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13519 Surgery

Kamli Rani 75 yrs old woman present with post myocardial infarction after 6 weeks with mild CHF. There was past WO neck surgery for parathyroid adenoma 5 years ago, EKG shows slow atrial fibrillation. Serum Ca+213.0 mg/L and urinary Ca2+ is 300 mg/ 24 hr. On examination their is small mass in the Para tracheal position behind the right clavicle. Appropriate management at this time is –

ARepeat neck surgery
BTreatment with technetium - 99
CObservation and repeat serum Ca+2 in two months
DUltrasound-guided alcohol injection of the mass
Surgery
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13523 Surgery

A 62-year-old man complains of experiencing intermittent, but increasing abdominal pain, and has had a 9 kg weight loss in the last month. On physical examination, he seems to be slightly jaundiced. Alkaline phosphatase and bilirubin are increased. CT scan demonstrates a mass in the head of the pancreas. Which of the following surgical methods is used most often to treat patients with small tumors of the head of the pancreas with no evidence of metastasis?

ABillroth l procedure
BBillroth ll procedure
CRoux-en-Y gastric bypass
DWhipple procedure
Surgery
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