A 45 year-old man comes to ER c/o nausea, vomiting and progressively worsening abdominal pain x 8 hrs. Upper gastro-intestinal radiographic studies reveal that a loop of small intestines has passed through the epiploic foramen into the omental bursa and is constricted by the margins of the foramen. What vascular structure is occluded?

A 35 year-old man complains of difficulty eating food and drinking liquids. He reveals that he can swallow the food but he feels it “does not go anywhere” after he swallows. He has recently began to vomit undigested food and started to cough at night. He has lost 5 lb over the last month without trying to lose weight. A barium swallow shows dilation of the distal esophagus with a tapered end. Which is the most likely cause of his disorder?

A 1 week old girl with symptoms of vomiting and anorexia has a temperature of 102 F. A bulging fontanel is noted on physical examination. Which of the following is the most likely causative agent?

A male infant begins to have persistent, projectile, non-bilious vomiting at age 2 to 3 weeks. Which of the following conditions is most likely responsible for infant’s symptoms?

A 32 year old man is spraying malathion on the plum trees in his backyard. While taking a break, he reaches down to grab his drink and accidentally takes a gulp of malathion instead. His girlfriend immediately takes him to the ER. Which of the following drugs would be best to induce emesis?

Apomorphine

Loperamide

Metochopramide

Ondansetron

Ranitidine

A 35 year old woman c/o vomiting dark, greenish material approximately 1 hour after eating. There is no pain and no icterus. She is scheduled for a barium meal to evaluate upper portion of the GI tract. Which of the following is the most likely cause of her condition?

A 3 week old boy develops vomiting, lethargy and focal seizures. Examination shows a bulging fontanel and nuchal rigidity. Which are the microorganisms most likely causing the problem?

Inguinal Canal

(area, function, contents) 

between the inguinal ligament and the aponeurosis of the external oblique

relocation of the testis during fetal development, passage out of abdominal cavity

contains spermatic cord or round ligamnet of the uterus, deep inguinal ring, femoral artery, femoral vein

Celiac trunk Artery

( origin, course, distribution)

adbominal aorta

after short course, bifurcates into splenic and common hepatic artery

esophagus, stomach, proximal duodenum, liver/niliary apparatus, pancreas

Left gastric artery

(origin, course, distribution)

celiac trunk

ascends and gives rise to esophageal branch; the descends along lesser curvature of stomach to anastomose with right gastric artery

distal esophagus and lesser curvature of stomach

Splenic artery

(origin, course, distribution)

celiac trunk

runs above pancreas, through retrospenal ligament, to spleen

body of pancreas, spleen, stomach

left gastro-omental artery

(origin, source, distribution)

splenic artery

greater curvature of stomach anastomoses with right artery

greater curvature of stomach

hepatic artery

(origin, course, distribution)

celiac trunk

bifrucates into right gastric and gastroduodenal artery

respective lobes of liver, gallbladder, stomanch, duodenum

intestinal artery

(origin, distribution)

superior mesenteric artery

jejunum and ileum

middle colic

(origin, distribution)

superior mesenteric artery

transverse colon

right colic

(origin, distribution)

SMA

ascending colon

left colic artery

(origin, distribution)

IMA

descending colon

sigmoid artery

(origin, distribution)

IMA

sigmoid colon

Hiatal Hernia

(definition, two main types)

protrusion of stomach through esophageal hiatus of the diaphragm

paraesophagela and sliding hiatal hernias

pancreatic juice from acinar cells

glucagon and insulin from Langerhans islets