醫(yī)用英語(yǔ)練習(xí)

醫(yī)用英語(yǔ)練習(xí)醫(yī)用英語(yǔ)練習(xí)#/80lysedduringsurgery.Thesebandsarecalled .a.prodromesb.sequelaec.adhesionsd.ascitese.fibroids 12.Theincidental(accidental)punctureoftheintestinesandnerveinjurytoC.F.’sarmarenotexpectedoutcomesofsurgery.Theyarecriticalincidentsandoccurreddespiteattemptstoprotectherfromharm.Thetermforthistypeofdisorderis (seeChapter6).a.iatrogenicb.nosocomialc.idiopathicd.etiologice.surgicalmisadventurecystorrhaphycystoplastycystotomycystopexycystostomyChemotherapy.Theothersareexaminingmethods;chemotherapyistreatmentwithchemicals.Syncope.Theothersareexamininginstruments;syncopeisfainting.cystorrhaphycystoplastycystotomycystopexycystostomyChemotherapy.Theothersareexaminingmethods;chemotherapyistreatmentwithchemicals.Syncope.Theothersareexamininginstruments;syncopeisfainting.Sequela.Theothersaresurgical49.TMN.Theothersareabbreviationsforimagingtechniques;TMNisanabbreviationforasystemofinstruments;sequelaisalastingeffectofdisease.stagingcancer.workingtogetherofpartsordrugsa.togetherFormationofcolororpigmentcolororigin,formationworkconditionofconditionofinstrumentforrecordingchestsoundssoundchestinstrumentforrecordingdata14.CA19.e15.ADL20.a16.TPR21.d17.bpm22.c18.WNL23.e19.D/C24.a20.NSS25.bAnswerstoChapterExercises26.eCHAPTERREVIEW7-127.a1.b28.d2.c29.b3.e30.c4.a31.d5.d32.c6.c33.a7.d34.e8.e35.b9.a36.erg/o;work10.b37.radi/o;11.bradiation,x-ray12.e38.chron/o;time13.a39.bar/o;14.dpressure15.c40.aer/o;air,16.boxygen17.dcacahistoryofpresentillnesscanceractivitiesofdailylivingtemperature,pulse,respirationbeatsperminutewithinnormallimitsdiscontinuenormalsalinesolutionsequelaepalpationnormocephalicparacentesisbiopsydiagnosticlaparoscopyhyperabductioncbdCaseStudy9-1:PTCAandEchocardiogramA.L.,a68-year-oldwoman,wasadmittedtotheCCUwithchestpain,dyspnea,diaphoresis,syncope,andnausea.Shehadtakenthreesublingualdosesofnitroglycerinetabletswithina10-minutetimespanwithoutreliefbeforedialing911.Apreviousstresstestandthalliumuptakescansuggestedcardiacdisease.Herfamilyhistorywassigni.cantforcardiovasculardisease.Herfatherdiedattheageof62ofanacutemyocardialinfarction.Hermotherhadbilateralcarotidendarterectomiesandafemoral-poplitealbypassprocedureanddiedattheageof72ofcongestiveheartfailure.A.L.’soldersisterdiedfromarupturedaorticaneurysmattheageof65.HerECGonadmissionpresentedtachycardiawitharateof126bpmwithinvertedTwaves.AmurmurwasheardatS1.Herskincolorwasduskytocyanoticonherlipsand.ngertips.Heradmittingdiagnosiswaspossiblecoronaryarterydisease,acutemyocardialinfarction,andvalvulardisease.Cardiaccatheterizationwithballoonangioplasty(PTCA)wasperformedthenextday.Signi.cantstenosisoftheleftanteriordescendingcoronaryarterywasshownandwastreatedwithangioplastyandstentplacement.Leftventricularfunctionwasnormal.Echocardiogram,2dayslater,showednormal-sizedleftandenlargedrightventricularcavities.Themitralvalvehadnormalamplitudeofmotion.Theanteriorandposteriorleafletsmovedinoppositedirectionsduringdiastole.Therewasalatesystolicprolapseofthemitralleafletatrest.Theleftatriumwasenlarged.Theimpressionofthestudywasmitralprolapsewithregurgitation.Surgerywasrecommended.CaseStudy9-2:MitralValveReplacementOperativeReportA.L.wastransferredtotheoperatingroom,placedinasupineposition,andgivengeneralendotrachealanesthesia.Herpericardiumwasenteredlongitudinallythroughamediansternotomy.Thesurgeonfoundthatherheartwasenlargedwithadilatedrightventricle.Theleftatriumwasdilated.Preoperativetransesophagealechocardiogramrevealedseveremitralregurgitationwithsevereposteriorandanteriorprolapse.Extracorporealcirculationwasestablished.Theaortawascross-clamped,andcardioplegicsolution(tostoptheheartbeat)wasgivenintotheaorticrootintermittentlyformyocardialprotection.Theleftatriumwasenteredviatheinteratrialgrooveontheright,exposingthemitralvalve.Themiddlescallopoftheposteriorlea.etwasresected.Theremaininglea.etswereremovedtotheareasofthecommissuresandpreservedfortheslidingplasty.Theelongatedchordaewereshortened.Thesurgeonslidtheposteriorlea.etacrossthemidlineandsutureditinplace.Ano.30annuloplastyringwassuturedinplacewithinterruptedno.2-0Dacronsuture.Thevalvewastestedbyin.atingtheventriclewithNSSandprovedtobecompetent.Theleftatriumwasclosedwithcontinuousno.4-0Prolenesuture.Airwasremovedfromtheheart.Thecross-clampwasremoved.Cardiacactionresumedwithnormalsinusrhythm.Afteraperiodofcardiacrecoveryandattainmentofnormothermia,cardiopulmonarybypasswasdiscontinued.Protaminewasgiventocounteracttheheparin.Pacerwireswereplacedintherightatriumandventricle.Siliconecatheterswereplacedinthepleuralandsubsternalspaces.Thesternumandsofttissuewoundwasclosed.A.L.recoveredfromhersurgeryandwasdischarged6dayslater.CASESTUDYQUESTIONSWritethewordorphrasefromthecasestudythathasthesamemeaningaseachofthefollowingwordsorphrases:Thestateofprofuseperspiration Underthetongue Testofcardiacfunctionduringphysicalexertion Diseasethatincludesbothheartandbloodvesselpathology Excisionoftheinnerliningalongwithatheroscleroticplaquefromanartery(plural) Anabnormalheartsound Bluishdiscolorationoftheskin;signofanoxia Thenounformofstenotic Betweentheatria Belowthesternum Multiplechoice:Selectthebestanswerandwritetheletterofyourchoicetotheleftofeachnumber. 11.Thewordtransluminalmeans:a.acrossawallbetweenbranchesthroughanouterlayerthroughacentralopeninge.acrossavalve 12.Thetermthatmeansback.ow,asofblood,is:a.infarctionregurgitationamplitudeprolapsetourniquet 13.Thetermforanarrowingofthebicuspidvalveis:atrialprolapsepulmonicstenosismitralstenosismitralprolapsee.atrialstenosis 14.Blowoutofadilatedsegmentofthemainarteryis:a.leftanteriordiastoleb.peritonealinfarctionc.coarctationoftheaortad.cardiactamponaderupturedaorticaneurysm 15.Sternotomyis:incisionintothesternumremovalofthesternumnarrowingofthesternumplasticrepairofthesternumsurgical.xationofthesternum6.Extracorporealcirculationoccurs:withinthebrainwithinthepericardiumwithinthebodyinthelegsoutsidethebody 17.Protaminewasgiventocounteracttheactionoftheheparin.Thisdrugactionisdescribedas:antagonisticsynergypotentiatingsimilationaddictionAbbreviations.De.nethefollowingabbreviations:CCU AMI CAD LAD CHF TEE MVR AnswerstoCaseStudyQuestions1.diaphoresis2.sublingual16.e3.stresstest17.a4.cardiovasculardisease5.endarterectomies18.coronary/cardiaccareunit6.murmur19.acutemyocardialinfarction7.cyanosis20.coronaryarterydisease8.stenosis21.leftanteriordescending9.interatrial22.congestiveheartfailure10.substernal23.transesophagealechocardiogram11.d24.mitralvalvereplacement12.b13.c14.e15.aCaseStudy10-1:LatexAllergyM.R.,a36-year-oldcerti.edregisterednurseanesthetist(CRNA),wasdiagnosed7yearsagowithlatexallergy.She.rstnoticedthatshedevelopedcontactdermatitiswhensheworepowderedlatexgloves.Shesoondevelopedtachycardia,hypotension,bronchospasm,urticaria,andrhinitiswithcontactorproximitytolatexinsurgery.Shehadonefrighteningepisodeofanaphylaxis.HerallergyisofthetypeIhypersensitivity,IgET-cell-mediatedlatexallergy,whichwasdiagnosedbybotharadioalle-rgosorbenttest(RAST)andaskin-pricktest.M.R.avoidsallcontactwithanynaturalrubberlatexinherhomeandatwork.ShecanonlyworkinapediatricORbecausetheyarelatex-free,sincemanychildrenwithcongenitaldisordersarelatexallergic.Shewearsamedicalalertbracelet,usesabronchodilatorinhaleratthe.rstsymptomofbronchospasm,andcarriesasyringeofepinephrineatalltimes.CaseStudy10-2:BloodReplacementC.L.,a16-year-oldgirl,sustainedarupturedliverwhenshehitatreewhilesledding.Emergencysurgerywasneededtostoptheinternalbleeding.Duringsurgery,therupturedsegmentoftheliverwasremovedandthelacerationwassuturedwithaheavy,absorbablesutureonalargesmoothneedle.Beforesurgery,herhemoglobinwas10.2g/dL,butthereadingdecreasedto7.6g/dLbeforehemostasiswasattained.Cellsalvage,orautotransfusion,wassetup.Inthisprocedure,thefreebloodwassuctionedfromherabdomenandmixedwithananticoagulant(heparin).TheRBCswerewashedinasterilecentrifugewithNSSandtransfusedbacktoherthroughtubing.ttedwitha.lter.Shealsoreceived6unitsofhomologous,leukocyte-reducedwholeblood,5unitsoffreshfrozenplasma,and2unitsofplatelets.Duringthesurgery,theCRNArepeatedlytestedherHgbandHctaswellasprothrombintimeandpartialthromboplastintimetomonitorherclottingmechanisms.C.L.isBpositive.Fortunately,therewasenoughB-positivebloodinthehospitalbloodbankforhersurgery.Thelabinformedhersurgeonthattheyhad2unitsofB-negativeand6unitsofO-negativeblood,whichshecouldhavereceivedsafelyifsheneededmorebloodduringthenight.However,herhemoglobinlevelincreasedto12g/dL,andshewasstableduringherrecovery.ShewasmonitoredforDICandpulmonaryemboli.CaseStudy10-3:Myelo.brosisA.Y.,a52-year-oldkindergartenteacher,hadmyelo.brosisthathadbeeninremissionfor25years.Shehadseenherhematologistregularlyandhadhadroutinebloodtestingsincetheageof27.Afterseveralweeksoffatigue,idiopathicjointandmuscleaching,weakness,andafrighteningepisodeofsyncope,shesawherhematologistforevaluation.Herhemoglobinwas9.0g/dLandherhematocritwas29%.Concernedthatshewashavinganexacerbation,herdoctorscheduledabonemarrowaspiration,andtheresultswerepositiveformyelo.brosis.A.Y.wentthrougha6-monththerapyregimenofironsupplementsintheformofferroussulfatetabletsandreceivedweeklyvitaminB12injections.Interferonwasgiveneveryotherweekinadditiontoerythropoiesistherapy,whichwasunsuccessful.Shewastreatedforpresumedaplasticanemia.Duringtreatment,shedevelopedsplenomegaly,whichcompromisedherabdominalorgansandpulmonaryfunction.Shecontinuedtoloseweight,andherhemoglobindroppedaslowas6.0g/dL.WeeklytransfusionsofpackedRBCsdidnotimproveherhemoglobinandhematocrit.Afteraregimenofhigh-dosechemotherapytoshrinkthe.bersinherbonemarrowandasplenectomy,A.Y.receivedastemcelltransplant.Thestemscellswereobtainedfromblooddonatedbyherbrother,whowasaperfectimmunologicmatch.Aftera6-monthperiodofrecoveryinaprotectedenvironment,requiredbecauseofherimmunocompromisedstate,A.Y.returnedhomeandhasbeenfreeofdiseasesymptomsforover1year.CASESTUDYQUESTIONSMultiplechoice:Selectthebestanswerandwritetheletterofyourchoicetotheleftofeachnumber. 1.Thenaturallatexproteininlatexglovesmayactasa(n):antibodyallergenlymphocytepurpuraimmunocyte 2.Urticariaiscommonlycalled:rhinitisdermatitishivesELISAcongenital 3.ThecellsinvolvedinaT-cell-mediatedallergicresponseare:basophilsmonocytesantigenTlymphocytesBcells 4.Anaphylaxis,alife-threateningphysiologicalresponse,isanextremeformof:remissionhypersensitivityhemostasisexacerbationhomeostasis 5.Thecommonnameforepinephrineis:heparinadrenalinecortisoneapheresisantihistamine 6.Theremovalofpartoftheliveriscalled:partialhepatectomyhepatomegalyresectionoftheliveraandbaandc 7.Theunitformeasurementofhemoglobin(g/dL)means:gramsindecimalpointgrainsinadecathlondropsin50ccgramsin100ccgrainsindeciliter 8.Heparin,ananticoagulant,isadrugthat:increasestherateofbloodclottingtakestheplaceof.brinsupportsthrombininterfereswithbloodclottingmakesbloodthinnerthanwater 9.TheRBCswerewashedwithNSS.Thismeans:the werewashedwithreticulocytes,heparinredbloodcells,nutritionalsolutionredbloodcells,normalsaltsolution(saline)reticulocytes,normalsaltsolution(saline)redbloodcells,heparin 10.Autotransfusionistransfusionofautologousblood,thatis,thepatient’sownblood.Homologousbloodistakenfrom:anotherhumansyntheticchemicalsplasmawithclottingfactorsananimalwithsimilarantibodiesashumansIV.uidwithelectrolytes 11.Patientswholoseasigni.cantamountofbloodmayloseclottingability.Effectivetherapyinsuchcaseswouldbereplacementof:IVsolutionwithelectrolytesironsupplementsplateletsheparinpackedRBCs 12.C.L.’sbloodtypeisBpositive.Thebestbloodforhertoreceiveis:positivenegativeABpositiveBnegativeBpositive 13.Myelo.brosis,likeaplasticanemia,isadiseaseinwhichthereis:overgrowthofRBCsdestructionofthebonemarrowdangerouslyhighhemoglobinandhematocritabsenceofbonemarrowlymphatictissueinthebonemarrow 14.Erythropoiesisis:productionofbloodproductionofredcellsproductionofplasmadestructionofwhitecellsdestructionofplatelets 15.The“ferrous”inferroussulfaterepresents:electrolytesRBCsironoxygenBvitamins 16.Hemoglobinandhematocritvaluespertainto:leukocytesimmuneresponsegranulocytesredbloodcells.brinogen7.Splenomegalyis:prolapseofthespleenmovementofthespleenenlargementofthelymphglandsdestructionofthebonemarrowenlargementofthespleen 18.ThestemcellsA.Y.receivedwereexpectedtodevelopintonew:spleencellsbonemarrowcellshemoglobinabdominalorganscartilage 19.A.Y.’shealthwascompromisedbecausethehigh-dosechemotherapycaused:immunode.ciencyelectrolyteimbalanceanoxiaRhincompatibilityautoimmunityAbbreviations.De.nethefollowingabbreviations:IgHgbHctFFPPTPTTDICAnswerstoCaseStudyQuestions

bbcbcdebaimmunoglobulinhemoglobinhematocritfreshfrozenplasmaprothrombintimepartialthromboplastintimedisseminatedintravascularcoagulationdbbeddcacebCaseStudy11-1:PreoperativeTestinginaPatientWithAsthmaA.D.,15yearsold,wasseeninthepreadmissiontestingunitinpreparationforherelectivespinalsurgery.Shehasahistoryofmildasthmasinceage4,withatleastoneattackperweek.Inanacuteattack,shewillhavemilddyspnea,diffusewheezing,yetanadequateairexchangethatrespondstobronchodilators.Shewassenttopulmonaryhealthservicesforaconsultwithaspecialistandpulmonaryfunctionstudiestoclearherforsurgery.Theanesthesiologistreviewedthepulmonologist’sreport.HerprebronchodilatorspirometryshowedamildreductioninvitalcapacitybutwithamoderatetoseveredecreaseinFEV1andFEV1/FVCratio.Afterbronchodilatoradministration,therewasamildbutinsigni.cantimprovementinFEV1.ThepostbronchodilatorFEV1was55%ofpredictedandwasconsideredmoderatelyabnormal.The.owvolumeloopsandspirographiccurveswereconsistentwithair-.owobstruction.CaseStudy11-2:GiantCellSarcomaoftheLungL.E.,a68-year-oldman,wasadmittedtothepulmonaryunitwithchestpainoninspiration,dyspnea,anddiaphoresis.Hehadsmoked11.2packsofcigarettesperdayfor52yearsandhadquit3monthsago.L.E.wasretiredfromtheadvertisingindustryandadmittedtooccasionalalcoholuse.Hewastreatedforprimarygiantcellsarcomaoftheleftlung3yearsagowithalobectomyoftheleftlungfollowedbyradiationandchemotherapy.Physicalexaminationwasunremarkableexceptforathoracotomyscarinthelefthemithorax,decreasedbreathsounds,anddullnesstopercussionoftheleftbase.Therewasnohemoptysis.Radionucleotidebonescanshowedincreasedactivityintheleftupperposteriorhemithorax.ChestandupperabdomenCTscanshowed.ndingscompatiblewithrecurrentsarcomaofthelefthemithorax.Abnormalmediastinalnodeswereevident.Thoracentesiswasattemptedbutdidnotyield.uid.L.E.wasscheduledforaleftthoracoscopy,mediastinoscopy,andbiopsy.CaseStudy11-3:TerminalDyspneaN.A.,a76-year-oldwoman,wasintheICUintheterminalstageofmultisystemorganfailure.Shehadbeenadmittedtothehospitalforbacterialpneumonia,whichhadnotresolvedwithantibiotictherapy.Shehada20-yearhistoryofCOPD.Shewasnotconsciousandwasunabletobreatheonherown.HerABGswereabnormal,andshewasdiagnosedwithrefractoryARDS.Thedecisionwasmadetosupportherbreathingwithendotrachealintubationandmechanicalventilation.After1weekandseveralunsuccessfulattemptstoweanherfromtheventilator,thepulmonologistsuggestedapermanenttracheostomyandfamilyconsiderationofcontinuingorwithdrawinglifesupport.Herphysiologicstatusmetthecriteriaofremoteornochanceforrecovery.N.A.’sfamilydiscussedherconditionanddecidednottopursueaggressivelife-sustainingtherapies.N.A.wasassignedDNRstatus.Afterthewrittenorderswerereadandsignedbythefamily,theendotrachealtube,feedingtube,pulseoximeter,andECGelectrodeswereremovedandamorphineIVdripwasstartedwithprnbolusesorderedtopromotecomfortandrelievepainandothersymptomsofdying.ThefamilysatwithN.A.formanyhourswhileherbreathsbecameshallowwithCheyne-Stokesrespirations.Shediedsurroundedbyherfamily,joinedbythehospitalchaplain.CASESTUDYQUESTIONSMultiplechoice:Selectthebestanswerandwritetheletterofyourchoicetotheleftofeachnumber. 1.Therootspir/o,asinspirometry,means:a.turbulenceb.breathingc.twistedd.airqualitye.saturation 2.Therootpulmon,asinpulmonary,means:a.chestairlungbreathsounde.bloodvessel 3.Hemoptysisis:a.droopingeyelidsb.discolorationofskinc.bluenailbedsd.spittingofbloode.acuteleukemia 4.DyspneacouldNOTbedescribedas:a.dif.cultybreathingb.eupneac.airhungerd.orthopneaCheyne-Stokesrespirations 5.Pulseoximetryisusedtomeasure:a.partialpressureofoxygeninthebloodb.tidalvolumeend-tidalCO2oxygensaturationofbloodpositiveend-expiratorypressure

6.Anendotrachealtubeisplaced:a.underthetracheab.beyondthecarinac.withinthebronchusd.aroundtheairwaye.withinthetracheaWritethewordinthecasehistorieswitheachofthefollowingmeanings:Removalofalobe Profusesweating Surgicalpunctureofthechest Adrugthatenlargesthelumenofthebronchi Endoscopicexaminationofthechestcavity Halfofthechest Movementofairintoandoutofthelungs Alunginfection Whistlingbreathsoundsduetonarrowingof thebreathingpassagewaysEndoscopicexaminationofthespacebetweenthelungs Abbreviations.De.nethefollowingabbreviations:COPD FEV FVC ABG ARDS DNR forcedvitalcapacityarterialbloodgasadultrespiratorydistresssyndromedonotresuscitateAnswerstoCaseStudyQuestions1.b2.c3.d4.b5.d6.e7.lobectomy8.diaphoresis9.thoracotomy10.bronchodilator11.thoracoscopy12.hemithorax13.ventilation14.pneumonia15.wheezing16.mediastinoscopy17.forcedvitalcapacityarterialbloodgasadultrespiratorydistresssyndromedonotresuscitateCaseStudy12-1:CholecystectomyG.L.,a42-year-oldobeseCaucasianwoman,enteredthehospitalwithnauseaandvomiting,.atulenceandeructation,afeverof100.5°F,andcontinuousrightupperquadrantandsubscapularpain.ExaminationonadmissionshowedreboundtendernessintheRUQwithapositiveMurphysign.Herskin,nails,andconjunctivaewereyellowish,andshecomplainedoffrequentclay-coloredstools.Herleukocytecountwas16,000.AnERCPandultrasoundoftheabdomensuggestedmanysmallstonesinhergallbladderandpossiblythecommonbileduct.Herdiagnosiswascholecystitiswithcholelithiasis.Alaparoscopiccholecystectomywasattempted,withanintraoperativecholangiogramandcommonbileductexploration.BecauseofG.L.’ssizeandsomeunexpectedbleeding,visualizationwasdif.cultandtheprocedurewasconvertedtoanopenapproach.Smallstonesandgranularsludgewereirrigatedfromhercommonduct,andthegallbladderwasremoved.ShehadaT-tubeinsertedintotheductforbiledrainage;thistubewasremovedonthesecondpostoperativeday.ShehadanNGtubeinplacebeforeandduringthesurgery,whichwasalsoremovedondaytwo.Shewasdischargedonthe.fthpostoperativedaywithaprescriptionforprnpainmedicationandalow-fatdiet.CaseStudy12-2:SurgicalPathologyReportGrossDescription:Thespecimenisreceivedinformalinlabeled“rupturedduodenaldiverticula”andconsistsofenterictissuemeasuringapproximately6.3-D2.8-D0.7cm.Theserosalsurfaceismarkedlydullinappearanceand.brotic.Themucosalsurfaceishemorrhagic.Representativesectionsaretakenformicroscopicexamination.MicroscopicDescription:Sectionedslideshowssegmentsofduodenaltissueswithareasofgangrenouschangeinthebowelwall,andacuteandchronicin.ammatoryin.ltrates.Therearechronicandfocalacutein.ammatorycellin.ltrateswithhemorrhageinthemesentericfattytissue.Thereareareasofacutein.ammatoryexudatesnotedinthefattytissue.Histopathologicchangesareconsistentwithrupturedduodenaldiverticula.CaseStudy12-3:ColonoscopyWithBiopsyS.M.,a24-year-oldman,hadarecenthistoryoflowerabdominalpainwithfrequentloosemucoidstools.Hedescribedsymptomsofoccasionaldysphagia,dyspepsia,nausea,andaphthousulcersofhistongueandbuccalmucosa.Apreviousbariumenemashowedsomeirregularitiesinthesigmoidandrectalsegmentsofhislargebowel.Stoolsamplesforculture,ova,andparasiteswerenegative.Histentativediagnosiswasirritablebowelsyndrome.Hefollowedalactose-free,low-residuedietandtookImodiumtoreduceintestinalmotility.Hisgastroenterologistrecommendedacolonoscopy.Aftera2-dayregimenofsofttoclearliquiddiet,laxatives,andanenemathemorningoftheprocedure,hereportedtotheendoscopyunit.Hewastransportedtotheprocedureroom.ECGelectrodes,apulseoximetersensor,andabloodpressurecuffwereappliedformonitoring,andanIVwasinsertedinS.M.’srightarm.AnIVbolusofDemerolandabolusofVersedweregiven,andS.M.waspositionedonhisleftside.Thecolonoscopewasgentlyinsertedthroughtheanalsphincterandadvancedproximally.S.M.wasinstructedtotakeadeepbreathwhenthescopeapproachedthesplenic.exureandthehepatic.exuretofacilitatecomfortablepassage.Thephysicianwasabletoadvancepasttheileocecalvalve,examiningtheentirelengthofthecolon.Ulceratedgranulomatouslesionswereseenthroughoutthecolon,withaconcentrationinthesigmoidsegment.Manybiopsyspecimensweretaken.Themucosaofthedistalileumwasnormal.PathologyexaminationofthebiopsysampleswasexpectedtoestablishadiagnosisofIBD.CASESTUDYQUESTIONSMultiplechoice:Selectthebestanswerandwritethelettertotheleftofeachnumber. 1.Flatulenceandeructationrepresent:regurgitationofchymedistentionoftheesophaguspassageofgasorairfromtheGItractmuscularmovementofthealimentarytractsoundsheardonlybyabdominalauscultation.Murphysignistestedfor:undertheribsontheleftnearthespleeninthelowerrightabdomenundertheribsontherightinthelowerleftabdomen 3.TheNGtubeisinsertedthroughthe andterminatesinthe a.nose/stomachnostril/gallbladderglottis/nephronanus/cecumNissen/glottis 4.Enterictissueisfoundinthe:gallbladderstomachesophagusliverintestine 5.Themucosalsurfaceofadigestiveorganisthe:outersurfacemedullacortexinnersurfacecentralopening.Diverticulaare:smallpouchesinthewallofthecoloncommunicationsbetweentwoorgansductsintheliverintestinalobstructionspolypsintheintestine 7.Dysphagiaanddyspepsiaaredif.cultyorpainwith:chewingandintestinalmotilityspeakingandmotilityswallowinganddigestionbreathingandabsorptionswallowingandnutrition 8.Thebuccalmucosaisinthe:nostril,medialsidemouth,insideofthecheekgreatercurvatureofthestomachlessercurvatureneartheduodenumbaseofthetongue 9.Agastroenterologistisaphysicianwhospecializesinstudyof:respirationandpathologymouthandteethstomach,intestines,andrelatedstructuresmusculoskeletalsystemnutritionalandweightlossdiets 10.Thesplenicandhepatic.exuresarebendsinthecolonnearthe:liverandsplanchnicveincommonbileductandbiliarytreespleenandappendixspleenandlivermesentericvesselsandliver1.Intestinalmotilityrefersto:chewingperistalsisabsorptionantiemeticsascites 12.Acolonoscopyis:aradiographofthesmallintestineanendoscopicstudyoftheesophagusanupperendoscopywithbiopsyatypeofbariumenemaanendoscopicexaminationofthelargebowel 13.Theileocecalvalveis:partofacolonoscopeatthedistalileumneartheappendixaandbbandcWritethemeaningofeachofthefollowingabbreviations:ERCP RUQ NG IBD Givethewordorwordsinthecasestudieswitheachofthefollowingmeanings:pertainingtothe.rstpartofthesmallintestine pertainingtothemembranethatsupportstheintestine

localized .uidthatescapesfrombloodvesselsasaresultof in.ammationpresenceofhiddenormicroscopicblood jaundice drugthattreatsnauseaandvomiting stonesinthegallbladder endoscopicsurgeryofthegallbladder in.ammationofthegallbladder radiographicstudyofthegallbladderand biliarysystemringofmusclethatregulatesthedistalopening ofthecolonsurgicalexcisionoftissueforpathology exudateoccultbloodicterusantiemeticcholelithiasislaparoscopiccholecystectomycholecystitischolangiogramsphincterbiopsyAnswerstoCaseStudyQuestions1.c2.d3.a4.e5.d6.a7.c8.b9.exudateoccultbloodicterusantiemeticcholelithiasislaparoscopiccholecystectomycholecystitischolangiogramsphincterbiopsyendoscopicretrogradecholangiopancreatographyrightupperquadrantnasogastricin.ammatoryboweldiseaseduodenal19.mesenteric20.focalCaseStudy13-1:RenalCalculiA.A.,a48-year-oldwoman,wasadmittedtothein-patientunitfromtheERwithsevereright.ankpainunresponsivetoanalgesics.Herpaindidnotdecreasewithadministrationof100mgofIVmeperidine.Shehada3-monthhistoryofchronicUTI.Sixmonthsagoshehadbeenprescribedcalciumsupplementsforlowbonedensity.Her