You are consulted for an otherwise healthy patient with abdominal pain, bloody diarrhea, and high fevers, in spite of 72 hours of triple antibiotic treatment; how would you respond?

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Entry Level
Answer Example
Experienced Level

Like another question, the one about a difficult intubation, this is a question that serves as a barometer for clinical common sense and basic medical judgment. Therefore, show them that you have that judgment. It is conventional medical wisdom that when a patient fails to respond to treatment based on a certain diagnosis, that you should doubt that diagnosis. Don't be afraid to be bold here with a drastic mid-course correction, because this is going to be a dead patient very soon!

"I would check what cultures came back and compare them with the antibiotic selection. Based on that, I would probably prepare the patient for a colonoscopy to rule out necrotic bowel."

"I would consider the therapy with the antibiotics a failure, so I would prepare to do what I needed to establish a correct diagnosis, which means a colonoscopy."

"I would prepare to get a definitive diagnosis via a colonoscopy, because after failure of powerful antibiotics, I would suspect necrotic bowel. However, in my experience, I know that any colon ravaged like this for three days presents a high risk of perforation, so I would make sure I emphasized that in the informed consent. I would also involve an anesthesiologist for both complete patient immobility to reduce the likelihood of perforation and to maintain a surgery readiness should the need for emergency surgery prove necessary, such as colon resection of necrotic bowel."

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How to Answer: You are consulted for an otherwise healthy patient with abdominal pain, bloody diarrhea, and high fevers, in spite of 72 hours of triple antibiotic treatment; how would you respond?

Advice and answer examples written specifically for a General Surgeon job interview.

2. You are consulted for an otherwise healthy patient with abdominal pain, bloody diarrhea, and high fevers, in spite of 72 hours of triple antibiotic treatment; how would you respond?

How to Answer

Like another question, the one about a difficult intubation, this is a question that serves as a barometer for clinical common sense and basic medical judgment. Therefore, show them that you have that judgment. It is conventional medical wisdom that when a patient fails to respond to treatment based on a certain diagnosis, that you should doubt that diagnosis. Don't be afraid to be bold here with a drastic mid-course correction, because this is going to be a dead patient very soon!

Written by D. Leo on April 13th, 2021

Entry Level

"I would check what cultures came back and compare them with the antibiotic selection. Based on that, I would probably prepare the patient for a colonoscopy to rule out necrotic bowel."

Written by D. Leo on April 13th, 2021

Answer Example

"I would consider the therapy with the antibiotics a failure, so I would prepare to do what I needed to establish a correct diagnosis, which means a colonoscopy."

Written by D. Leo on April 13th, 2021

Experienced Level

"I would prepare to get a definitive diagnosis via a colonoscopy, because after failure of powerful antibiotics, I would suspect necrotic bowel. However, in my experience, I know that any colon ravaged like this for three days presents a high risk of perforation, so I would make sure I emphasized that in the informed consent. I would also involve an anesthesiologist for both complete patient immobility to reduce the likelihood of perforation and to maintain a surgery readiness should the need for emergency surgery prove necessary, such as colon resection of necrotic bowel."

Written by D. Leo on April 13th, 2021

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