AMC MCQ - Australian Medical Council Multiple Choice Questions General Surgery Principles Questions and Answers

Question 1

A 70-year-old man is on day one post-sigmoid colectomy.
The nursing staff report he is hypotensive with a blood pressure of 90/50 mmHg, a heart rate of 115 bpm, and a urine output of less than 20 mL/hour for the past two hours.
There is no evidence of active bleeding.
What is the most appropriate initial intravenous fluid for resuscitation?

Accepted Answer

0.9% Sodium Chloride

Answer

4% Albumin solution

Answer

Packed red blood cells

Answer

5% Dextrose in water

Question 2

A 58-year-old man with a 40-pack-year smoking history is undergoing a laparotomy. In the context of wound healing, which of the following phases is most directly impaired by the physiological effects of cigarette smoking?

Accepted Answer

Proliferative phase

Answer

Haemostasis

Answer

Inflammatory phase

Answer

Remodelling phase

Question 3

A 62-year-old man is scheduled for an elective inguinal hernia repair. He has no known drug allergies. According to Australian Therapeutic Guidelines for surgical prophylaxis, what is the optimal timing for the administration of intravenous antibiotics to prevent a surgical site infection?

Accepted Answer

Within 60 minutes prior to skin incision

Answer

In the post-anaesthesia care unit (PACU)

Answer

At the time of skin closure

Answer

Two hours prior to skin incision

Question 4

A 55-year-old patient develops a fever of 38.5°C on post-operative day 1 following an open cholecystectomy. Chest auscultation reveals decreased breath sounds at the lung bases. Which of the following is the most common cause of fever in the first 48 hours after major surgery?

Accepted Answer

Atelectasis

Answer

Surgical site infection

Answer

Urinary tract infection

Answer

Deep vein thrombosis

Question 5

A 78-year-old woman with oesophageal cancer is found to be severely malnourished, having lost 15% of her body weight over 3 months. Pre-operative nutritional support is initiated via a nasogastric tube. The initiation of feeding in this patient must be done cautiously to avoid which of the following life-threatening metabolic complications?

Accepted Answer

Refeeding syndrome

Answer

Hypernatraemia

Answer

Metabolic acidosis

Answer

Hypercalcaemia

Question 6

When closing the fascial layer of a midline laparotomy, a surgeon requires a suture material that provides long-term tensile strength and has a low risk of harbouring bacteria. Which of the following is a non-absorbable, monofilament suture commonly used for this purpose?

Accepted Answer

Polypropylene (Prolene)

Answer

Polyglactin 910 (Vicryl)

Answer

Silk

Answer

Catgut