2025/2026 Principle of surgery exam part 4

1. A 65-year old female with a 15cm ulcerating and foul-smelling cancer of her left breast with bone and liver metastasis. In addition to taking care of her pain and anxiety, what is the best management option for this patient? * a) Supportive surgical care b) Non-curative surgery c) Surgical palliative care d) Palliative care surgery 2. Estimated blood loss in a patient presented with gastrointestinal bleeding with cardiac rate of 110 decreased pulse pressure but with normal blood pressure * a) <750 cc b) 750-1500 cc c) 1500 to 2000 cc d) > 2000 cc 3. A 67-year-old female is diagnosed with severe sepsis secondary to purulent peritonitis due to ruptured sigmoid diverticulitis. Patient is highly febrile, tachycardic and tachypneic with marginal urine output. What is the accepted first-step in the management of this patient? * a) administration of intotropic agents to support the cardiovascular system b) restoration of perfusion by rapid administration of isotonic fluids c) drainage of the intraperitoneal abscesses to control the source d) giving of intravenous broad-spectrum antimicrobial agents 4. The expected infection rate of patients with perforated diverticulitis is: * a) 3.4-13.2% b) 3.1-12.8% c) 1-2% d) 2.1-9.5% 5. Which among the following is true regarding all the layers of palliative care? * a) Promotes the utilization of an end-of-life doula b) Addresses the psychospiritual aspects of patient care c) Affirms that the dying process can be postponed artificially d) Conditions the patient to accept the pain and other symptoms