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Retired NBME Free 120 Answers

free120/Block 2/Question#35 (reveal difficulty score)
A 47-year-old woman comes to the emergency ...
Annular pancreas ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
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submitted by โˆ—bwdc(697)
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An annular pancreas surrounds the duodenum and can cause intermittent duodenal obstruction. While this question theoretically requires the imaging to answer correctly, the only other choice that is feasible is Choice D, which is known as SMA syndrome. SMA syndrome is quite rare and typically seen in people who have recently had significant weight loss. On the imaging, it would be smooshing of the duodenum by a bright contrast filled artery as opposed to surrounding by soft tissue. I also think itโ€™s highly unlikely to be tested.

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houseppary  I agree except that on the imaging, if this was SMA, the artery would not be bright and filled with contrast because the problem states that these studies were taken with oral contrast. So that's not a feasible way to eliminate SMA as the correct answer. I to think the quality of the obstruction seen in the UGI series show an annular-looking obstruction rather than a focal compression as you'd see in SMA. +3



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