cases

Question 1

In general, pancreaticoduodenectomy should be reserved for

Answer 1

patients with localized malignancies near the ampulla of Vater.

Question 2

Primary hyperparathyroidism:

Confirmation of diagnosis?

Answer 2

↑ parathyroid hormone (PTH) level

sestamibi scan= localization adenoma prior to surgery

rx= primary hyperparathyroidism is surgery.

Question 3

hypercalcemic crisis

Answer 3

Ca > 15
AMS
NVD

Question 4

most common cause of ↑ Ca in the inpatient setting, particularly when hyperparathyroidism is ruled out.

Answer 4

Malignancy

Question 5

Surgical indications for primary hyperparathyroidism include

Answer 5

a markedly ↑ calcium
hypercalcemic crisis
kidney stones/ ↓ fxn
↓ bone density.

Question 6

food fear with postprandial pain and significant weight loss, which are the hallmarks of ____________

Answer 6

chronic mesenteric ischemia

duplex ultrasonography is an excellent screening test. In

Question 7

Arteriography can aid in the diagnosis but may lead to treatment delays and should not be applied toward individuals who are suspected of having intestinal ischemic necroses.

Answer 7

Acute mesenteric ischemia is a surgical emergency.

Question 8

A patient with chronic mesenteric ischemia almost always has

Answer 8

significant unexplained weight loss. If there is no weight loss, the diagnosis should be questioned.

Question 9

A nonhealing anal fissure or a fissure located anywhere other than in the posterior area of the anus should alert the clinician to the possibility of _________

Answer 9

Crohn disease or a malignancy.

Question 10

Assessment of functional studies is the first step in the evaluation of any patient with an adrenal mass.

The functional assessment consists of evaluation for

Answer 10

pheochromocytoma, aldosterone-producing

adenoma, and a cortisol-producing tumor.