100+ Free ABPS General Surgery Practice Questions

Alimentary Tract Surgery

Esophagus (GERD, hiatal/paraesophageal hernia, achalasia — Heller myotomy + Dor fundoplication, Barrett's esophagus surveillance, esophageal cancer NCCN staging and CROSS neoadjuvant), stomach (peptic ulcer disease, gastric cancer, GIST — imatinib for KIT/PDGFRA mutations), small bowel (SBO with adhesions most common, Crohn's bowel-sparing, Meckel's rule of 2s, carcinoid), colon (diverticulitis Hinchey classification, ulcerative colitis, colorectal cancer NCCN — screening age 45, CEA surveillance), rectum (TME, neoadjuvant chemoradiation, TAMIS/TEM for early T1), anorectal (hemorrhoids Goligher grades, fissure, fistula Parks, perianal abscess).

Hepatobiliary & Pancreas Surgery

Biliary disease (cholecystitis Tokyo Guidelines 2018, choledocholithiasis ERCP, Mirizzi syndrome, gallbladder cancer incidental on path, cholangiocarcinoma — Bismuth-Corlette classification), liver (hepatocellular carcinoma — Milan criteria for transplant, colorectal liver metastases resectability, hepatic abscess pyogenic vs amebic, FNH vs hepatic adenoma management), pancreas (acute pancreatitis revised Atlanta — interstitial vs necrotizing, walled-off necrosis step-up approach; chronic pancreatitis pain management; pancreatic adenocarcinoma — Whipple pancreaticoduodenectomy; IPMN — Fukuoka high-risk stigmata; pancreatic NETs including insulinoma Whipple's triad and gastrinoma Zollinger-Ellison).

Breast Surgery

Breast cancer NCCN — screening mammography, BRCA1/2 testing criteria and prophylactic mastectomy, lumpectomy + RT equivalent survival to mastectomy (NSABP B-06), SLNB (ACOSOG Z0011 — T1-T2 cN0 with 1-2 positive SLN may skip ALND), neoadjuvant for triple-negative/HER2+ (KEYNOTE-522 pembrolizumab), endocrine therapy (tamoxifen premenopausal, aromatase inhibitors postmenopausal); DCIS (Van Nuys Prognostic Index), LCIS observation vs risk reduction, inflammatory breast cancer (cT4d) neoadjuvant first, Paget's disease of the nipple, fibroadenoma vs phyllodes tumor margins, gynecomastia.

Abdominal Wall & Hernia

Inguinal hernia (Hesselbach's triangle anatomy, direct vs indirect; Lichtenstein tension-free mesh repair, TEP and TAPP laparoscopic, watchful waiting acceptable for asymptomatic men), femoral hernia (higher incarceration risk — repair when found), ventral and incisional hernia (component separation — anterior Ramirez vs posterior TAR transversus abdominis release; Rives-Stoppa retromuscular; mesh choice — synthetic vs biologic by CDC wound class), umbilical and epigastric hernia, hiatal/paraesophageal hernia repair (Nissen 360 vs Toupet 270/Dor partial fundoplication), parastomal hernia, Spigelian and obturator hernias.

Surgical Critical Care

Shock classification (hypovolemic, cardiogenic, distributive, obstructive), Surviving Sepsis Campaign 2021 hour-1 bundle (lactate, blood cultures before antibiotics, broad-spectrum antibiotics within 1 hour, 30 mL/kg crystalloid for hypotension or lactate ≥4, vasopressor — norepinephrine first-line, target MAP ≥65), mechanical ventilation (ARDSnet 6 mL/kg ideal body weight, plateau <30, prone positioning >12 hr for P/F <150, ECMO criteria), AKI KDIGO staging and CRRT indications, abdominal compartment syndrome (WSACS — IAP >20 with new organ dysfunction), delirium (CAM-ICU, limit benzodiazepines), VAP/CLABSI/CAUTI prevention bundles, stress ulcer prophylaxis.

Trauma & Burns

ATLS 10th edition primary survey (ABCDE), FAST and eFAST, REBOA indications (zone 1 vs zone 3), massive transfusion protocol 1:1:1 plasma:platelets:RBC, permissive hypotension and damage control resuscitation, AAST organ injury grading (spleen, liver, kidney — high-grade often nonoperative if hemodynamically stable), pelvic fracture binder/preperitoneal packing/angioembolization, traumatic brain injury (Monro-Kellie, ICP <22, CPP 60-70), spinal cord injury, blunt vs penetrating chest trauma; burns — Parkland formula 4 mL/kg/%TBSA LR with half in first 8 hr, airway concern with facial/inhalation injury, escharotomy for circumferential burns, ABA transfer criteria.

Endocrine Surgery

Thyroid (Bethesda system FNA cytology I-VI, papillary thyroid cancer — lobectomy vs total thyroidectomy ATA 2015, follicular/Hurthle, medullary — RET mutation in MEN2 prophylactic thyroidectomy, anaplastic), parathyroid (primary hyperparathyroidism — sestamibi/4D-CT localization, focused vs bilateral exploration, intraoperative PTH ≥50% drop criterion), adrenal (incidentaloma >4 cm or functional, pheochromocytoma — alpha-blockade first then beta to avoid hypertensive crisis, Conn's primary hyperaldosteronism, Cushing's syndrome workup, adrenocortical carcinoma), MEN syndromes (MEN1 — 3 P's: parathyroid/pancreas/pituitary; MEN2A/2B — RET protooncogene).

Vascular Access & Basic Vascular

Hemodialysis access (KDOQI Fistula First — AV fistula > graft > tunneled catheter; brachiocephalic and radiocephalic configurations; complications — steal syndrome, pseudoaneurysm, thrombosis), central venous access (subclavian vs IJ vs femoral risk profiles, ultrasound guidance, pneumothorax recognition and management), AAA (USPSTF screening — men 65-75 ever-smokers; repair threshold ≥5.5 cm, rapid expansion >0.5 cm/6 mo, symptomatic; EVAR vs open), acute limb ischemia (6 Ps — pain/pallor/pulselessness/paresthesia/paralysis/poikilothermia; Rutherford I-III; heparin, embolectomy, fasciotomy for compartment syndrome), carotid disease basics, mesenteric ischemia (SMA embolus most common; chronic — postprandial pain, sitophobia).

Surgical Oncology, Skin & Soft Tissue

Melanoma (Breslow thickness, AJCC 8 staging, SLNB for ≥0.8 mm or thin high-risk; WLE margins 0.5-2 cm based on thickness; adjuvant anti-PD-1 nivolumab/pembrolizumab for stage III), non-melanoma skin cancer (BCC and SCC — Mohs micrographic surgery for H-zone and high-risk lesions), Merkel cell carcinoma (aggressive — wide excision + SLNB + adjuvant RT), soft-tissue sarcoma (extremity — limb-sparing surgery + RT; retroperitoneal — en bloc resection of involved organs; histologic subtype drives systemic therapy), GIST (KIT/PDGFRA — imatinib adjuvant for high-risk per Miettinen-Lasota), desmoid (often observed first per NCCN), necrotizing soft-tissue infection (LRINEC ≥6, emergency wide debridement, broad-spectrum antibiotics including clindamycin for toxin suppression).

Perioperative Care, Nutrition & Surgical Infections

Preoperative risk stratification (ASA class, RCRI, NSQIP risk calculator, frailty scores), antibiotic prophylaxis (SCIP — cefazolin within 60 minutes, redose every 4 hr or blood loss >1,500 mL; vancomycin within 120 min for MRSA risk), VTE prophylaxis (Caprini score, mechanical + pharmacologic), perioperative glycemic control, ERAS protocols (carbohydrate loading, multimodal opioid-sparing analgesia, early enteral feeding, early ambulation); fluids and electrolytes (hypo/hypernatremia correction rates to avoid central pontine myelinolysis, hyperkalemia management, hypocalcemia post-thyroidectomy — Chvostek/Trousseau); nutrition (enteral preferred when gut works, refeeding syndrome — phosphate/thiamine/magnesium replacement, immunonutrition); SSI prevention (CDC 2017), C. difficile colitis (oral vancomycin or fidaxomicin first-line per IDSA), intra-abdominal infection source control.