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A 68-year-old man, day 5 post laparotomy for small bowel obstruction, develops tachycardia, abdominal pain, and metabolic acidosis. CT shows portal venous gas. Which is the most likely diagnosis?

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Anastomotic leak

Mesenteric ischemia

Intra-abdominal abscess

Ileus

Pancreatitis

None

A trauma patient has a liver laceration with active bleeding but is hemodynamically stable. Next best step?

mmediate surgery

Angioembolization

Observation only

ERCP

Liver resection

None

A patient with painful irreducible groin swelling and vomiting. Diagnosis?

Incarcerated hernia

Strangulated hernia

Reducible hernia

Lymphadenopathy

Hydrocele

None

Best modality for local staging of Rectal tumor?

MRI pelvis

PET

Colonoscopy

Ultrasound

None

A 59-year-old man has a low rectal tumor (4 cm from anal verge), staged T3N1 on MRI. Best initial treatment?

Surgery first

Chemotherapy only

Long-course chemoradiotherapy

Short-course radiotherapy only

Palliative care

None

A 50-year-old woman develops severe abdominal pain and elevated amylase after ERCP. She becomes hypotensive and tachycardic. Best next step?

Immediate CT scan

Aggressive IV fluids

ERCP repeat

Surgery

Antibiotics only

None

A 60-year-old woman with prior hysterectomy presents with abdominal pain, vomiting, and obstipation. CT shows small bowel obstruction with a transition point and mesenteric swirl sign. Lactate is mildly elevated. What is the best management?

Conservative management

NG decompression and fluids

Urgent laparotomy

CT with contrast repeat

Laparoscopic adhesiolysis later

None

A 48-year-old female presents with fatigue and weight loss. Hb is 7 g/dL with microcytic hypochromic anemia. There is no history of rectal bleeding. Colonoscopy reveals a mass in the caecum. What is the most likely presentation mechanism?

Early obstruction

Visible rectal bleeding

Iron deficiency anemia due to occult bleeding

Tenesmus

Mucus discharge

None

A 55-year-old female presents with progressive painless jaundice, pruritus, pale stools, and weight loss. On examination: palpable, non-tender gallbladder. Bilirubin is 14 mg/dL (direct predominant). What is the most appropriate initial investigation?

ERCP

MRCP

Ultrasound abdomen

CT abdomen with contrast

Percutaneous transhepatic cholangiography

None

A 42-year-old woman diagnosed with medullary thyroid carcinoma. Serum calcitonin elevated. Genetic testing reveals RET mutation. What is the most important additional step before surgery?

Radioiodine scan

Serum thyroglobulin

Screening for pheochromocytoma

FNAC of lymph nodes

PET scan

None

1 out of 10

User	Correct Score %	Time Taken
Musa Al Amin	81	00:00:21
test-3	50	00:00:34
test -2	50	00:00:34
test-1	45	00:01:02

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