Mouth
While dental abscesses have a good prognosis with treatment, if they are not treated, they can progress to ______.
osteomyelitis
______ ______ are a common cause of "steakhouse syndrome"
Schatski rings
Gastritis is most commonly caused by ______. The presence of this bacteria can be identified by doing a ______. It can be treated with _______.
Helicobacter pylori
urea breath test
triple therapy: PPI, clarithromycin, amoxicillin
Carbohydrate malabsorption will cause a positive ________. The most clinically important malabsorption CHO is ________.
hydrogen breath test
lactase malabsorption-- presents with abdominal pain, diarrhea, cramps, and flatulence
A 45 year old female with a BMI of 39 comes into your office complaining of crampy abdominal pain in the RUQ. What is your diagnosis (1)? What is the most likely cause (2)? What is the most common type of 2?
gallstone
cholesterol
Koplik's spots are the oral manifestation of what systemic disease?
measles
A 60 year old man comes in with his daughter complaining of difficulty swallowing and occasional aspiration. His daughter also tells you that his breath smells really bad (halitosis). What does he have and where is it located?
Zenker's diverticulum
proximal to cricopharyngeus aka Killian's triangle
There are two main types of stress-inducing ulcers: Cushings and Curlings... they are caused by ______ and ______, respectively.
Severe trauma-- in setting of acute brain injury
Massive burns
You conduct a small intestine mucosal biopsy and you find diffuse, specific lesions; what are the possible diagnoses? If you found diffuse, non-specific lesions, what are the possible diagnoses?
-Whipple's, Giardia
-Caliac, tropical sprue
A 63 year old man comes into your office because "his wife told him he looked yellow and needed to see a doctor now." Looking at him, you do notice that he's jaundiced. He says he doesn't have any pain, but he tells you he doesn't feel great because he's being treated for pancreatic cancer. What do you suspect as your diagnosis?
Biliary stricture
Oral lichen planus, oral candidiasis, and parotid swelling can be oral signs and symptoms of _________.
Diabetes mellitus
76 year old man comes into your office complaining of difficulty swallowing both solids and liquids. You decide to do a barium swallow and note a "bird's beak" appearance at the distal end of the esophagus. What is the diagnosis? What is it caused by? What disease/bug can also cause it?
Achalasia
loss of inhibitory neurons
Chagas disease/Trypanosoma cruzi
Gastroparesis is common in ______ patients, and the DOC is _________.
Diabetic patients (more common in type 1)
metoclopramide
A 13 year old girl comes into your office with a history of diarrhea and a skin rash; she also tells you she's lost 10 lbs in the last month. You decide to take a biopsy, and the path slide indicates villous atrophy and intraepithelial lymphocytes. Additionally, she has a positive result for serum IgA tissue transglutaminase (tTG) antibodies. What is your suspected diagnosis? What is the gene associated with this diagnosis? What is her recommended treatment? Would your diagnosis change if she responded to antibiotic treatment?
Celiac disease
HLA-DQ2/8
Gluten free diet
yes, tropical sprue
A 50 year old female comes into your office with pruritis and jaundice... what's the likely diagnosis?
What would it be with patient was a male (age 45 or younger)?
-primary biliary cholangitis
-primary sclerosing cholangitis
Mucosal petechiae are often the first indicator of ________.
Luekemia
A 63 year old woman comes into your office complaining of chest pain that radiates to her throat. She tells you it is worse when she eats spicy foods or lays down on her back. What is the diagnosis? What is it treated with? If left untreated, what can it progress to (2 things)?
GERD
PPIs (-prazole)
Barrett's esophagus
Adenocarcinoma
Gastric Cancers
-_________ is the most common physical exam finding of metastatic disease
-_____ tumor: metastasis to ovaries or a mass in the Cul-de-sac on rectal exam (Mucin filled signet rings on pathology)
Krukenberg
A 52 year old caucasian male comes into your clinic complaining of joint pain, minor abdominal discomfort, and a history of weight loss. Based on this presentation, what is your suspected diagnosis? What stain would you use if you were to take a biopsy? What would you give to treat her?
whipple's disease
PAS stain
tetracycline
Primary sclerosing cholangitis put you at an increased risk for ________.
adenocarcinoma of the bile duct (cholangiocarcinoma)
A 50-year-old man comes into your office complaining of fatigue. You decide to get some blood work in addition to a peripheral blood smear, you note basophilic stippling on the blood smear. On physical exam, you see a blue line on the gingival margin in the mouth. What is the diagnosis?
Lead poisoning
A patient comes in on Saturday hungover after a night out. She said that she threw up a 3 times, and there was blood in the vomit on the 3rd time. She is now here concerned about it... what is her most likely diagnosis?
Mallory-Weiss-- submucosal tear
If a patient is diagnosed with hereditary diffuse gastric cancer (HDGC), you should recommend genetic counseling and test for ______ mutations.
Cadherin 1 (CDH-1)
if the patient meets at least one of the following criteria:
•FMHX of two gastric cancers at any age with at least one confirmed diffuse gastric cancer
•Diffuse gastric cancer diagnosed at less than 40 years regardless of family history
•Personal or family history of diffuse gastric cancer and lobular breast cancer with at least one diagnosed at less than age 50
A 48 year old woman arrives at your clinic complaining of bloating, gas, and weird bowel changes. She tells you she is diabetic with autonomic dysfunction. You perform a hydrogen breath test, and it is positive. What is your diagnosis?
SIBO
(small intestinal bacterial overgrowth)
A patient's labs show elevated serum alkaline phosphatase, elevated total and direct bilirubin levels, and a slight increase in their transaminase levels, and you note dilated intrahepatic ducts on ultrasounds... what is your diagnosis?
bile duct tumor