CBC Título de Especialista em Cirurgia Geral Practice Questions - Exame para Obtenção do Título de Especialista em Cirurgia Geral - CBC AMB Exam - CBC Título de Especialista em Cirurgia Geral Practice Questions - Exame para Obtenção do Título de Especialista em Cirurgia Geral

Question 1

During the initial neuroendocrine and metabolic response to major surgical trauma (resposta metabólica ao trauma cirúrgico - REMT), which of the following hormonal alterations is characteristically observed in the immediate post-injury 'ebb phase' transitioning into the 'flow phase'?

Increased secretion of ACTH, cortisol, catecholamines, and glucagon accompanied by peripheral insulin resistance and accelerated muscle proteolysis. Suppression of the hypothalamic-pituitary-adrenal axis with profound hypoinsulinemia and generalized stimulation of glycogen synthesis. Marked elevation of anabolic hormones including growth hormone and testosterone with sustained nitrogen retention. Selective hypersecretion of thyroid hormones (T3 and T4) without activation of the sympathoadrenal system.

Correct Answer:

Increased secretion of ACTH, cortisol, catecholamines, and glucagon accompanied by peripheral insulin resistance and accelerated muscle proteolysis.

Question 2

According to the evidence-based multimodal perioperative protocol Projeto ACERTO (Aceleração da Recuperação Total Pós-Operatória) endorsed by the Colégio Brasileiro de Cirurgiões (CBC), what is the recommended preoperative fasting guideline for an elective laparoscopic cholecystectomy in an otherwise healthy adult without delayed gastric emptying?

Fasting for clear carbohydrate-rich liquids (such as 12.5% maltodextrin solution) abbreviated to 2 hours before anesthesia induction, with solid food withheld for 6 to 8 hours. Absolute nil per os (nada por via oral) for at least 12 hours prior to surgery for all solids and liquids to avoid aspiration pneumonia. Fasting from midnight (zero hora) for both solids and water regardless of the scheduled time of surgery. Ingestion of a full solid meal containing complex fats up to 3 hours prior to the administration of general anesthesia.

Correct Answer:

Fasting for clear carbohydrate-rich liquids (such as 12.5% maltodextrin solution) abbreviated to 2 hours before anesthesia induction, with solid food withheld for 6 to 8 hours.

Question 3

A 58-year-old male undergoes an uncomplicated elective laparoscopic right hemicolectomy for colon adenocarcinoma under general anesthesia and multimodal analgesia. Under Projeto ACERTO / ERAS guidelines, what is the best evidence-based strategy regarding postoperative nasogastric tube (SNG) and oral refeeding?

Avoid routine prophylactic nasogastric tube decompression and initiate early oral intake (clear liquids or light diet) on the first postoperative day (PO 1) or within 24 hours. Keep a nasogastric tube on continuous suction until the patient passes flatus, withholding oral fluids until postoperative day 5. Maintain strict fasting and initiate total parenteral nutrition (NPT) on postoperative day 1 to rest the ileocolic anastomosis. Administer aggressive mechanical saline flushes through a wide-bore nasogastric tube every 4 hours until bowel sounds return.

Correct Answer:

Avoid routine prophylactic nasogastric tube decompression and initiate early oral intake (clear liquids or light diet) on the first postoperative day (PO 1) or within 24 hours.

Question 4

During a major abdominal resection, administration of large volumes of 0.9% normal saline (soro fisiológico 0,9%) can lead to a specific iatrogenic acid-base and electrolyte derangement. What is this disorder and its primary pathophysiological mechanism?

Hyperchloremic metabolic acidosis with normal anion gap, caused by excess chloride load diminishing the strong ion difference (SID) and decreasing serum bicarbonate. High anion gap metabolic acidosis, caused by direct accumulation of circulating lactate and ketoacid anions. Hypochloremic metabolic alkalosis, caused by excessive renal bicarbonate retention and loss of hydrogen ions. Hyperkalemic respiratory acidosis, caused by acute suppression of the central medullary respiratory drive.

Correct Answer:

Hyperchloremic metabolic acidosis with normal anion gap, caused by excess chloride load diminishing the strong ion difference (SID) and decreasing serum bicarbonate.

Question 5

A 62-year-old severely malnourished patient with gastric cancer (BMI 16 kg/m², 20% weight loss over 3 months) is started on aggressive high-calorie total parenteral nutrition. On postoperative day 2, the patient develops severe muscle weakness, confusion, cardiac arrhythmias, and acute respiratory failure. What electrolyte abnormality is the hallmark of this condition (Refeeding Syndrome / Síndrome de Realimentação)?

Severe hypophosphatemia, accompanied by hypokalemia and hypomagnesemia, triggered by insulin-mediated intracellular shift of electrolytes during carbohydrate reintroduction. Severe hyperphosphatemia and hypercalcemia resulting from massive osteoclastic bone resorption. Profound hypernatremia due to acute antidiuretic hormone suppression and renal water loss. Isolated severe hyperkalemia caused by acute tubular necrosis and rhabdomyolysis.

Correct Answer:

Severe hypophosphatemia, accompanied by hypokalemia and hypomagnesemia, triggered by insulin-mediated intracellular shift of electrolytes during carbohydrate reintroduction.

Question 1

Exam overview

About this Exam

Prepare with the CBC Título de Especialista em Cirurgia Geral Practice Questions - Exame para Obtenção do Título de Especialista em Cirurgia Geral - CBC AMB Exam practice quiz. This question bank includes 100 questions covering year-old, abdominal, trauma, surgical, and presents. Use it to review important concepts, identify knowledge gaps, and build confidence for the related exam, course, or assessment.

More details

Additional Information

CBC Título de Especialista em Cirurgia Geral Practice Questions - Exame para Obtenção do Título de Especialista em Cirurgia Geral - CBC AMB Exam

This practice set contains 100 questions from the matching question bank and focuses on year-old, abdominal, trauma, surgical, and presents. 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.

Quiz information

Frequently Asked Questions

The complete question count is available after full access is unlocked.

No fixed duration is currently configured for this quiz.

Question explanations are included where they are available in the quiz content, helping you review the reasoning after answering.

Yes. You can retake the practice test again as you continue studying during your available access period.

After your access is confirmed, you can continue into the complete practice exam from this quiz flow.

Unless explicitly stated otherwise, this page provides independent practice material for study and exam preparation and is not the official examination itself.

Keep studying

Correct Answer:

Correct Answer:

Correct Answer:

Correct Answer:

Correct Answer:

About this Exam

Additional Information

CBC Título de Especialista em Cirurgia Geral Practice Questions - Exame para Obtenção do Título de Especialista em Cirurgia Geral - CBC AMB Exam

Frequently Asked Questions

Related Questions

CDH Paramedic Entrance Practice Exam

CET Paramedical Admission Practice Test

Ashworth Paralegal Practice Exam

COPR Primary Care Paramedic (PCP) Practice Exam

Community Paramedic Practice Test

Companion Animal Parasite Council (CAPC) Practice Exam