1 How common is hyperthyroidism? Of the 1.2% prevalence of hyperthyroidism in the United States, 0.5% is overt, while 0.7% is subclinical. The incidence of overt disease is approximately 0.4 per 1000 women, and 0.1 per 1000 men, but varies…
1 How common is hyperparathyroidism (HPT)? The prevalence of hyperparathyroidism is 1:1000. There are approximately 100,000 new cases of HPT annually in the United States. Seventy-four percent of all cases are in women, and the risk increases with age. Primary…
1 My patient weighs 250 lb (114 kg). Is he or she morbidly obese? Maybe. The most widely used definition of morbid obesity uses the concept of body mass index (BMI), which is weight (kg) divided by height squared (m).…
1 Groin hernia refers to which three hernias? Direct and indirect inguinal hernias and femoral hernias. 2 Francois Poupart, a French surgeon and anatomist (1616–1708), described a ligament that bears his name. What is the anatomic name of the Poupart…
1 What aspect of the initial patient encounter is most important in the diagnosis of anorectal disease? A careful history of anal complaints can point to the correct diagnosis even before completion of a physical exam. It is important to…
1 What are the top three causes of cancer deaths in the United States? Lung, breast or prostate, and colon cancer. 2 List a few of the presenting symptoms of patients with colorectal cancer Intermittent rectal bleeding, vague abdominal pain,…
1 What are polyps? A gastrointestinal (GI) polyp is an abnormal growth of tissue projecting from the mucosal layer anywhere along the GI tract. Almost half of patients with GI polyps do not complain of bowel symptoms. Bowel habit alteration…
1 Describe the initial treatment of a patient who presents with massive lower gastrointestinal (GI) bleeding Assessment of ABCs (airway, breathing, circulation). Vital signs including orthostatics should be assessed to determine the severity of blood loss. Treatment begins with resuscitation.…
1 What is upper gastrointestinal bleeding (UGIB)? Bleeding from a gastrointestinal (GI) source proximal to the ligament of Treitz (i.e., from the esophagus, stomach, or duodenum). 2 What is the ligament of Treitz? It is a thin, suspensory muscle that…
1 What clinical entities encompass the diagnosis of inflammatory bowel disease (IBD)? Crohn’s disease (CD) and ulcerative colitis (UC). A third entity called indeterminate colitis describes the situation when the clinical or pathologic features do not entirely fit the criteria…