McGuffin

Question 1

Inflammation/infection of bile system

Answer 1

Cholangitis

Question 2

RUQ pain, fever, jaundice, altered mental status, hypotension (shock)

Answer 2

Cholangitis (inflammation/infection of bile system)

Question 3

Elevated alkaline phosphatase and direct bilirubin. Ultrasound will show stone in common bile duct. E. Coli, enterococcus, klebsiella

Answer 3

Cholangitis

Question 4

Inflammation of gallbladder

Answer 4

Cholecystitis

Question 5

Fat, female, forties, fever

Answer 5

Cholecystitis

Question 6

Female with several kids. RUQ > 6 hrs. Pain worsens with intake of fatty food. Patient stops in mid-exhalation with examiner pushing down on RUQ. Ultrasound shows thickened gallbladder wall and pericholecystic fluid with gallstones

Answer 6

Cholecystitis

Question 7

Presence of at least one gall stone in common bile duct

Answer 7

Choledocholithiasis

Question 8

Severe abdominal pain, Pruritus (from elevated liver enzymes), jaundice, dark urine, and pale, clay colored stools

Answer 8

Choledocholithiasis

Question 9

Presence of gallstones in gall bladder

Answer 9

Cholelithiasis

Question 10

RUQ pain for a few hrs, N/V. Associated with fatty meals. RUQ ultrasound shows gallstones that are not obstructing

Answer 10

Cholelithiasis

Question 11

Jaundice, Ascites, edema, hepatomegaly, palmar erythema, encephalopathy, gynecomastia, hypogonadism. Hx of alcoholism and hepatitis. Prolonged PT and hypoalbuminemia

Answer 11

Cirrhosis

Question 12

Microcytic anemia. Pencil - thin stools with blood

Answer 12

Colorectal cancer

Question 13

Inflammation/infection caused by diverticula getting obstructed

Answer 13

Diverticulitis

Question 14

LLQ pain, fever. Leukocytosis

Answer 14

Diverticulitis

Question 15

Inflammation of gallbladder w/o evidence of gallstones or cystic duct obstruction. Seen in critically ill (burn/trauma patient).

Answer 15

Acalculous cholecystitis

Question 16

Painless rectal bleeding. Pts > 60 yrs. Hx of low fiber diet. Risk of colon cancer and contraindication to colonoscopy

Answer 16

Diverticulosis

Question 17

Choking, coughing, and dysphasia while eating. Regurgitating food eaten a while back. Halitosis

Answer 17

Esophageal diverticula

Question 18

False diverticulum of posterior pharyngeal constrictor muscles, arising from between inferior pharyngeal constrictor and cricopharyngeus muscle

Answer 18

Zenker

Question 19

Hx of recent esophageal procedure, vomiting, or retching. Hematemesis and Hx of alcoholism. Crepitus on neck and mediastinum

Answer 19

Esophageal rupture, BoerHaave syndrome

Question 20

Chest pain when drinking cold liquids. Corkscrew appearance during episodes. Treat with ca channel blockers and nitrates

Answer 20

Esophageal spasm

Question 21

Due to dilated submucosal veins

Answer 21

Esophageal varices

Question 22

Chest pain, dysphasia, odynophagia. Associated with GERD, chemical exposure. Sign of AIDS

Answer 22

Esophagitis

Question 23

Nodular filling defects on barium swallow

Answer 23

Candida

Question 24

Linear ulcers

Answer 24

CMV

Question 25

Punched out ulcers

Answer 25

HSV

Question 26

Intranuclear lesion

Answer 26

CMV

Question 27

Hx smoked foods, chronic gastritis, achlorhydria, h. Pylori. Lymphadenopathy in left supraclavicular area and umbilical area. Acanthosis nigricans

Answer 27

Gastric cancer