Esophagus, Stomach, Spleen and Pancreas

Question 1

Both the ____ esophageal sphincter and ___ esophageal sphincter are closed at rest

Answer 1

upper and lower

Question 2

Achalasia

Answer 2

Failure of the Lower esophageal sphincter tone to relax during swallowing accompanied with a lack of peristalsis

Question 3

Barrett Esophagus

Answer 3

Normal squamous epithelium changes to metaplastic columnar epithelium

Chronic exposure to acidic gastric contents – GERD
Chronic alcohol abuse
Smoking

Question 4

Types of hiatal hernia

Answer 4

Sliding / Type I
Paraesophageal / Type II
Mixed / Type III
Type IV

Question 5

Acid release in the stomach is mediated by:

Answer 5

Vagal stimulation (acetylcholine)
Gastrin release – G cells in response to gastric distention
Histamine

Question 6

Peptic Ulcer Disease causes:

Answer 6

Helicobacter pylori bacterium is the major etiologic factor
Overuse of medications such as aspirin and nonsteroidal anti-inflammatory drugs (NSAIDS), and corticosteroids
Excessive alcohol consumption, tobacco use, stress, and receiving radiation therapy can increase one’s risk for peptic ulcers

Question 7

Most common complications of peptic ulcer disease are

Answer 7

hemorrhage> perforation> obstruction

Question 8

What are the most effective antisecretory agents for PUD?

Answer 8

Proton pump inhibitors

Question 9

Most frequent complication of gastric ulceration is _______

Answer 9

perforation

Question 10

PUD most common cause of ________

Answer 10

hemorrhage

Question 11

Increased gastric mucosal acidosis is common in :

Answer 11

Critically ill patients
Pt. undergoing prolonged, complex surgical procedure
Pt. undergoing cardiopulmonary bypass

Question 12

Insulin is eliminated by the _____ and ___ and has an elimination half-life of ____ minutes.

Answer 12

kidneys and liver
5 minutes

Question 13

Whipple procedure / Pancreatoduodenectomy

Answer 13

complex operation to remove the head of the pancreas, the first part of the small intestine (duodenum), the gallbladder and the bile duct.

Question 14

Small intestine section lengths:

Answer 14

Duodenum ~ 20cm
Jejunum ~ 100cm
Ileum ~150cm

Question 15

The three major classes of nutrients that undergo digestion in the small intestine are :

Answer 15

proteins, lipids (fats), and carbohydrates

Question 16

Anesthesia Considerations for Intestinal Surgery

Answer 16

Aspiration Risk
Fluid and electrolyte status
History of steroid use ~ perioperative coverage
Avoid Nitrous Oxide
TPN
Bowel prep
Malnutrition and anemia
Thermoregulation – SCIP 36*C
Post op ileus

Question 17

The spleen is a non-vital organ located in the ______ ______ quadrant of the abdominopelvic region.

Answer 17

left upper

Question 18

______ is the largest lymphatic organ, acting as a site of lymphocyte proliferation and in immune surveillance and response.
In the fetus, it is a hematopoietic organ.

Answer 18

The Spleen

Question 19

Most effective treatment to reverse obesity?

Answer 19

Bariatric surgery
-can lead to the resolution of HTN and DM2

Question 20

Common signs of anastomotic leak:

Answer 20

1. tachycardia (72%)
2. fever (63%)
3. abdominal pain (54%)

Question 21

______ _____ is the most sensitive sign of an anastomotic leak.

Answer 21

Unexplained tachycardia

Question 22

_____ shoulder pain common with anastomotic leak.

Answer 22

Left

Question 23

Examples of procedures for Malabsorption issues

Answer 23

Jejunoileal bypass
Biliopancreatic diversion
Duodenal switch

Question 24

Examples of procedures for Restriction issues

Answer 24

Gastric band
Sleeve gastrectomy

Question 25

Combo restriction/malabsorption procedure

Answer 25

Roux-en-Y gastric bypass

Question 26

What weight loss procedure yields the most improvement in comorbidities and weight loss