A 65-Year-Old Man Is Evaluated in the Clinic Due to Several

question 261

Multiple Choice

A 65-year-old man is evaluated in the clinic due to several months of abdominal pain and vomiting.  The pain starts 2 to 3 hours after meals, is characterized as crampy, and is often associated with bilious vomiting.  Lately, the patient has been tolerating only liquids and has consequently lost 12 lbs in the past 4 months.  On physical examination, he has mild epigastric tenderness on deep palpation.  Contrast-enhanced CT scan of the abdomen shows an irregular mass in the third portion of the duodenum that is infiltrating beyond the gut wall.  If this mass continues to enlarge, which of the following structures is most likely to be compromised in this patient?

• A)Common bile duct
• B)Gastroduodenal artery
• C)Portal vein
• D)Superior mesenteric artery
• E)Ureter

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Definitions:

Object Persistence

The property of an object to continue existing even when it is not being perceived or observed.

Piaget's Theory

A theory of cognitive development that describes how children's intellectual abilities evolve through four stages from infancy to adolescence.

Vygotsky's Theory

A theory that emphasizes the fundamental role of social interaction in the development of cognition, suggesting that community and culture play central roles in the process of making meaning.

Cognitive Development

The process by which a person's ability to think, reason, and understand the world around them evolves over time.