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USMLE Step 2 - General Surgery Verified Solution

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USMLE Step 2 - General Surgery Verified Solutions Gold-standard for GERD diagnosis ️️pH-manometry Classic clinical scenario of GERD ️️Overweight + heartburn elicited by bending over, wearing tight clothes, or lying flat + symptom improvement with OTC antacids or H2 blockers Complica...

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  • November 14, 2024
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  • 2024/2025
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  • USMLE Step 2 - General Surgery Verified Solution
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USMLE Step 2 - General Surgery Verified Solutions

Gold-standard for GERD diagnosis ✔️✔️pH-manometry



Classic clinical scenario of GERD ✔️✔️Overweight + heartburn elicited by bending over, wearing tight
clothes, or lying flat + symptom improvement with OTC antacids or H2 blockers



Complications of long-standing GERD ✔️✔️Peptic esophagitis and Barret esophagus



Evaluation of long-standing GERD ✔️✔️Endoscopy and biopsy



Indications for laparoscopic Nissen fundoplication in GERD ✔️✔️Long-standing symptomatic disease
that can't be controlled by medical means



Development of complications: ulceration, stenosis



Indication for resection in GERD ✔️✔️Severe dysplastic changes



Clinical pattern of uncoordinated massive contraction ✔️✔️Crushing pain with swallowing



Clinical pattern in achalasia ✔️✔️Dysphagia worse for liquids that is improved when the patient sits
up straight and waits



Diagnostic tests for motility problems ✔️✔️Barium swallow and manometry



Therapy for achalasia ✔️✔️Balloon dilation by endoscopy



Clinical manifestations of esophageal cancer ✔️✔️Progressive dysphagia + weight loss

, Esophageal squamous cell carcinoma risk factors ✔️✔️Black + men + smoking + drinking



Esophageal adenocarcinoma risk factors ✔️✔️Long-standing GERD



Diagnosis of esophageal cancer ✔️✔️Barium swallow



Endoscopy and biopsies



CT to assess operability



Surgery for esophageal cancer ✔️✔️In most cases is palliative rather than curative



Mallory-Weiss tear clinical picture ✔️✔️Bright red blood after prolonged, forceful vomiting



Diagnosis of Mallory-Weiss tear ✔️✔️Endoscopy



Treatment of Mallory-Weiss tear ✔️✔️Photocoagulation during endoscopy



Boerhaave syndrome ✔️✔️Esophageal perforation following prolonged, forceful vomiting



Boerhaave syndrome clinical picture ✔️✔️Continuous, severe, epigastric and low sternal pain of
sudden onset



Fever, leukocytosis, very sick-looking patient



Diagnostic tests for Boerhaave syndrome ✔️✔️Contrast swallow: gastrografin first, barium if negative

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