Surgery COMAT Exam Questions Set | 350+
Questions with Correct Verified Answers
Work up for suspected SBO? - ✔✔• Palin film radiographs sould be obtained first in those
with suspected small bowel obstruction
• An abdominal series is the test of choice when SBO is suspected and includes:
○ Upright chest radiograph to look for pneumoperitoneum
○ Upright abdomen to see air-fluid levels
○ Supine abdomen which can best show bowel dilation
Plain films used in evaluation of? - ✔✔SBO, volvulus, constipation
CT is used in evaluation of? - ✔✔appendicitis, diverticulitis
barium swallows are used for evaluation of? - ✔✔esophageal pathology
Who requires treatment for tetanus? - ✔✔• Those who have not had 3 tetanus boosters in
the past need a tetanus booster after a skin wound
• Those who have not received a booster in the past 10 years
• Those who have dirty wounds need a tetanus booster if they have not received a booster in
the past 5 years
Who is a candidate for TIG? - ✔✔Those who have not received 3 tetanus toxoid in the past
also recommended for treatment of tetanus
,Who gets tetanus toxoid? - ✔✔For clean or minor wounds, tetanus toxoid should be given if
the last booster was greater than 10 years ago
for contaminated or deep puncture wounds, a booster should be given if the patient's last one
was greater than 5 years ago
what is the treatment for toxic megacolon? - ✔✔subtotal abdominal colectomy and end
ileostomy
What is hartmann's procedure? - ✔✔involves resection of teh rectosigmoid colon with
closure of the rectal stump to form a colostomy
What is total colectomy? - ✔✔removal of the entire colon including the rectum
what are the only cephalosporins that have coverage for anaerobic bacteria? - ✔✔Cefotetan
and Cefoxitin
Other antibiotic that can be used in GI tract? - ✔✔○ Ampicillin/sulbactam
○ Cefazolin plus metronidazole
Clindamycin plus fluoroquinolone or aztreonam
cefazolin? - ✔✔• First generation
• Most effective for gram positive coverage
• It can be used with metronidazole for anaerobic coverage for preoperative treatment
,Sectioning and removal of the lower half of the stomach (gastrectomy), closure of the duodenal
stump, and attachment (anastomosis) of the proximal jejunum (small intestine) to the
remainder of the stomach
Billroth I procedure? - ✔✔Gastroduodenostomy
indication for Billroth I and II? - ✔✔peptic ulcer disease or gastric adenocarcinoma
What factors increase risk of malignancy in a patient with colonic polyps? - ✔✔Increased
size, villous histology, increased epithelial dysplasia
Removal of sessile polyps? - ✔✔Done via cautery snare
* inject saline underneath the polyp to raise itup and assure that during polypectomy the
muscular layer of the bowel wall is not affect
what determines the tensile strength of the colonic wall? - ✔✔Determined by collagen cross-
linking
* the submucosal layer has a high content of collagen fibers and is where the tensile strength of
the bowel lies
therefore constructing a hand-sewn intestinal anastomosis, it is imperative that this layer is
included when extramucosal bites are taken
Foods that decrease the LES pressure? - ✔✔ETOH, tobacco, chocolate, coffee, and high fat
foods
Causes of GERD? - ✔✔Impaired relaxation of LES, decreased esophageal motility, gastric
outlet obstruction, hiatal hernia or diet
clinical feature of GERD? - ✔✔heartburn
, dyspepsia
cough
Other less common symptoms: hoarseness, sore throat, otitis media, chest pain
Risk factors of cholelithiasis? - ✔✔Age (forty), female, pregnancy, obesity,
hypertriglyceridemia, and cirrhosis
What are the most common causes of esophagitis? - ✔✔noninfectious conditions such as
GERD
infectious etiologies are less common and are more common in immunocompromised
Most common causes of infectious esophagitis? - ✔✔Candida, cytomegalovirus, herpes
simplex virus
Who gets candida esophagitis? - ✔✔Most commonly affects HIV patients
It is an AIDS defining illness because it occurs at a cD4 count below 200/microL
Hallmark symptoms of esophageal candidiasis? - ✔✔odynophagia or painful swallowing,
retrosternal pain, fever, and hematemesis
symptoms of peptic ulcer disease? - ✔✔epigastric pain, gnawing sensation that occurs after
meals
Risk factors for stable angina pectoris caused by coronary ischemia? - ✔✔DM,
hyperlipidemia, HTN, cigarette smoking and age
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