Physical Exam Jam
Picture This
Pharmstand
Butts and Guts
Hep Hep Hooray
100
This is the name of the area of maximal tenderness 1.5-2 inches from the anterior superior iliac crest commonly seen in acute appendicitis
McBurney's point
100
A 52 year old male presents with left lower quadrant pain x 2 days, constipation, and low grade fever and a CT that looks like this. What is the diagnosis?
Acute diverticulitis
100
Famotidine belongs to which class of medications?
H2 blockers
100
A patient who has a 1st degree relative with colorectal cancer should have screening completed how many years prior to age of onset of disease of the relative?
10 years
100
Which liver function test lab is most specific to the hepatocellular damage?
ALT
200
Flapping of outstretched hands in the setting of hepatic encephalopathy goes by this name
Asterixis
200
Pictured here is the appearance the colon can take in a patient with Crohn's disease
Cobblestoning
200
Which anti-nausea medication has a black box warning for tardive dyskinesia
Metoclopramide
200
Crohn's Disease often affects which specific area of the small intestine
Terminal Ileum
200
What is the most common type of infectious hepatitis in the United States
Hep C
300
_____ sign is the name for hemorrhagic discoloration of the flanks sometimes seen in acute pancreatitis
Grey-Turner's
300
A patient with dysphagia has an upper GI showing a bird's beak appearance of the LES
Achalasia
300
What is the INITIAL pharmacotherapeutic class used for a patient with fulminant (severe, acute) Crohn's or ulcerative colitis especially in a hospital setting
Corticosteroids
300
What is the best serologic test for celiac disease?
Tissue Transglutaminase IgA
300
In patient's with Wilson's disease, copper levels are elevated due to deficiency in this protein synthesized by the liver
Ceruloplasmin
400
A 21 year male presents to your office with complaints of recent onset weight loss, foul smelling loose stools, and bilateral blistering pruritic rash on his knees. What is your top diagnosis on differential before testing?
Celiac sprue
400
This is described as having a "telescoping" or "Bulls' Eye" appearance on abdominal ultrasound
Intussussception
400
Name a medication that should NOT be used in severe colitis and could contribute to toxic megacolon?
Anti or pro motility drugs (loperamide or prucalopride)
400
The 3 D's - Diarrhea, dermatitis, and dementia can be the result of the deficiency in which essential vitamin
Niacin (B3)
400
A patient with ulcerative colitis for many years presents with increasing transaminases and bilirubin. ERCP reveals "beading" of the biliary tree. What is the likely diagnosis based on labs and imaing?
Primary Sclerosing Cholangitis
500
This is the name of a nodular periumbilical protrusion that can be seen in advanced colorectal or intraabdominal malignancy
Sister Mary Joseph's Node
500
A 75 year old female with PMH of CAD c/o sudden onset lower abdominal cramping pain and bloody stools has a colonoscopy that reveals a dusky appearance of the descending colon has what her likely diagnosis?
Ischemic Colitis
500
Which class of biologic therapy has been associated with immunogenicity and antidrug antibody development?
TNF alpha inhibitors
500
Zollinger-Ellison syndrome involves the hypersecretion of which hormone?
Gastrin
500
A patient with nonreactive Hep B surface Ag, a reactive Hep B surface Ab, and reactive Hep B core Ab signifies what Hep B status?
Immune individual due to prior infection