Rosh Review Surgery Questions with
100% Correct Answers
s/sx hypothyroidism Correct Answer: weakness, fatigue, facial swelling,
constipation, cold intolerance, and weight gain, periorbital edema, dry skin and
coarse brittle hair
MCC hypothyroidism Correct Answer: Hashimoto thyroiditis
Risk factor for non-hodgkin lymphoma Correct Answer: Hashimoto thyroiditis
tx hypothyroidism Correct Answer: levothryoxine
risk factors for diverticular disease Correct Answer: high dietary consumption of
red meat, low dietary fiber, sedentary lifestyle, BMI > 25, and cigarette smoking
painless hematochezia, management Correct Answer: diverticulosis,
colonoscopy
where does the majority of colonic bleeding occur? Correct Answer: right side
of colon
MCC significant lower GI bleed Correct Answer: diverticulosis
s/sx pituitary mass (specifically prolactinoma) Correct Answer: Diminished
temporal vision, or bitemporal hemianopsia (tumor applies pressure on the optic
chiasm), amenorrhea, galactorrhea, and headaches,
first line tx of pituitary adenoma Correct Answer: dopamine agonists
(cabergoline and bromocriptine)
MC side effects of dopamine agonists used to tx hyperprolactinemia Correct
Answer: nausea, postural hypotension
,what are the four degrees of internal hemorrhoids Correct Answer: 1- does not
protrude through anus
2- hemorrhoids prolapse but reduce spontaneously
3- hemorrhoids prolapse and require manual reduction 4- hemorrhoids cannot
be reduced
what distinguishes internal v external hemorroid Correct Answer: internal:
proximal to dentate line
esternal: distal to dentate line
s/sx hemorrhoids Correct Answer: anal pain and itching, bleeding
initial test for spontaneous PTX: Correct Answer: CXR
tall thin young male w/ SOB cough chest pain, decreased fremitus, decreased
breath sounds, hyperresonant to percussion on one side Correct Answer:
spontaneous PTX
tracheal deviation towards PTX Correct Answer: spontaneous PTX
initial step for tension PTX Correct Answer: needle decompression
tx spontaneous PTX Correct Answer: <20%: oxygen + obs
>20%: chest tube thoacostomy
Colicky abdominal pain, distention, emesis (can be bilious vomiting), prior abd
surgery Correct Answer: acute bowel obstruction
XR: dilated bowel, air fluid levels, stack of coins/pearls Correct Answer: SBO
, test for confirming jaundice Correct Answer: fractionated bilirubin
unconj./indirect elevated bilirubin Correct Answer: pre hepatic jaundice
unconjugated bilirubin is (fat/protein) soluble? Correct Answer: fat soluble, but
protein bound which prevents diffusion across BBB
conjugated/direct bilirubin is (fat/protein) soluble? Correct Answer: bound to
albumin in plasma (water soluble)
MCC inherited unconjugated hyperbilirubinemia Correct Answer: gilbert
syndrome
confirmatory test for cholecystitis Correct Answer: cholescintigraphy scan (HIDA)
overweight (Fat),Fertile,Female in her Forties (4Fs) Correct Answer: cholecystitis
colicky, steadily increasing RUQ or epigastric pain after eating fatty foods
Correct Answer: cholecystitis
positive Murphy's sign, Boas sign Correct Answer: cholecystitis
tx cholecystitis Correct Answer: cholecystectomy
Patient with mucosal hemorrhage or bleeding that is difficult to control + a
history of a parent with similar symptoms
Complaining o Correct Answer: von willebrand
decreased factor VIII, prolonged bleeding time Correct Answer: von willebrand
disease
Most common inherited bleeding disorder, autosomal dominant Correct
Answer: von willebrand disease
100% Correct Answers
s/sx hypothyroidism Correct Answer: weakness, fatigue, facial swelling,
constipation, cold intolerance, and weight gain, periorbital edema, dry skin and
coarse brittle hair
MCC hypothyroidism Correct Answer: Hashimoto thyroiditis
Risk factor for non-hodgkin lymphoma Correct Answer: Hashimoto thyroiditis
tx hypothyroidism Correct Answer: levothryoxine
risk factors for diverticular disease Correct Answer: high dietary consumption of
red meat, low dietary fiber, sedentary lifestyle, BMI > 25, and cigarette smoking
painless hematochezia, management Correct Answer: diverticulosis,
colonoscopy
where does the majority of colonic bleeding occur? Correct Answer: right side
of colon
MCC significant lower GI bleed Correct Answer: diverticulosis
s/sx pituitary mass (specifically prolactinoma) Correct Answer: Diminished
temporal vision, or bitemporal hemianopsia (tumor applies pressure on the optic
chiasm), amenorrhea, galactorrhea, and headaches,
first line tx of pituitary adenoma Correct Answer: dopamine agonists
(cabergoline and bromocriptine)
MC side effects of dopamine agonists used to tx hyperprolactinemia Correct
Answer: nausea, postural hypotension
,what are the four degrees of internal hemorrhoids Correct Answer: 1- does not
protrude through anus
2- hemorrhoids prolapse but reduce spontaneously
3- hemorrhoids prolapse and require manual reduction 4- hemorrhoids cannot
be reduced
what distinguishes internal v external hemorroid Correct Answer: internal:
proximal to dentate line
esternal: distal to dentate line
s/sx hemorrhoids Correct Answer: anal pain and itching, bleeding
initial test for spontaneous PTX: Correct Answer: CXR
tall thin young male w/ SOB cough chest pain, decreased fremitus, decreased
breath sounds, hyperresonant to percussion on one side Correct Answer:
spontaneous PTX
tracheal deviation towards PTX Correct Answer: spontaneous PTX
initial step for tension PTX Correct Answer: needle decompression
tx spontaneous PTX Correct Answer: <20%: oxygen + obs
>20%: chest tube thoacostomy
Colicky abdominal pain, distention, emesis (can be bilious vomiting), prior abd
surgery Correct Answer: acute bowel obstruction
XR: dilated bowel, air fluid levels, stack of coins/pearls Correct Answer: SBO
, test for confirming jaundice Correct Answer: fractionated bilirubin
unconj./indirect elevated bilirubin Correct Answer: pre hepatic jaundice
unconjugated bilirubin is (fat/protein) soluble? Correct Answer: fat soluble, but
protein bound which prevents diffusion across BBB
conjugated/direct bilirubin is (fat/protein) soluble? Correct Answer: bound to
albumin in plasma (water soluble)
MCC inherited unconjugated hyperbilirubinemia Correct Answer: gilbert
syndrome
confirmatory test for cholecystitis Correct Answer: cholescintigraphy scan (HIDA)
overweight (Fat),Fertile,Female in her Forties (4Fs) Correct Answer: cholecystitis
colicky, steadily increasing RUQ or epigastric pain after eating fatty foods
Correct Answer: cholecystitis
positive Murphy's sign, Boas sign Correct Answer: cholecystitis
tx cholecystitis Correct Answer: cholecystectomy
Patient with mucosal hemorrhage or bleeding that is difficult to control + a
history of a parent with similar symptoms
Complaining o Correct Answer: von willebrand
decreased factor VIII, prolonged bleeding time Correct Answer: von willebrand
disease
Most common inherited bleeding disorder, autosomal dominant Correct
Answer: von willebrand disease
