Complete Test Bank for Current Surgical Therapy, 14th Edition
by John L. Cameron MD (Editor), Andrew M. Cameron MD, PhD, FACS (Editor)
Inclusive Study Guide For American Board of Surgery Certifying (Oral) Examination 2024/2025
,Chapter 1: The Esophagus
1. A 58-year-old male presents with dysphagia and regurgitation of undigested food.
After performing a barium swallow, the radiologist reports a "bird-beak"
appearance. Which of the following is the most likely diagnosis?
a) Achalasia
b) Gastroesophageal reflux disease (GERD)
c) Zenker's diverticulum
d) Esophageal cancer
Answer: a) Achalasia
Rationale: Achalasia presents with dysphagia and regurgitation, often visualized on barium
swallow as a "bird-beak" appearance, indicating failure of the lower esophageal sphincter
to relax properly.
DIF: Moderate
OBJ: Diagnose esophageal motility disorders
TOP: Achalasia of the Esophagus
REF: Chapter 1
MSC: Remembering
2. In a patient with gastroesophageal reflux disease (GERD), which of the following
would be an appropriate initial step in management?
a) Fundoplication
b) Proton pump inhibitors (PPIs)
c) LINX procedure
d) Esophagectomy
Answer: b) Proton pump inhibitors (PPIs)
Rationale: PPIs are the first-line treatment for GERD, aiming to reduce acid production and
manage symptoms.
DIF: Easy
OBJ: Understand basic treatment strategies for GERD
TOP: Surgical Management of Gastroesophageal Reflux Disease
REF: Chapter 1
MSC: Understanding
3. A patient with chronic GERD develops a columnar-lined esophagus, and biopsy
confirms the presence of metaplastic epithelium. What is the most appropriate next
, step?
a) Long-term PPI therapy
b) Surveillance endoscopy
c) LINX procedure
d) Immediate esophagectomy
Answer: b) Surveillance endoscopy
Rationale: This is consistent with Barrett’s esophagus, a premalignant condition.
Surveillance endoscopy is recommended to monitor for progression to esophageal
adenocarcinoma.
DIF: Moderate
OBJ: Recognize the management of Barrett’s esophagus
TOP: Management of Barrett’s Esophagus
REF: Chapter 1
MSC: Applying
4. Which of the following is a key feature in diagnosing achalasia during esophageal
function testing?
a) Increased lower esophageal sphincter pressure
b) Decreased lower esophageal sphincter pressure
c) Absence of peristalsis in the distal esophagus
d) Inability to relax the upper esophageal sphincter
Answer: c) Absence of peristalsis in the distal esophagus
Rationale: Achalasia is characterized by a lack of peristalsis in the distal esophagus and
failure of the lower esophageal sphincter to relax.
DIF: Moderate
OBJ: Identify key diagnostic findings in esophageal function tests
TOP: Esophageal Function Tests
REF: Chapter 1
MSC: Understanding
5. A patient with a history of Barrett's esophagus develops dysphagia and weight loss.
Endoscopic evaluation reveals a mass in the distal esophagus. What is the most
likely diagnosis?
a) Esophageal adenocarcinoma
b) Squamous cell carcinoma
c) Esophageal varices
d) Zenker's diverticulum
, Answer: a) Esophageal adenocarcinoma
Rationale: Barrett's esophagus is a major risk factor for the development of esophageal
adenocarcinoma, particularly when there are new symptoms such as dysphagia and
weight loss.
DIF: Moderate
OBJ: Recognize the risk of esophageal cancer in patients with Barrett’s esophagus
TOP: Management of Esophageal Cancer
REF: Chapter 1
MSC: Analyzing
6. A 74-year-old male with chronic GERD undergoes the LINX procedure for reflux
control. What is the mechanism of action of this procedure?
a) Repair of the esophageal sphincter
b) Placement of a magnetic device around the lower esophagus
c) Removal of the lower esophageal sphincter
d) Esophageal lengthening
Answer: b) Placement of a magnetic device around the lower esophagus
Rationale: The LINX procedure involves placing a magnetic device around the lower
esophagus to prevent reflux while allowing normal swallowing.
DIF: Moderate
OBJ: Understand new approaches in the management of GERD
TOP: New Approaches to Gastroesophageal Reflux Disease (LINX)
REF: Chapter 1
MSC: Understanding
7. A 70-year-old patient with a paraesophageal hernia presents with symptoms of
postprandial fullness and chest pain. Which of the following is the preferred
management?
a) Observation with periodic follow-up
b) Laparoscopic paraesophageal hernia repair
c) Proton pump inhibitor therapy
d) Chemotherapy
Answer: b) Laparoscopic paraesophageal hernia repair
Rationale: Paraesophageal hernias are typically managed surgically due to the risk of
incarceration and strangulation.
DIF: Moderate
OBJ: Identify the management approach for paraesophageal hernias
by John L. Cameron MD (Editor), Andrew M. Cameron MD, PhD, FACS (Editor)
Inclusive Study Guide For American Board of Surgery Certifying (Oral) Examination 2024/2025
,Chapter 1: The Esophagus
1. A 58-year-old male presents with dysphagia and regurgitation of undigested food.
After performing a barium swallow, the radiologist reports a "bird-beak"
appearance. Which of the following is the most likely diagnosis?
a) Achalasia
b) Gastroesophageal reflux disease (GERD)
c) Zenker's diverticulum
d) Esophageal cancer
Answer: a) Achalasia
Rationale: Achalasia presents with dysphagia and regurgitation, often visualized on barium
swallow as a "bird-beak" appearance, indicating failure of the lower esophageal sphincter
to relax properly.
DIF: Moderate
OBJ: Diagnose esophageal motility disorders
TOP: Achalasia of the Esophagus
REF: Chapter 1
MSC: Remembering
2. In a patient with gastroesophageal reflux disease (GERD), which of the following
would be an appropriate initial step in management?
a) Fundoplication
b) Proton pump inhibitors (PPIs)
c) LINX procedure
d) Esophagectomy
Answer: b) Proton pump inhibitors (PPIs)
Rationale: PPIs are the first-line treatment for GERD, aiming to reduce acid production and
manage symptoms.
DIF: Easy
OBJ: Understand basic treatment strategies for GERD
TOP: Surgical Management of Gastroesophageal Reflux Disease
REF: Chapter 1
MSC: Understanding
3. A patient with chronic GERD develops a columnar-lined esophagus, and biopsy
confirms the presence of metaplastic epithelium. What is the most appropriate next
, step?
a) Long-term PPI therapy
b) Surveillance endoscopy
c) LINX procedure
d) Immediate esophagectomy
Answer: b) Surveillance endoscopy
Rationale: This is consistent with Barrett’s esophagus, a premalignant condition.
Surveillance endoscopy is recommended to monitor for progression to esophageal
adenocarcinoma.
DIF: Moderate
OBJ: Recognize the management of Barrett’s esophagus
TOP: Management of Barrett’s Esophagus
REF: Chapter 1
MSC: Applying
4. Which of the following is a key feature in diagnosing achalasia during esophageal
function testing?
a) Increased lower esophageal sphincter pressure
b) Decreased lower esophageal sphincter pressure
c) Absence of peristalsis in the distal esophagus
d) Inability to relax the upper esophageal sphincter
Answer: c) Absence of peristalsis in the distal esophagus
Rationale: Achalasia is characterized by a lack of peristalsis in the distal esophagus and
failure of the lower esophageal sphincter to relax.
DIF: Moderate
OBJ: Identify key diagnostic findings in esophageal function tests
TOP: Esophageal Function Tests
REF: Chapter 1
MSC: Understanding
5. A patient with a history of Barrett's esophagus develops dysphagia and weight loss.
Endoscopic evaluation reveals a mass in the distal esophagus. What is the most
likely diagnosis?
a) Esophageal adenocarcinoma
b) Squamous cell carcinoma
c) Esophageal varices
d) Zenker's diverticulum
, Answer: a) Esophageal adenocarcinoma
Rationale: Barrett's esophagus is a major risk factor for the development of esophageal
adenocarcinoma, particularly when there are new symptoms such as dysphagia and
weight loss.
DIF: Moderate
OBJ: Recognize the risk of esophageal cancer in patients with Barrett’s esophagus
TOP: Management of Esophageal Cancer
REF: Chapter 1
MSC: Analyzing
6. A 74-year-old male with chronic GERD undergoes the LINX procedure for reflux
control. What is the mechanism of action of this procedure?
a) Repair of the esophageal sphincter
b) Placement of a magnetic device around the lower esophagus
c) Removal of the lower esophageal sphincter
d) Esophageal lengthening
Answer: b) Placement of a magnetic device around the lower esophagus
Rationale: The LINX procedure involves placing a magnetic device around the lower
esophagus to prevent reflux while allowing normal swallowing.
DIF: Moderate
OBJ: Understand new approaches in the management of GERD
TOP: New Approaches to Gastroesophageal Reflux Disease (LINX)
REF: Chapter 1
MSC: Understanding
7. A 70-year-old patient with a paraesophageal hernia presents with symptoms of
postprandial fullness and chest pain. Which of the following is the preferred
management?
a) Observation with periodic follow-up
b) Laparoscopic paraesophageal hernia repair
c) Proton pump inhibitor therapy
d) Chemotherapy
Answer: b) Laparoscopic paraesophageal hernia repair
Rationale: Paraesophageal hernias are typically managed surgically due to the risk of
incarceration and strangulation.
DIF: Moderate
OBJ: Identify the management approach for paraesophageal hernias
