Free ABSITE Sample Questions
See why TrueLearn is a trusted resource for thousands of medical students and residents. We understand that it’s all about the content. That’s why we have high-yield ABSITE practice questions written and screened by high-performing physician authors, which are updated on a regular basis to ensure our SmartBanks stay up-to-date with exam blueprint changes.
Below is a free ABSITE sample question and see what we mean.
First free ABSITE Sample Question from the 2026 New Edition
A 35-year-old healthy woman presents with a 6-week history of dysphagia. An esophagogram is shown below. Which of the following is the most definitive treatment for this patient?
- A. calcium channel blockers
- B. Botox injection
- C. pneumatic dilation
- D. Heller esophagomyotomy with Dor fundoplication
- E. Heller esophagomyotomy with Nissen fundoplication
The Answer and Explanation
Did you get it right? The correct answer is: D
This patient has an esophagogram with the classic finding of a “bird-beak” appearance, suggesting achalasia.
Did you get it right? The correct answer is D, Heller esophagomyotomy with Dor fundoplication.
This patient has an esophagogram with the classic finding of a “bird-beak” appearance, suggesting achalasia.
Due to the high long-term success rate of operative management, surgery should be considered as first-line therapy for good operative risk candidates, especially in young patients less than 40 years old. Operative management consists of distal (Heller) esophagomyotomy through both the longitudinal and circular muscle layers.
This procedure can be performed laparoscopically in most instances. The addition of a partial fundoplication, such as a Dor or Toupet, helps to prevent postoperative reflux symptoms. It is important to note that a complete (Nissen) fundoplication is contraindicated in patients with an esophageal motility disorder such as achalasia, and only a partial wrap should be performed. Esophagectomy is rarely performed in achalasia but may be indicated in cases of end-stage disease with a tortuous (megaesophagus) or sigmoid esophagus.
Per-oral endoscopic myotomy (POEMS) is a novel approach by which the myotomy is performed endoscopically via a submucosal tunnel. It is currently unknown if the long-term results are comparable to Heller myotomy.
“Bird-beak” appearance (red arrow) due to dilated esophagus on barium swallow study.
Incorrect Answer Explanations
Answer A, calcium channel blockers: Medical treatment includes calcium channel blockers or nitrates to relax the lower esophageal sphincter (LES) and can provide symptom relief in the short-term. However, results are often limited by side effects, and patients have poor long-term outcomes on medical therapy alone, generally requiring definitive surgical management for symptom control.
Answer B, Botox injection: Botox injections into the LES often require repeated treatments as symptoms recur more than half of the time within 6 months. Botox is a good treatment choice for high-risk patients (for example, the elderly or comorbid), as it is the least invasive option.
Answer C, pneumatic dilation: Pneumatic dilation has comparably high success rates compared with myotomy; however, patients frequently require repeated interventions.
Answer E, Heller esophagomyotomy with Nissen fundoplication: Although a Heller myotomy is the first-line therapy for good operative risk candidates, a Nissen (360-degree) fundoplication is contraindicated due to the patient’s esophageal dysmotility. A partial wrap, such as a Dor or Toupet, should be performed instead.
Bottom Line
Esophagomyotomy should be considered as first-line therapy for good operative risk candidates with achalasia, especially in young patients less than 40 years old. A partial (not complete) wrap such as a Dor or Toupet fundoplication is generally performed concurrently to reduce the rates of postoperative reflux.
Another Free ABSITE Practice Question
A 16-year-old boy with end-stage renal disease due to glomerulonephritis had a peritoneal catheter placed approximately 6 weeks ago. The catheter worked well for peritoneal dialysis for the first 2 weeks of use; however, for the last week, he and his family have not been able to obtain adequate peritoneal emptying of the dialysate. The boy denies any abdominal pain or fevers. His parents assist him with each dialysis run, and they have not seen any clot or cellular material in the dialysis fluid. What is the most common cause of peritoneal dialysis catheter outflow dysfunction?
- A. infection
- B. fibrin clot wrapping
- C. kinking of the tube
- D. tube migration
- E. constipation
The Answer and Explanation
Did you get it right? The correct answer is: E
Peritoneal dialysis (PD) is a less common dialysis modality for end-stage renal disease patients in the United States, but is popular among young patients and compares similarly to hemodialysis using conventional clinical outcomes. PD catheter maintenance and troubleshooting are unique requirements of this method of dialysis delivery. This patient is experiencing PD catheter “outflow failure.” Outflow failure, or inadequate dialysate emptying, is a common problem for patients undergoing PD.Treatment is determined by the etiology of the outflow failure, hence the importance of knowing the differential and being able to work up the complaint. The most common cause of PD catheter complications overall is infection. The most common non-infectious complication is outflow failure. The most common cause of outflow failure is constipation (5-20% of the cases). A large, bulky colon reduces the size of the average fluid collection that the catheter can lay in for optimal functioning. Other common causes of outflow failure include fibrin clot, kinking of the tube, tube migration, or solid organ abutment. Treating constipation with conventional bowel regimens when constipation-related outflow failure occurs usually leads to resolution of the output failure. Similarly, fibrin clots can often be addressed with the use of alteplase (tPA). Tube malposition can be solved by fluoroscopic stiff-wire tube manipulation. Once a catheter is kinked, it most often requires replacement.
Postoperative photo after peritoneal dialysis catheter placement.
Incorrect Answer Explanations:
Answer A: This patient has no symptoms of infection. PD catheter infections are usually characterized by cloudy dialysate, fevers, and abdominal pain.
Answer B: Omental fat, fibrin scar tissue, and peritoneal blood products can all result in intraluminal or extraluminal PD catheter occlusion, which reduces outflow. This is less common than constipation, and these cases typically exhibit small amounts of tissue or filamentous particulate matter in the dialysate.
Answer C: While an x-ray of the boy’s abdomen is an appropriate part of the initial workup to rule out mechanical occlusion, kinking of the tube phenomenon occurs less frequently than constipation-related outflow failure. Also, kinking of the tube is diagnosed early after placement and not 6 weeks after uneventful use as in this scenario.
Answer D: A malpositioned tube with outflow failure is frequently symptomatic, and the patient would likely describe focal pain at the point of tube occlusion. In addition, tube malposition is a less frequent cause of outflow failure.
Bottom Line
Outflow failure is a common noninfectious problem of peritoneal dialysis. The most common cause of outflow failure is constipation.
For more information, see:
Image source:
Peritoneal dialysis catheter: Open-i
Keep Taking ABSITE Practice Questions
According to a recent study published by the Journal of Surgical Education, ABSITE scores are positively correlated to the number of TrueLearn ABSITE practice questions taken.
ABSITE exam success just got better! With updated questions, clear and concise explanations, and hundreds of visuals designed to support your exam excellence, TrueLearn’s ABSITE SmartBank is the top choice for the ABSITE.
Here’s what you get with the ABSITE SmartBank 2026 New Edition:
- 1000+ exam-style questions aligned to the ABSITE content outline
- Explanations that clearly and concisely break down why each answer choice is correct or incorrect
- 650+ surgical illustrations, decision-making algorithms, radiology images, and clinical photographs
- 480+ tables summarizing high-yield topics, conditions, and procedures
- Supported by references to authoritative textbooks, journal articles, and guidelines
- A test-taking interface that closely mirrors that of the actual ABSITE
Evidence
Blog
Blog