthreeNweeks.NTheseNsymptomsNhaveNcausedNhimNtoNmissNw
orkNonNoccasion.NHeNdeniesNanyNconstitutionalNsymptoms,NandNhasNnoNotherNcomplaintsNatNthisNtime.NOn
NphysicalNexamination,NyouNcannotNdetectNaNhernia,NevenNwithNprovocativeNmaneuversN(i.e.,NValsalva,Ncou
gh).NYourNrecommendationNatNthisNtimeNwouldNbe:
A.NComputedNtomographyN(CT)NofNtheNabdomenNandNpelvisNwithNoralNandNintravenousNcontrastNforNfurth
erNevaluation
B.NDiagnosticNlaparoscopy
C.NContrastNherniographyN(peritoneography)
D.NLeftNgroinNexplorationNwithNpossibleNinguinalNherniaNrepair
E.NUltrasonographyNofNtheNleftNgroinN-NCORRECTNANSWERN-UltrasonographyNofNtheNleftNgroin
, Correct.
ThisNpatientNmayNhaveNanNoccultNinguinalNherniaNwhichNisNnotNdetectableNonNphysicalNexamination.NUltras
onography,NherniographyNandNCTNareNallNusefulNdiagnosticNstudies,NwithNultrasoundNbeingNtheNleastNinvas
ive,NlessNcostly,NandNwithNhighNsensitivityNandNspecificity.NInNthisNpatientNwithNminimalNsymptoms,NthereNis
NnoNindicationNforNimmediateNlaparoscopyNorNgroinNexploration.
AN60-year-
oldNmaleNpresentsNwithNpersistentNpainNoverNhisNrightNlowerNabdomenNsixNmonthsNafterNaNbilateralNTEPPNl
aparoscopicNinguinalNherniaNrepair.NThereNisNnoNevidenceNofNherniaNrecurrence,NseromaNorNinfectionNonNp
hysicalNexamination.NAsNpartNofNyourNinvestigation,NyouNobtainNaNplainNabdominalNradiograph,NwhichNreve
alsNmultipleNbilateralNspiralNtacksNacrossNtheNlowerNabdomen.NYouNobtainNtheNoperativeNreport,NandNconfi
rmNyourNsuspicionNthatNtheNsurgeonNusedNpermanentNspiralNtacksNforNmeshNfixation.NInjuryNtoNwhichNofNt
heNfollowingNnervesNisNtheNmostNlikelyNcauseNforNhisNpersistentNpain?
A.NIlioinguinalNnerve
B.NIliohypogastricNnerve
C.NGenitalNbranchNofNtheNgenitofemoralNnerve
D.NLateralNfemoralNcutaneousNnerve
E.NFemoralNnerveN-NCORRECTNANSWERN-IliohypogastricNnerve
Correct.
Post-
herniorrhaphyNneuralgiaNhasNbeenNreportedNtoNoccurNinNupNtoN20%NofNcases.NInjuryNtoNanyNofNtheNnervesN
mentionedNcanNresultNinNpost-
herniorrhaphyNneuralgia.NGivenNtheNlocationNofNtheNpatient'sNsymptomsNandNtheNmethodNusedNforNmeshN
fixation,NtheNiliohypogastricNnerveNisNtheNmostNvulnerableNtoNinjuryNduringNlaparoscopicNmeshNfixation.
AN67-year-oldNmanNpresentsNwithNvomitingNandNabdominalNdistension.NAnNabdominalNx-
rayNrevealsNair/fluidNlevelsNsuggestingNsmallNbowelNobstruction.NOnNexam,NherNabdomenNisNdistendedNwit
hNdiffuseNtendernessNandNthereNisNaNtenderNmassNinNtheNrightNgroin.NAtNoperation,NyouNresectNaNstrangula
tedN6-
cmNsegmentNofNsmallNintestineNandNthereNisNmoderateNcontaminationNwithNbowelNcontents.NWhatNshould
NyouNdoNforNtheNhernia?
A.NCompleteNtheNoperationNandNplanNaNsubsequentNherniaNrepair.
B.NPerformNaNrepairNusingNpolypropyleneNmesh.
C.NPerformNaNrepairNusingNbiologicNmesh.
D.NPerformNaNtissue-basedNrepair.N-NCORRECTNANSWERN-PerformNaNtissue-basedNrepair.