Esophageal Disorders
Stomach Disorders
Biliary Disorders
Liver Disorders
Just for fun!
100
The test of choice in diagnosing oropharyngeal dysphagia.
What is modified barium swallow (video fluoroscopy accepted)?
100
The two most common causes of peptic ulcer disease.
What are NSAID's and H.Pylori?
100
The etiology of 80% of acute pancreatitis in the USA is caused by these two disorders.
What are alcoholism and gallstones?
100
A 21 year old college student with a history of depression arrives in the ER and is intubated for progressive somnolence and hypercapnea. His roommate is present and states that the patient took a large quantity of pain pills. AST and ALT are greater than 1000. Which drug therapy should be started before serologies return?
What is N-acetylcysteine (NAC)? (Accept mucomyst).
100
Famous for his renditions of "Blowin' in the Wind" and "The Times They are a Changin'," this folk artist drew considerable ire from fans when he appeared onstage with an electric guitar (instead of his usual acoustic) for the first time in 1965.
Who is Bob Dylan?
200
Occurring after the initiation of a swallow, esophageal dysphagia is often described as food "sticking" in the patients chest or throat. What is the diagnostic test of choice in patients with esophageal dysphagia?
What is upper endoscopy?
200
If NSAID's must be resumed after an ulcer due to NSAID use has healed, which agent is first line to prophylax against recurrent ulcer?
What are PPI's? (superior to H2 blockers, misoprostol, and sucralfate).
200
When clinical suspicion for cholecystitis is high and the RUQ ultrasound is negative, this test should be performed as its sensitivity for cholecystitis is 97% (with specificity of 90%) compared to 84% for ultrasound.
What is a HIDA scan or biliary scinitgraphy?
200
A 53 year old female with DM2, obesity, hyperlipidemia, and HTN presents with progressive transaminitis. Alkaline phosphatase and bilirubin are normal. Viral hepatitis is screen is normal. The patient takes metformin, insulin, and an ACE inhibitor. This is the most likely abnormal finding on ultrasound.
What is steatosis? (Accept NASH or NAFLD).
200
Even though it was first invented during his lifetime, J.S. Bach never composed music for this very popular instrument, as it was initially considered a novelty.
What is the piano?
300
These two viruses can cause infectious esophagitis in the immune compromised host.
What are HSV and CMV?
300
An SBHCC student presents with recurrent nausea and vomiting. They have been seen about this problem before and blood work, imaging, and endoscopy all fail to provide a diagnosis. She denies alcohol or drug use other than marijuana. She states she feels better with hot showers and frequently irritates her roomates by using all the hot water with her compulsive showering. Dx?
What is cannabinoid hyperemesis syndrome?
300
Name one of the three risk factors for gallbladder cancer that require prophylactic cholecystectomy.
What are gallstones larger than 3 cm, gallbladder polyps larger than 1 cm, or porcelain gallbladder? (Other risk factors which don't require cholecystectomy include female sex, age greater than 50, obesity, and chronic infection with salmonella typhi)
300
A 57 year old patient with a long standing history of alcoholic cirrhosis presents with SOB upon standing. Room air ABG reveals a pO2 of 52mmHg and is otherwise normal. CT PE protocol is normal. Echocardiography reveals microbubbles in the left atrium after 5 cardiac cycles. RV pressure is normal. Most likely diagnosis?
What is Hepatopulmonary Syndrome?
300
This temple built in Athens, Greece was originally used to worship Athena. It was later converted to a Christian church, and then a mosque until it was partially destroyed by invading Venetians.
What is the the Parthenon?
400
A patient with solid food esophageal dysphagia is sent for endoscopy. Biopsies from the procedure reveal 23 eosinophils per high powered field. Before a diagnosis of eosinophilic esophagitis is made, which disorder must be excluded?
What is GERD?
400
A 32 year old patient with dyspepsia unresponsive to PPI's undergoes upper endoscopy. She is found to have numerous polyps in the gastric fundus. They are resected and sent to pathology. What is the next diagnostic test that should be performed?
What is colonoscopy? (To examine for familial adenomatous polyposis syndrome)
400
A 45 year old woman presents to your outpatient clinic with fatigue and dry eyes. Serologies reveal an alkaline phosphatase of 400, AST 90, ALT 100, total bilirubin of 1.4. Anti-mitochondrial antibodies are positive with a 1:80 dilution. Most likely diagnosis?
What is Primary Biliary Cirrhosis?
400
An asymptomatic patient's serologies: HBV surface antigen negative, HBV surface antigen antibody negative, HBV core antibody positive. Normal transaminases, bilirubin and alkaline phosphatase. This patient's vaccination status:
What is unvaccinated? (Though the patient is likely immunized from resolved infection)
400
Apple Computers' employee number one, this genius computer engineer revolutionized and essentially created the personal computer industry by inventing the Apple I and Apple II computers.
Who is Steve Wozniak?
500
A patient diagnosed with Barrett's esophagus was found to have no dysplasia on their biopsy. When should they return for repeat endoscopy?
What is one year? (and then every three years after if the patient continues to have no dysplasia).
500
A young patient with DM1 and resultant gastroparesis who is well known to your service presents in clinic for follow up. She recently had a jejunostomy tube placed in the hospital. Name at least one indication for J-tube placement in patients with severe gastroparesis?
What is unintentional weight loss greater than 10% over 3-6 months, repeated hospitalizations and/or NG tube placements to deal with symptoms, or complete inability to deliver nutrition or medications orally.
500
A 34 year old man with a history of ulcerative colitis presents at his yearly checkup. Serologies were normal last year, and now reveal an alkaline phosphatase of 400, AST 90, ALT 100, total bilirubin of 1.4. Anti-mitochondrial antibodies are negative. ANA is positive with a high titer. Most likely diagnosis?
What is Primary Sclerosing Cholangitis? !!!!!!!DAILY DOUBLE!!!!!!!
500
A 65 year old previously healthy man presents with RUQ discomfort. Serologies are normal, however, ultrasound imaging reveals a 5cm irregularly shaped cyst in the liver with thin septations. What is the next test or procedure this patient should be referred for?
What is surgical resection? (alarm features: irregularity and septations).
500
The number of US presidents assassinated while in office.
What is four? (Lincoln, McKinley, Garfield, and Kennedy)
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