GI Jeopardy

Gold Standards

100

Gold Standard Diagnosis for IBD

Colonoscopy

200

Gold standard diagnosis for hiatal hernia

Barium swallow

300

Gold standard diagnosis for Mallory-Weiss

EGD

400

Gold standard diagnosis for achalasia

esophageal manometry

500

Gold Standard diagnosis for pancreatic cancer

Abdominal CT with contrast

GI Cancers

100

Signs and symptoms of esophageal cancer

Progressive food dysphagia

weight loss

Chest pain

GI bleed

Vocal hoarseness

Dyspnea

200

Anatomical location for the majority of stomach cancers:

1. cardia

2. antrum

3. body

300

Name the specific mutation linked to gastric cancer

cadherin 1 gene (CDH1) – autosomal dominant trait

400

Most common type of exocrine pancreatic cancer

Adenocarcinoma-ductal carcinoma

500

What gene mutation often leads to colorectal cancer over a period of 10-15 years?

Most CRCs begin with adenomatous polyposis coli (APC) gene inactivation 

(Multiple genetic hits are required)

Esophageal disorders

100

Atypical signs and symptoms of GERD

Chronic cough

Chronic laryngitis

Sore throat

Chest pain and asthma

200

In what condition will you see a "beak-like" structure during a barium swallow?

Achalasia

300

How is Boerhaave syndrome definitively diagnosed?

CT or contrast esophagography (gastrograffin)

400

Endoscopic findings associated with EoE

Mucosal fragility

Whitish papules (representing eosinophilic microabscesses)

Linear furrows

Stacked circular rings - "trachealization"

Strictures

500

What are specific indications for anti-reflux surgery in GERD patients?

grade C/D, hiatal hernias, stricture ulcers, hemorrhage

Signs and Symptoms

100

Which type of hemorrhoid bleeds the easiest?

Internal

200

Name the classic signs for acute appendicitis patients

McBurney point tenderness

Psoas sign

Obturator sign

Rovsing sign

300

Describe the Mackler triad. What condition is this for?

1. vomiting

2. retrosternal pain 

3. SCE 

(Boerhaave's syndrome)

400

Differentiate the signs and symptoms of a Small vs Large bowel obstruction

Small: 

symptoms: abdominal pain/cramping, vomiting, diarrhea (partial) or Obstipation (complete)

signs: Hyperactive, high-pitched peristaltic rushes, palpable bowel loops

Large:

symptoms: develop gradually, distention, vomiting, inability to pass gas or stool 

signs: loud borborygmi, distention

500

Describe Reynold's pentad. What condition is this for?

jaundice

fever

RUQ pain

hypotension

AMS

for cholangitis

Treatments

100

What type of bowel obstruction is most commonly treated by a laparotomy?

Complete small bowel obstruction (85%)

200

Cholangitis treatment:

-ERCP and sphincterotomy (allows for stone removal)

-Can do elective laparoscopic cholecystectomy which is recommended

-IV antibiotics

300

Treatment plan for anorectal abscess:

Incision and Drainage right away

Antibiotics if Febrile, immunocompromised, diabetic, or marked cellulitis is present

• Cipro 500 mg IV every 12 hours plus metronidazole 500 mg IV every 8 hours

• Ampicillin/sulbactam 1.5 g IV every 8 hours

400

Pharmacological agents for IBS:

• Antidiarrheal agents (loperamide)

• Osmotic laxatives (polyethylene glycol)

• Antispasmodic agents (dicyclomine)

• Tricyclic antidepressants (amitriptyline)

500

Basic treatment and follow up plan for a CRC patient without metastatic disease

Wide surgical resection 

Follow up- surveillance colonoscopy: 1 year after surgery, then 3 years if no tumor is found

• Then goes to 5 year intervals