Mayo Clinic Gastroenterology and Hepatology Board Review

433 Pages·2014·63.91 MB·English

by  Stephen Hauser

Mayo Clinic Gastroenterology and Hepatology Board Review
Fifth Edition
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Mayo Clinic Gastroenterology
and Hepatology Board Review
FIFTH EDITION
Editor-in-Chief
Stephen C. Hauser, MD
Consultant, Division of Gastroenterology and Hepatology
Mayo Clinic, Rochester, Minnesota
Associate Professor of Medicine
Mayo Clinic College of Medicine
Associate Editors
Amy S. Oxentenko, MD
Consultant, Division of Gastroenterology and Hepatology
Mayo Clinic, Rochester, Minnesota
Associate Professor of Medicine
Mayo Clinic College of Medicine
William Sanchez, MD
Consultant, Division of Gastroenterology and Hepatology
Mayo Clinic, Rochester, Minnesota
Assistant Professor of Medicine
Mayo Clinic College of Medicine
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Library of Congress Cataloging-in-Publication Data
Mayo Clinic gastroenterology and hepatology board review / editor-in-chief, Stephen C. Hauser ; associate editors,
Amy S. Oxentenko, William Sanchez. — 5th edition.
p. ; cm.
Gastroenterology and hepatology board review
Includes bibliographical references and index.
ISBN 978–0–19–937333–8 (alk. paper)
I. Hauser, Stephen C., editor. II. Oxentenko, Amy S., editor. III. Sanchez, William, 1973– editor.
IV. Mayo Clinic, issuing body. V. Title: Gastroenterology and hepatology board review.
[DNLM: 1. Gastrointestinal Diseases—Examination Questions. 2. Liver Diseases—Examination
Questions. WI 18.2]
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2014015238
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Preface
Gastroenterology and hepatology encompass a vast anatomical The book is organized by subspecialty topics, including
assortment of organs that have diverse structure and function and esophageal disorders, gastroduodenal disorders, small-bowel
potentially are afflicted by a multiplicity of disease processes. We disease and nutrition, colonic disorders, pancreaticobiliary dis-
have designed the Mayo Clinic Gastroenterology and Hepatology ease, liver disease, and miscellaneous disorders. Numerous
Board Review course and the revised fifth edition of this book color and black-and-white figures support the text. Each subspe-
to assist both physicians-in-training who are preparing for the cialty section concludes with a set of board examination–type,
gastroenterology board examination and the increasing num- single-best-answer multiple-choice questions with annotated
ber of gastroenterologists awaiting recertification. Mayo Clinic answers. (The content of the questions and answers is not included
Gastroenterology and Hepatology Board Review is not intended in the index.) The faculty responsible for the book (at the time it
to replace the many more encyclopedic textbooks of gastroen- was produced) all are Mayo Clinic gastroenterologists and hepa-
terology, hepatology, pathology, endoscopy, nutrition, and radi- tologists who spend the majority of their time caring for patients
ology now available. Nor is this book intended to serve as an but have a commitment to teaching medical students, house offi-
“update” to physicians looking for the newest advances in the cers, fellows, nurses, and physicians. Most of the faculty have
science and art of gastroenterology and hepatology. Instead, this particular interests in subspecialty areas of clinical gastroenterol-
book provides a core of essential knowledge in gastroenterol- ogy and hepatology, which provides broad expertise.
ogy, hepatology, and integral related areas of pathology, endos- We want to thank the staffs of Scientific Publications and
copy, nutrition, and radiology. Clinical knowledge related to Media Support Services at Mayo Clinic and the Mayo School
diagnostic and therapeutic approaches to patient management is of Continuous Professional Development for their contributions.
emphasized. Case-based presentations and short board exami- The support of Mayo Clinic Scientific Press and our publisher,
nation–type, single-best-answer multiple-choice questions with Oxford University Press, are also greatly appreciated. We want
annotated answers are featured. The text is also intended to be to give special thanks to our secretaries and to Vijay H. Shah,
used by medical students and residents during their clerkships MD, for his ongoing enthusiasm and support for our faculty and
in internal medicine and gastroenterology and by gastroenterol- teaching mission.
ogy fellows in training. Physicians in practice should find this
book to be a practical review for consolidating their knowledge Stephen C. Hauser, MD
in gastroenterology. Editor-in-Chief
vii

Contents
Contributors xi Section IV Miscellaneous Disorders
Section I Esophagus 10 Gastrointestinal Manifestations of Human
Immunodeficiency Virus Infection 113
1 Gastroesophageal Reflux Disease 3 Stephen C. Hauser, MD
Joseph A. Murray, MD
11 Nonvariceal Gastrointestinal Tract Bleeding 120
2 Barrett Esophagus and Esophageal Cancer 17 Jeffrey A. Alexander, MD
Prasad G. Iyer, MD, MS
12 Vascular Disorders of the Gastrointestinal Tract 126
3 Normal and Abnormal Esophageal Motility 26 Stephen C. Hauser, MD
David A. Katzka, MD
13 Gastrointestinal Manifestations of Systemic
Questions and Answers 36
Disease 133
Seth R. Sweetser, MD
Section II Stomach
Questions and Answers 145
4 Peptic Ulcer Disease 43
Stephanie L. Hansel, MD, MS Section V Colon
5 Gastritis and Gastropathy 49 14 Inflammatory Bowel Disease: Clinical Aspects 155
Stephanie L. Hansel, MD, MS David H. Bruining, MD
6 Gastric Neoplasms and Gastroenteric and Pancreatic 15 Inflammatory Bowel Disease: Therapy 160
Neuroendocrine Tumors 57 Darrell S. Pardi, MD
Mark V. Larson, MD
16 Inflammatory Bowel Disease: Extraintestinal
7 Gastrointestinal Motility Disorders 73 Manifestations and Colorectal Cancer 168
Lawrence A. Szarka, MD, Michael Camilleri, MD Laura E. Raffals, MD
Questions and Answers 82
17 Gastrointestinal Infections, Clostridium difficile–
Associated Disease, and Diverticular Disease 174
Section III Small Bowel and Nutrition
Conor G. Loftus, MD
8 Clinical Features of Malabsorptive Disorders, 18 Colorectal Neoplasms 185
Small-Bowel Diseases, and Bacterial Overgrowth
John B. Kisiel, MD
Syndromes 89
Amy S. Oxentenko, MD
19 Irritable Bowel Syndrome 192
Seth R. Sweetser, MD, G. Richard Locke III, MD
9 Nutritional Disorders: Vitamins and Minerals 102
Stephen C. Hauser, MD
20 Constipation and Disorders of Pelvic Floor
Questions and Answers 106 Function 197
Adil E. Bharucha, MBBS, MD
ix