These questions are similar to those asked on the American Board of Surgery Recertification Examination. You can use them to prepare for the examination, fulfill learning requirements for various maintenance of competence programs, or simply improve your surgical knowledge. Answers can be seen by following the link at the end of the questions.

1. Following Roux-en-Y gastric bypass
1. Patients no longer need antihypertensive agents
2. Diabetes improves after only modest weight loss
3. Quality of life improves, but life expectancy is not lengthened
4. Cholesterol levels fall by more than 70%
5. Fertility is not improved in patients with polycystic ovarian syndrome


2. A replaced right hepatic artery
1. Runs anterior to the pancreatic head
2. Courses to the left of the portal vein
3. Is anterior to the common bile duct
4. Is a branch of the pancreaticoduodenal artery
5. Is a branch of the superior mesenteric artery


3. In a normotensive 78-year-old patient who develops oliguria immediately following a major abdominal procedure, the FIRST step is to
1. Increase the rate of crystalloid infusion
2. Check the hematocrit
3. Listen to the lungs
4. Place a central venous line
5. Measure the serum electrolytes


4. In the anesthesia care of diabetic patients, the major potential problem is
1. Impaired gastric emptying
2. Hyperglycemia
3. Small vessel extremity disease
4. Metformin-induced lactic acidosis
5. Malnutrition


5. In adenocarcinoma of the head of the pancreas
1. There is a survival advantage for a palliative Whipple procedure
2. Survival rates following a curative Whipple procedure average 35%
3. Extending the excision to include total pancreatectomy improves the survival rates
4. Most patients develop diabetes after a Whipple procedure
5. 40% of patients are resectable for cure


6. HNPCC (hereditary nonpolyposis colon cancer)
1. Accounts for 20% of carcinomas of the colon
2. Can be diagnosed only in patients with a strong family history
3. Is due to a single genetic mutation
4. Also includes carcinomas of the endometrium, stomach, and pancreas
5. Requires total proctocolectomy for cure


7. Solitary splenic abscesses
1. Should be initially treated by CT-guided drainage and antibiotics
2. Are generally due to infection of a contiguous structure
3. Are associated with mortality rates of 60% in immunocompromised patients
4. Require splenectomy
5. Most commonly culture Escherichia coli or Enterococcus



Web-only Questions

8. Gastric stump cancers (gastric adenocarcinomas in patients who underwent gastric resection)
1. Are the consequence of Helicobacter pylori infection
2. Are generally of the polypoid type
3. Have a 5-year survival rate of 40%
4. Occur within 5 years after gastrectomy
5. Are caused by bile reflux


9. Calf claudication is symptomatic of occlusion of the
1. Aortic bifurcation
2. External iliac artery
3. Superficial femoral artery
4. Popliteal artery
5. Anterior tibial artery


10. Characteristics of Budd-Chiari syndrome include all of the following EXCEPT
1. Severe ascites
2. Hepatic vein thrombosis
3. Caudate lobe hypertrophy
4. Jaundice
5. Frequent variceal hemorrhages


11. Carboxyhemoglobin
1. Has a half-life of 30 minutes
2. Shifts the oxyhemoglobin dissociation curve to the right
3. Is directly toxic to skeletal and cardiac muscle
4. Has no effect on oxygen delivery until it reaches 30%
5. Has minimal direct central nervous system effects


12. Loss of sensation in the lateral upper arm just above the elbow is indicative of injury to the
1. C4 nerve root
2. C7 nerve root
3. C6 nerve root
4. C5 nerve root
5. C3 nerve root