Free Practice Questions for OMSB General Surgery (OEGS)

Breast

Evaluation of palpable breast masses, mammographic abnormalities (BI-RADS), management of DCIS and invasive ductal/lobular carcinomas, breast conservation vs mastectomy, sentinel lymph node biopsy, and systemic endocrine/targeted therapies.

Hepatobiliary

Acute and chronic cholecystitis, choledocholithiasis, acute ascending cholangitis, Tokyo Guidelines, hepatic abscesses, hepatocellular carcinoma, bile duct injury classification, and management of biliary strictures.

Lower GIT

Colorectal cancer screening and staging, surgical resection principles (TME, hemicolectomy), acute diverticulitis (Hinchey classification), ulcerative colitis and Crohn's disease surgical indications, volvulus, and anorectal sepsis and fistula.

Endocrine

Evaluation of thyroid nodules (Bethesda criteria), papillary and follicular thyroid carcinomas, primary hyperparathyroidism localization and operative indications, pheochromocytoma, and adrenal incidentalomas.

Surgical oncology/abdominal wall/soft-tissue tumors

Cutaneous melanoma resection margins and sentinel node biopsy, extremity and retroperitoneal soft tissue sarcomas, gastrointestinal stromal tumors (GIST), abdominal wall fibromatosis (desmoid tumors), and oncologic margins.

Acute abdomen

Initial diagnostic approach, imaging modalities (ultrasound vs CT), differential diagnosis of acute abdominal pain, hollow viscus perforation, acute mesenteric ischemia, and operative vs non-operative management decisions.

Hernia

Inguinal anatomy (myopectineal orifice of Fruchaud), Lichtenstein open repair, TAPP and TEP laparoscopic techniques, femoral hernia emergency presentation, ventral hernia component separation, and mesh infection management.

Upper GIT

Staging and surgical management of esophageal adenocarcinoma and squamous cell carcinoma, gastric adenocarcinoma, perforated peptic ulcer, acute upper GI bleeding, achalasia, and GERD surgical indications (fundoplication).

Bariatric

Candidate selection and contraindications for metabolic surgery, operative anatomy of sleeve gastrectomy and Roux-en-Y gastric bypass, management of staple line leaks, internal hernia, and marginal ulceration.

Subspecialties (vascular, pediatric, plastic, lung/mediastinum)

Abdominal aortic aneurysm screening and rupture management, acute limb ischemia (6 Ps and Fogarty embolectomy), infantile hypertrophic pyloric stenosis, malrotation, skin graft vs local flap choices, and spontaneous pneumothorax.

Complications

Clavien-Dindo classification, detection and management of gastrointestinal anastomotic leaks, postoperative bleeding, deep vein thrombosis and pulmonary embolism prophylaxis and treatment, and wound dehiscence.

Transplant

Evaluation of brain-dead and circulatory-death donors, kidney and liver transplant indications, surgical complications (hepatic artery thrombosis, ureteral leak), immunosuppressive mechanisms, and graft rejection.

Trauma

ATLS protocol prioritization, FAST exam in blunt abdominal trauma, indications for emergency exploratory laparotomy, damage control laparotomy steps (packing, temporary closure), and hepatic/splenic injury grading.

Pre/postoperative care

Cardiac and pulmonary risk stratification (RCRI), preoperative fasting guidelines, ERAS multimodal pathways, total parenteral and enteral nutrition support, and postoperative delirium management.

Surgical critical care

Physiologic monitoring, septic shock definition and early goal-directed resuscitation, acute respiratory distress syndrome (lung-protective ventilation), intra-abdominal hypertension, and abdominal compartment syndrome.

Biostatistics

Study designs (cohort, case-control, randomized controlled trials), measures of association (odds ratio, relative risk), sensitivity, specificity, positive and negative predictive values, and statistical significance testing.

Hemostasis and blood products

Coagulation pathway physiology, indications for packed red blood cells, fresh frozen plasma, platelets, and cryoprecipitate, massive transfusion protocols (1:1:1 ratio), and reversal of direct oral anticoagulants and warfarin.

Ethics

Informed consent requirements, assessing decision-making capacity, surrogate decision-makers, advance directives, do-not-resuscitate orders in the perioperative setting, and error disclosure.

Anesthesia and pain

Local anesthetic toxicity thresholds and lipid rescue therapy, spinal vs epidural anesthesia anatomy, multimodal analgesia regimens, and perioperative airway evaluation and difficult airway algorithms.

Surgical infection

CDC surgical site infection prevention guidelines, timing and selection of prophylactic antibiotics, management of necrotizing fasciitis, source control for tertiary peritonitis, and handling Clostridioides difficile enterocolitis.