July 9, 2009 | In: ABDOMINAL SURGERY
53 COLORECTAL POLYPS Carlton C. Barnett Jr. M.D., Michael B. Wallace M.D., M.P.H. 1. What are polyps? Show answer A polyp is an elevation of the mucosal surface that can occur anywhere in the gastrointestinal (GI) tract. Two thirds of...
July 9, 2009 | In: ABDOMINAL SURGERY
52 LOWER GASTROINTESTINAL BLEEDING Kathleen Liscum M.D. 1. Describe the treatment of a patient who presents with lower gastrointestinal (GI) bleeding. Show answer Treatment begins with the ABCs (airway, breathing, circulation). Place two...
July 8, 2009 | In: ABDOMINAL SURGERY
51 UPPER GASTROINTESTINAL BLEEDING G. Edward Kimm Jr. M.D., Allen T. Belshaw M.D. 1. What is upper gastrointestinal (GI) bleeding? Show answer Bleeding from proximal to the ligament of Treitz (the transition point between duodenum and...
July 8, 2009 | In: ABDOMINAL SURGERY
CONTROVERSIES 17. Should all patients with enteroenteral fistulas secondary to Crohn's disease have surgery when the fistula is discovered? Show answer For: Such patients ultimately do poorly, develop further intraperitoneal septic...
July 8, 2009 | In: ABDOMINAL SURGERY
50 INFLAMMATORY BOWEL DISEASE Anthony J. LaPorta M.D., Gilbert Hermann M.D. 1. What two clinical entities encompass the diagnosis of inflammatory bowel disease? Show answer Crohn's disease and ulcerative colitis (acute or chronic). 2....
July 8, 2009 | In: ABDOMINAL SURGERY
49 ACUTE LARGE BOWEL OBSTRUCTION Elizabeth C. Brew M.D. 1. What are the mechanical causes of large bowel obstruction? Show answer The three most common mechanical causes are carcinoma (50%), volvulus (15%), and diverticular disease (10%)....
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...