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Question 1
A 24-year-old male presents with an 18-hour history of periumbilical pain that migrated to the right lower quadrant, associated with anorexia, nausea, and a low-grade fever of 38.1°C. On examination, there is marked tenderness and guarding at McBurney's point with a positive Rovsing sign. Bedside ultrasound demonstrates a 9 mm non-compressible, blind-ending tubular structure in the right iliac fossa with wall hyperemia and periappendiceal fat stranding. What is the most appropriate definitive management?
Correct Answer:
Laparoscopic appendectomy
Question 2
A 52-year-old female presents with a 36-hour history of severe right upper quadrant pain radiating to the right scapula, nausea, vomiting, and a fever of 38.4°C. On examination, she exhibits marked inspiratory arrest during deep palpation of the right subcostal margin (positive Murphy's sign). Laboratory tests show a white blood cell count of 15,400/mcL, with normal bilirubin, alkaline phosphatase, and transaminases. Ultrasound shows a distended gallbladder with multiple gallstones, gallbladder wall thickness of 5 mm, and pericholecystic fluid, with a 4 mm common bile duct. What is the most appropriate management plan?
Correct Answer:
Early laparoscopic cholecystectomy during the index admission
Question 3
A 68-year-old female presents with severe right upper quadrant pain, deep jaundice, and high swinging fevers with rigors (temperature 39.2°C). Her blood pressure is 95/60 mmHg and heart rate is 114 bpm. Laboratory studies reveal total bilirubin of 7.2 mg/dL, alkaline phosphatase 480 IU/L, and leukocyte count of 18,200/mcL. Abdominal ultrasound shows a dilated common bile duct (13 mm) with an acoustic shadow in the distal duct and intrahepatic biliary radical dilation. What is the most appropriate next step in definitive management following fluid resuscitation and broad-spectrum intravenous antibiotics?
Correct Answer:
Urgent endoscopic retrograde cholangiopancreatography (ERCP) with biliary sphincterotomy and drainage
Question 4
A 46-year-old male with a history of heavy NSAID use presents with sudden, agonizing, catastrophic epigastric pain that began 4 hours ago. On examination, he is diaphoretic with shallow respirations, pulse 118 bpm, and diffuse abdominal board-like rigidity with involuntary guarding and absent bowel sounds. An erect chest radiograph demonstrates crescentic free air under both diaphragmatic copulae. At emergency exploratory laparotomy, a 0.7 cm clean-edged perforation is identified on the anterior prepyloric gastric antrum with moderate peritoneal contamination. What is the most appropriate surgical procedure?
Correct Answer:
Thorough peritoneal lavage and Graham patch omentopexy closure of the perforation
Question 5
A 62-year-old female with a history of open abdominal hysterectomy presents with a 3-day history of colicky abdominal pain, severe bilious vomiting, progressive abdominal distension, and failure to pass flatus or stool. Abdominal examination reveals localized left lower quadrant tenderness with rebound and guarding. Contrast-enhanced CT scan of the abdomen demonstrates mechanical small bowel obstruction with two transition points along a closed loop, regional bowel wall thickening, mesenteric vascular engorgement ('mesenteric swirl'), and lack of mucosal enhancement. What is the most appropriate next step in management?
Correct Answer:
Emergent exploratory laparotomy
Question 1
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Prepare with the Arab Board Surgery Clinical Practice Questions - Arab Board General Surgery Final Clinical and Oral Exam practice quiz. This question bank includes 100 questions covering year-old, male, management, presents, and abdominal. Use it to review important concepts, identify knowledge gaps, and build confidence for the related exam, course, or assessment.

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Arab Board Surgery Clinical Practice Questions - Arab Board General Surgery Final Clinical and Oral Exam

This practice set contains 100 questions from the matching question bank and focuses on year-old, male, management, presents, and abdominal. Work through each question carefully, review the provided solutions, and revisit topics that need more study before your next attempt.

This is an independent study resource intended for practice and review; it is not an official examination or an endorsement by any organization named in the title.

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