AMC MCQ General Surgery Principles 2 — Questions and Answers
Question 1: A 60-year-old man develops a tender, erythematous wound with purulent discharge on postoperative day 5. Which type of surgical site infection is this?
- Superficial incisional SSI (Correct answer)
- Deep incisional SSI
- Organ/space SSI
- Sterile inflammatory reaction
Correct answer: Superficial incisional SSI
A superficial incisional SSI involves only skin and subcutaneous tissue within 30 days of surgery.
Question 2: What is the most appropriate timing for prophylactic antibiotic administration in clean-contaminated surgery?
- At induction, within 60 minutes before incision (Correct answer)
- 24 hours before surgery
- Immediately after skin closure
- Only if infection develops
Correct answer: At induction, within 60 minutes before incision
Prophylactic antibiotics are most effective when given within 60 minutes before incision to ensure adequate tissue levels.
Question 3: Which suture material is most appropriate for a contaminated abdominal wound closure?
- Monofilament absorbable (Correct answer)
- Braided non-absorbable silk
- Braided absorbable polyglactin
- Stainless steel wire only
Correct answer: Monofilament absorbable
Monofilament absorbable sutures harbour fewer bacteria than braided material in contaminated fields.
Question 4: A patient has a Glasgow Coma Scale of 8 after major trauma. What is the immediate airway priority?
- Definitive airway via endotracheal intubation (Correct answer)
- Continue observation with oxygen
- Insert a nasogastric tube
- Arrange an urgent CT brain
Correct answer: Definitive airway via endotracheal intubation
A GCS of 8 or less indicates the patient cannot protect their airway and requires definitive intubation.
Question 5: What does a rising serum lactate in a postoperative patient most strongly suggest?
- Tissue hypoperfusion (Correct answer)
- Adequate oxygen delivery
- Hypothermia alone
- Normal recovery
Correct answer: Tissue hypoperfusion
Elevated lactate reflects anaerobic metabolism from tissue hypoperfusion and warrants resuscitation review.
Question 6: Which finding is most consistent with an anastomotic leak after colorectal surgery on day 5?
- Fever, tachycardia and peritonism (Correct answer)
- Immediate brisk haematemesis
- Painless jaundice
- Isolated hyperkalaemia
Correct answer: Fever, tachycardia and peritonism
Anastomotic leaks typically present around day 5 with sepsis signs and peritoneal irritation.
Question 7: What is the primary goal of damage control surgery in an unstable trauma patient?
- Control haemorrhage and contamination, then resuscitate (Correct answer)
- Complete definitive repair in one operation
- Delay all surgery until stable
- Perform reconstruction immediately
Correct answer: Control haemorrhage and contamination, then resuscitate
Damage control prioritises arresting bleeding and contamination, deferring definitive repair until physiology is restored.
AMC MCQ General Surgery Principles 2
A 60-year-old man develops a tender, erythematous wound with purulent discharge on postoperative day 5.
Which type of surgical site infection is this?