July 8, 2009 | In: ABDOMINAL SURGERY
48 DIVERTICULAR DISEASE OF THE COLON Gregory P. Victorino M.D., Jyoti Arya M.D., Lawrence W. Norton M.D. 1. What is a colonic diverticulum? Show answer A protrusion of mucosa and submucosa through the muscular layers of the bowel wall. It...
July 8, 2009 | In: ABDOMINAL SURGERY
CONTROVERSIES 30. What is celiac compression syndrome (Dunbar's syndrome)? Show answer Celiac compression is a rare and controversial disorder most commonly described in women (female-to-male ratio = 4:1) between the ages of 20 and 50 years....
July 8, 2009 | In: ABDOMINAL SURGERY
47 INTESTINAL ISCHEMIA Thomas F. Rehring M.D. 1. What is the arterial supply to the gut? Show answer The foregut (stomach and duodenum) receives its blood supply from the celiac artery, the midgut (jejunum to the proximal descending colon)...
July 8, 2009 | In: ABDOMINAL SURGERY
46 SMALL BOWEL OBSTRUCTION Joyce A. Majure M.D. 1. Name three mechanisms of bowel obstruction, and give examples and incidence of each type. Show answer 1. Extrinsic compression: adhesions (60%), malignancy (20%), hernias (10%),...
July 8, 2009 | In: ABDOMINAL SURGERY
GASTRIC ULCER DISEASE 41. What is the most important factor in managing gastric ulcers? Show answer All gastric ulcers must be evaluated for malignancy. The incidence of malignancy is about 10%. 42. How is gastric ulcer evaluated?...
July 8, 2009 | In: ABDOMINAL SURGERY
45 ACID-PEPTIC ULCER DISEASE Frank H. Chae M.D. DUODENAL ULCER DISEASE 1. What is the risk of duodenal ulcer disease? Show answer The lifetime risk for duodenal ulcer is about 1 in 14. It usually occurs between ages 20 and 60 years, with...
July 8, 2009 | In: ABDOMINAL SURGERY
44 ESOPHAGEAL CANCER Casey M. Calkins M.D. 1. What are the risk factors for developing esophageal cancer? Show answer Both alcohol and tobacco increase the risk of carcinoma of the esophagus by a factor of 10. Additional risk factors...
July 8, 2009 | In: ABDOMINAL SURGERY
CONTROVERSIES 15. Is GERD better treated in the long term by PPI therapy or Nissen fundoplication? Show answer PPIs really work in resolving esophagitis and eliminating symptoms of GERD, but the long-term side effects are not fully known....
July 8, 2009 | In: ABDOMINAL SURGERY
43 GASTROESOPHAGEAL REFLUX DISEASE Michael E. Fenoglio M.D., Lawrence W. Norton M.D. 1. What symptoms suggest gastroesophageal reflux disease (GERD)? Show answer Substernal burning after meals or at night, associated occasionally with...
July 8, 2009 | In: ABDOMINAL SURGERY
CONTROVERSY 32. How should a patient with known esophageal varices be treated to prevent an initial variceal bleed? Show answer The combination of beta blocker and nitrate is used for primary prophylaxis, but endoscopic band ligation is at...
July 8, 2009 | In: ABDOMINAL SURGERY
42 PORTAL HYPERTENSION AND ESOPHAGEAL VARICES Ramin Jamshidi B.S., B.S., Gregory V. Stiegmann M.D. 1. Describe the blood supply to the liver. Show answer Total hepatic blood flow is roughly 1500 mL/min, or 25% of cardiac output. The hepatic...
July 8, 2009 | In: ABDOMINAL SURGERY
41 DIAGNOSIS AND THERAPY OF CHRONIC PANCREATITIS Clay Cothren M.D., Jon M. Burch M.D. 1. What is chronic pancreatitis? Show answer The classic syndrome consists of smoldering abdominal pain and evidence of pancreatic insufficiency....
July 8, 2009 | In: ABDOMINAL SURGERY
40 ACUTE PANCREATITIS Clay Cothren M.D., Jon M. Burch M.D. 1. What are the common causes of acute pancreatitis? Show answer Gallstones (45%), alcohol (35%), and other (20%). 2. What are the uncommon causes? Show answer...
July 8, 2009 | In: ABDOMINAL SURGERY
39 PANCREATIC CANCER Nathan W. Pearlman M.D. 1. What are the general features of pancreatic cancer? Show answer There are about 30,000 new cases per year in the United States, and more than 29,000 deaths, so it is a highly lethal disease....
July 8, 2009 | In: ABDOMINAL SURGERY
38 GALLBLADDER DISEASE Jeff Cross M.D. 1. What is the prevalence of gallstones in Western society for women and men 60 years of age? Show answer Women, 50%; men, 15%, although there is formidable ethnic predilection with gallstones endemic...
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