1/23/15

Question 1

What is Trousseau’s sign? What disease is it associated with?

Answer 1

Migratory thrombophlebitis (tender, erythematous veins that goes away after awhile) A sign of pancreatic adenocarcinoma

Question 2

What hepatic disease is characterized by jaundice, pruritis and hypercholesterolemia, elevated levels of alkaline phosphatase and granulomas in the intrahepatic bile ducts?

Answer 2

primary biliary cirrhosis

Question 3

What hepatic lesion/mass is associated with oral contraceptive/anabolic steroid use and will regress when oral contraceptives are stopped?

Answer 3

hepatic adenomas

Question 4

How does the composition of saliva change as it passes through the salivary ducts?

Answer 4

Initial saliva has the same composition of electrolytes as blood. As it goes through the salivary ducts, sodium and chloride are reabsorbed while potassium and bicarbonate are secreted. In the end, saliva has less NaCl and more K+ and HCO3- than blood

Question 5

Although any broad spectrum antibiotic can lead to pseudomembranous colitis from c. difficile infection, what are the two most likely antibiotics?

Answer 5

ampicillin and clindamycin

Question 6

What is the difference between Mallory bodies and Councilman bodies?

Answer 6

Councilman bodies are eosinophilic apoptotic hepatocytes associated with yellow fever virus while Mallory bodies are eosinophilic inclusions in the cytoplasm of swollen, necrotic hepatocytes associated with alcoholic hepatitis and alcoholic cirrhosis

Question 7

What is the most common cause of acute appendicitis in children?

Answer 7

obstruction of the lumen of the appendix due to lymphoid hyperplasia from a recent viral infection. NOT fecalith formation

Question 8

Why do patients that have undergone ileal resection (e.g. from Crohn’s disease) have a decreased risk of Shigella infections?

Answer 8

The ileum is the only place in the gut where Peyer’s patches and M cells are located. Shigella invades the gut through the M cells. If the M cells aren’t there, Shigella can’t invade. Other organisms that invade through M cells are salmonella, e. coli and yersinia enterocolitica

Question 9

What underlying disease is pyoderma gangrenosum associated with?

Answer 9

Crohn’s disease (an extraintestinal manifestation)

Question 10

What are the extraintestinal manifestations of Crohn’s disease? Of ulcerative colitis?

Answer 10

Crohn’s: migratory polyarthritis, pyoderma gangrenosum, ankylosing spondylitis, aphthous ulcers, uveitis, erythema nodosum, kidney stones; Ulcerative colitis: pyoderma gangrenosum, erythema nodosum, primary sclerosing cholangitis, ankylosing spondylitis, aphthous ulcers, uveitis