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NBME 21 Answers

nbme21/Block 4/Question#19

A 45-year-old woman comes to the emergency ...

Hepatopancreatic ampulla

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 +2  upvote downvote
submitted by hungrybox(254),

aka ampulla of Vater or the hepatopancreatic duct

hungrybox  tripped me up cause I didn't know the names :( +5  
sympathetikey  @hungrybox same +2  
angelaq11  omg, same here! I thought, well, I don't know of any duct that connects the pancreas to the liver, so...2nd part of the duodenum it is :'( :'( +  




 +0  upvote downvote
submitted by tamey(2),

im a little confused isnt blocking ampulla of vater(hepatopancreatic ampula) would cause obstruction of both pancreatic duct and common bile duct and in this case the patient would have cholangits too, not only pancreatitis!!!

divya  true but none of the other options cause pancreatic duct dilation. options a, b and c would cause obstruction above the level of pancreas. +  
lilmonkey  It doesn't say ONLY pancreatitis, but just enough information to choose the correct answer. Maybe, in the test writers mind if they mention cholangitis and jaundice that would be too much hints :). +  




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