Surgery

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Appendicitis

Which one of the following statements about children aged 5–16 years with suspected non-perforated appendicitis treated with antibiotics rather than early appendectomy is false?

  • About one-third will subsequently require appendectomy.
  • They have a quicker return to normal activities.
  • They have a decreased risk of adverse events.
  • Use of pain medication is less.
Volume 40.3 - Question 2

Perioperative Management of Antithrombotic Therapy

Which one of the following statements regarding perioperative management of antithrombotic therapy is false?

  • For patients taking aspirin, continuation for elective noncardiac surgery is suggested.
  • For patients with atrial fibrillation taking vitamin K antagonists (VKA) who are undergoing an elective procedure with low to moderate risk of thromboembolism heparin bridging is recommended.
  • For patients with a mechanical heart valve with low to moderate risk of thromboembolism who require VKA interruption for an elective surgery or procedure heparin bridging is not suggested.
  • For patients receiving a direct oral anticoagulant (DOAC) who will be undergoing an elective surgery or procedure, discontinuing DOAC therapy is suggested.
Volume 40.2 - Question 23

Evaluation of the Acute Abdomen

Which one of the following statements about the evaluation of the acute abdomen is false?

  • The administration of opiate analgesics results in a significant increase in management errors.
  • Contrast enhanced CT-angiography scans are more accurate than scans without contrast.
  • A wait of at least 2 hours for the final interpretation of by a radiologist is associated with an increase in death.
  • Earlier surgical consultation has been shown to reduce complications.
Volume 40.2 - Question 17

Dupuytren Contracture Treatment

For patients with Dupuytren contracture, surgery provides the highest success (at least 50% of contracture release) at 2 years, compared with percutaneous non-surgical office-based interventions.

  • True
  • False
Volume 40.1 - Question 29

Surgical Care for People Experiencing Homelessness

Of the few people experiencing homelessness who presented with early stage lung cancer, most (80%) received curative surgery and all completed follow up with no recurrences or deaths.     

  • True
  • False
Volume 39.5 - Question 28

Pediatric Appendicitis

Which one of the following statements about management of pediatric appendicitis is false?

  • Approximately 20% of children will fail non-operative management of acute appendicitis.
  • The presence of a faecolith significantly increases the risk for non-operative failure.
  • Operative treatment has an overall rate of reported complications of less than 10%.
  • Negative appendicectomy (i.e., operating on a normal appendix) is common.
Volume 39.3 - Question 9

Metabolic-bariatric Surgery

Adults with severe obesity, with or without baseline diabetes, who underwent metabolic–bariatric surgery, had lower rates of all-cause mortality.  

  • True
  • False
Volume 36.6 - Question 21

Inguinal Hernias

The diagnosis of inguinal hernias in women often requires imaging. 

  • True
  • False
Volume 36.4 - Question 21

Preoperative Anemia

Which one of the following statements about preoperative anemia is false? 

  • It affects about 50% of all patients undergoing major elective surgery. 
  • It is associated with increased risk of in-hospital complications. 
  • Treatment of anemic surgical patients with oral iron is considered ineffective.  
  • Preoperative intravenous iron reduces the need for blood transfusion.
Volume 36.3 - Question 39

Oral Moxifloxacin for Appendicitis

For adults with uncomplicated acute appendicitis, treatment with seven days of oral moxifloxacin resulted in treatment success rates greater than 65%.  

  • True
  • False
Volume 36.3 - Question 21

Antibiotics and Appendicitis

When comparing antibiotics and appendectomy for the treatment of appendicitis in adults, which one of the following statements is false? 

  • Antibiotics are noninferior on the basis of health status at 30 days.   
  • Appendectomy has a higher rate of complications.   
  • Hospitalization after the index treatment is more common in the antibiotic treatment group.   
  • Complications in the antibiotic group occurred more commonly in patients with an appendicolith. 
Volume 36.3 - Question 20

Anesthesia for Hip Fracture Surgery

Spinal anesthesia for hip fracture surgery in older adults is superior to general anesthesia with respect to survival and recovery of ambulation at 60 days.

  • True
  • False
Volume 37.4 - Question 27

Anal Fissures

Which one of the following statements about anal fissures is false?

  • Multiple fissures may indicate a secondary cause.
  • Primary fissures are common in elderly patients.
  • The presence of proximal hypertrophied anal papillae suggests a chronic fissure.
  • Topical diltiazem provides analgesia.
Volume 37.4 - Question 24

Acute Pancreatitis

Which one of the following statements about acute pancreatitis is false? 

  • The solution of choice for fluid resuscitation is Ringer’s lactate.
  • Prophylactic antibiotics are recommended for all admitted patients.
  • Nearly a quarter of patients are diagnosed with diabetes following the first episode.
  • Cholecystectomy during the same admission is advised for mild biliary pancreatitis.
Volume 36.1 - Question 34

Bariatric Surgery and Pregnancy

Which one of the following statements about bariatric surgery and pregnancy is false?

  • It decreases the risk of gestational diabetes mellitus.
  • It is associated with fewer caesarian deliveries.
  • It reduces the risk of preeclampsia.
  • It reduces the risk of postpartum hemorrhage.
Volume 37.4 - Question 9

Constipation

Which one of the following statements about chronic constipation is false? 

  • It is defined as a stool frequency of fewer than three bowel movements per week.   
  • It can be due to pelvic floor dysfunction. 
  • An obstruction or mass is a very common cause of chronic constipation. 
  • Routine use of blood tests or imaging is not indicated in the absence of alarm symptoms. 
Volume 38.1 - Question 29

Preservation of Amputated Parts

Proper preservation of amputated parts consists of wrapping the part in saline soaked gauze inside a watertight bag and placing it on ice.

  • True
  • False
Volume 38.1 - Question 21

Carpal Tunnel Syndrome

Which one of the following statements about carpal tunnel syndrome is false?

  • Computer mouse use is associated with a higher prevalence.
  • The 6-item CTS (CTS-6) questionnaire has specificity comparable to electrodiagnostic testing.
  • Nocturnal wrist-neutral splinting is associated with a lower rates of symptom resolution than wrist-extension splinting.
  • Steroid injection temporarily relieves symptoms.
Volume 38.2 - Question 19

De Quervain Tenosynovitis

Which one of the following statements about de Quervain tenosynovitis is false?

  • It is associated with increased smartphone use in younger populations.
  • Splinting for immobilization should include the wrist and thumb.
  • Combined treatment with corticosteroid injection and immobilization does not improve outcome compared to either alone.
  • The Finkelstein test is highly specific.
Volume 38.2 - Question 18

Acute Cholecystitis

Which one of the following statements about acute cholecystitis is false?

  • Acalculous cholecystitis occurs in 5 – 10 % of cases.
  • Early cholecystectomy (performed within 1 – 3 days) is associated with fewer post operative complications.
  • During pregnancy, laparoscopic cholecystectomy is only recommended in the second trimester.
  • In people older than 65 years of age, laparoscopic cholecystectomy is associated with lower mortality at 2-year follow-up compared with nonoperative management.
Volume 37.5 - Question 39

Early-Onset Colorectal Cancer

Which one of the following statements regarding early-onset (<50 years of age) colorectal cancer is false?

  • It now accounts for approximately 10% of all new diagnoses of this cancer.
  • An increase in colorectal cancer-related mortality has been observed in the past decade among younger patients.
  • Most cases are due to a hereditary syndrome.
  • More than 70% are detected in the left colon at presentation.
Volume 37.5 - Question 22

Body Dysmorphic Disorder

Which one of the following statements about body dysmorphic disorder (BDD) is false? 

  • The prevalence in people requesting cosmetic surgery is much higher than the general population. 
  • Dissatisfaction with their appearance results in a low quality of life. 
  • Nose, hair, skin, and lips are parts of the body most associated with BDD. 
  • They have a low risk of suicide. 
Volume 38.1 - Question 9

Cholecystectomy after Acute Biliary Pancreatitis

In patients with severe acute biliary pancreatitis, early cholecystectomy (within 14 days of admission) is associated with increased postoperative mortality when compared to delayed cholecystectomy. 

  • True
  • False
Volume 39.1 - Question 30

Diabetic Foot Ulcers

Which one of the following statements about the management of diabetic foot ulcers is false? 

  • Weekly, as compared to less frequent debridement, results in significantly more healing. 
  • The most effective treatment for off-loading a plantar foot ulcer is a knee-high nonremovable device. 
  • Hyperbaric oxygen therapy improves healing when standard of care alone has failed.  
  • In the absence of an acute soft tissue infection in forefoot osteomyelitis, antibiotics are not as effective as surgery. 
Volume 39.1 - Question 29

Stercoral Colitis

Which one of the following statements regarding stercoral colitis is false?

  • It occurs most commonly in people with advanced age and psychological or neurological comorbidities
  • The absence of abdominal pain is common.
  • Short-term mortality rates are less than 1%.
  • Evidence-based guidance for management is lacking
Volume 38.6 - Question 1

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