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Master Specialist General Surgery (GEN5341)
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Medically reviewed by Prof. Dr. Hashim AL MAHMUD — MD - FRCS

GMC Licensed - DHA Certified · Reviewed Oct 2026 · Editorial policy

Sample Practice Questions

Question 1 FULLY WORKED EXAMPLE

A 68-year-old man is scheduled for elective laparoscopic cholecystectomy for symptomatic gallstones. He has a history of stable angina and is taking aspirin 75 mg once daily. His cardiologist placed a bare-metal coronary stent 5 weeks ago. His vital signs are normal, and his platelet count and coagulation profile are within normal limits. According to current guidelines, what is the most appropriate perioperative management of his antiplatelet therapy?

A) Continue aspirin and add clopidogrel perioperatively

B) Stop aspirin 7 days before surgery

C) Continue aspirin throughout the perioperative period ✓ Correct

D) Stop aspirin 24 hours before surgery and restart on postoperative day 1

Explanation:

The deciding finding is the recent bare-metal stent placement (5 weeks ago), which mandates uninterrupted dual antiplatelet therapy or at least aspirin continuation to prevent stent thrombosis. Current guidelines recommend continuing aspirin perioperatively in patients with recent coronary stents undergoing non-cardiac surgery. Stopping aspirin 7 days before surgery (option B) or 24 hours before (option D) increases the risk of stent thrombosis and is unsafe. Adding clopidogrel (option A) without indication is not standard and increases bleeding risk without benefit. Therefore, continuing aspirin is the safest approach.

References: ESC/ESA Guidelines on non-cardiac surgery: cardiovascular assessment and management (2014)

Question 2 TRY IT — TAP AN ANSWER

A 45-year-old woman with a body mass index of 42 kg/m? is undergoing laparoscopic sleeve gastrectomy. She has a history of type 2 diabetes mellitus and is on metformin. Her renal function is normal. Postoperatively, she develops nausea and vomiting, and her serum creatinine rises to 2.1 mg/dL (baseline 0.8 mg/dL). Which of the following is the most appropriate management regarding her metformin therapy?

A) Continue metformin at the same dose

B) Reduce metformin dose by 50%

C) Hold metformin and monitor renal function

D) Switch to insulin immediately

💡 Pick an answer above to see if you're right — the full explanation unlocks instantly.

Question 3 TRY IT — TAP AN ANSWER

A 32-year-old woman, 26 weeks pregnant, presents with acute right lower quadrant pain, fever of 38.2?C, and a white blood cell count of 15,000/uL. Ultrasound is inconclusive, and magnetic resonance imaging (MRI) confirms acute appendicitis. She has no allergies. What is the most appropriate management?

A) Intravenous antibiotics and observation until after delivery

B) Laparoscopic appendectomy

C) Open appendectomy through a McBurney incision

D) Percutaneous drainage of the appendix

💡 Pick an answer above to see if you're right — the full explanation unlocks instantly.

Question 4 TRY IT — TAP AN ANSWER

A 70-year-old man with a history of atrial fibrillation on warfarin (INR 2.5) is admitted with acute cholecystitis. He is scheduled for urgent laparoscopic cholecystectomy. His renal function is normal. What is the most appropriate perioperative management of his anticoagulation?

A) Continue warfarin and proceed with surgery

B) Stop warfarin and give vitamin K 10 mg IV

C) Stop warfarin and bridge with therapeutic low-molecular-weight heparin

D) Stop warfarin and give fresh frozen plasma

💡 Pick an answer above to see if you're right — the full explanation unlocks instantly.

Question 5 TRY IT — TAP AN ANSWER

A 55-year-old man with a history of peptic ulcer disease presents with a perforated duodenal ulcer. He is hemodynamically stable, and computed tomography shows free air. He is scheduled for surgery. Which of the following is the most appropriate acid-suppressing therapy in the perioperative period?

A) Intravenous pantoprazole 40 mg twice daily

B) Oral omeprazole 20 mg once daily

C) Intravenous ranitidine 50 mg every 8 hours

D) Oral sucralfate 1 g four times daily

💡 Pick an answer above to see if you're right — the full explanation unlocks instantly.

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Specialist General Surgery (GEN5341) Questions for DHA Speciality — FAQ

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MedLumen currently has 700+ Specialist General Surgery (GEN5341) practice questions for DHA Speciality, each with a detailed explanation so you understand the reasoning behind every answer.

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