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...
July 8, 2009 | In: ABDOMINAL SURGERY
37 APPENDICITIS Alden H. Harken M.D. 1. What is the classic presentation of acute appendicitis? Show answer Periumbilical pain that migrates to the right lower quadrant (RLQ) in a patient who is anorexic. 2. Where is McBurney's point?...
July 8, 2009 | In: TRAUMA
36 PEDIATRIC TRAUMA David A. Partrick M.D., Denis D. Bensard M.D. 1. What is the leading cause of death in children in the United States? Show answer Injuries cause more death and disability in children from ages 1 to 18 years than all...
35 BURNS Paulus C. Bauling MBChB, M.Med., FACS 1. Why is it essential to have sound clinical knowledge of urgent and emergent burn care? Show answer The events of September 11, 2001, have vividly underlined the fact that wars, plane...
July 8, 2009 | In: TRAUMA
34 BASIC CARE OF HAND INJURIES Michael J.V. Gordon M.D., Lawrence L. Ketch M.D. 1. What are the goals of hand repair? Show answer Functional considerations override cosmesis in the treatment of hand trauma. There are no minor hand injuries....
July 8, 2009 | In: TRAUMA
CONTROVERSIES 14. What controversies exist regarding the care and repair of facial lacerations? Show answer There is little controversy about the care and repair of facial lacerations. Attention to basic principles of wound care usually...
July 8, 2009 | In: TRAUMA
33 FACIAL LACERATIONS Lawrence L. Ketch M.D. 1. What distinguishes facial from other lacerations? Show answer Appearance is clearly of primary importance. Quality of the final result depends on strict adherence to basic principles of wound...
July 8, 2009 | In: TRAUMA
32 EXTREMITY VASCULAR INJURIES Kyle H. Mueller M.D., William H. Pearce M.D. 1. What are the "hard signs" of arterial injury? Show answer * Distal circulatory deficit: ischemia or diminished or absent pulses * Bruit *...
July 8, 2009 | In: TRAUMA
31 LOWER URINARY TRACT INJURY AND PELVIC TRAUMA Fernando J. Kim M.D., Siam Oottamasathien M.D. 1. What are the causes of bladder injury? Show answer Iatrogenic manipulation and penetrating or blunt trauma. Because of the rich detrusor blood...
July 8, 2009 | In: TRAUMA
30 UPPER URINARY TRACT INJURIES Fernando J. Kim M.D., Siam Oottamasathien M.D. 1. What is the most common type of renal trauma in the United States, blunt or penetrating? Show answer Blunt, by far. 2. Do most kidney injuries require...