ABSTRACT
Multiple Choice (choose the one best answer) 1. A 46-year-old man is referred to you for a treatment rec-
ommendation. Six weeks ago, he underwent an exploratory laparotomy for evaluation of chronic abdominal pain, postprandial abdominal bloating, and irregular bowel movements. The laparotomy was normal, and a cholecystectomy and appendectomy were performed. Pathologic analysis of the gallbladder was normal, but the appendix had a 1-cm carcinoid tumor and no inflammation. Preoperatively, computed tomography of the abdomen and pelvis was normal. Postoperatively, the patient’s symptoms improved, and a colonoscopy showed a normal colon and terminal ileum. What is the most appropriate treatment recommendation? a. Exploratory laparotomy b. Laparoscopy c. Right hemicolectomy d. Octreotide e. Observation
2. A 39-year-old woman comes to your office with recurrent epigastric pain. She has had documented duodenal ulcers in the past and Helicobacter pylori studies have been negative. She denies use of alcohol, aspirin, and nonsteroidal anti-inflammatory drugs. Her weight has been stable. Laboratory results include a hemoglobin value of 10.0 g/dL, gastrin 1,243 pg/mL, and negative H. pylori serology. Esophagogastroduodenoscopy shows a duodenal bulb ulcer. Which of the following is the most appropriate next step in evaluation of this patient?
