GI/Nutrition

Question 1

Fat, forty, female, fertile w/ RUQ pain

Answer 1

Cholelithiasis or cholecystitis

Question 2

Fever, RUQ pain, radiation to back

Answer 2

Cholecystitis

Question 3

Chronic cough, bitter taste in mouth or throat, dyspepsia

Answer 3

GERD

Question 4

N/V, epigastric abdominal pain, radiates to the back, worse supine, caused by alcohol ingestion, or following fatty meals

Answer 4

Acute pancreatitis

Question 5

Peri-umbilical or flank ecchymosis

Answer 5

acute pancreatitis (cullen and grey turner’s sign)

Question 6

Urologic emergencies

Answer 6

Testicular torsion and paraphimosis

Question 7

Abdominal distension, bloating, intermittent, colicky pain, high-pitches rushes and tinkles

Answer 7

SBO

Question 8

Air fluid levels on upright abd plain film

Answer 8

SBO

Question 9

Air under diaphragm, rigid board-like abdomen

Answer 9

Perforated viscus, perforated ulcer

Question 10

> 60yo F, LLQ pain

Answer 10

diverticulitis. IV ABx, fluids, NPO

Question 11

Transmural granulomatous disease, affecting any part of GI tract - mouth to anus

Answer 11

Crohn’s disease

Question 12

Elderly, Hx atherosclerosis. Dull periumbilical pain post-prandial

Answer 12

mesenteric ischemia

Question 13

Neonate with projectile vomiting. Olive sized mass

Answer 13

pyloric stenosis

Question 14

Alcoholic with massive hemoptysis

Answer 14

esophageal varices (tx with octreotide)

Question 15

Apple core lesion

Answer 15

Colon cancer

Question 16

Elderly with positive hemoccult

Answer 16

colon cancer - get colonoscopy

Question 17

CEA

Answer 17

colon carcinoma

Question 18

Family history of young age colon cancer, multiple polyps found on colonoscopy

Answer 18

Familial adenomatous polyposis (Gardner’s syndrome)

Question 19

CA-125

Answer 19

Ovarian carcinoma

Question 20

Traveler’s diarrhea

Answer 20

E. coli is cause. hydration and cipro treat

Question 21

Greasy, foul smelling, floating stools. Pear-shaped flagellated protozoan w/ 2 “eyes”. water, travel, camping history

Answer 21

Giardia

Question 22

Painless rectal bleeding. Bulging perianal mass with straining

Answer 22

internal hemorrhoids

Question 23

Pediatric with perianal pruritis esp at PM. Positive cellophane tape test

Answer 23

Pruritis anus - pinworms (enterobiasis). Tx is Mebendazole

Question 24

With your finer in male patient’s inguinal canal the patient coughs. You feel intestine tap the lateral aspect of your finger

Answer 24

Direct inguinal hernia

Question 25

Weight loss, recurrent greasy stools (steatorrhea) mixed with diarrhea after certain foods

Answer 25

Celiac sprue

Question 26

With your finger in a male patient's inguinal canal the patient coughs. You feel intestine tap the distal tip of your finger

Answer 26

indirect inguinal hernia

Question 27

Inflammatory disease of the mucosa and submucosa only. Continuous pattern, with rectum nearly always involved

Answer 27

Ulcerative colitis

Question 28

Anatomical separation for upper verses lower GI bleed

Answer 28

Ligament of Treitz

Question 29

Most common cause of nonerosive gastritis

Answer 29

H. pylori

Question 30

Ranson's criteria

Answer 30

Pancreatitis

Question 31

Pancreatitis

Answer 31

Abdominal pain, alleviating factor is leaning forward

Question 32

BMI suggestive of obesity

Answer 32

Greater than 30