Challenge Bowl Gi

Front 1

What is the most common bacteria found in the colon?

Back 1

Bacteriodes spp.

Front 2

A patient with hepatic centrilobular necrosis and fatty change of the liver might have been exposed to what substance?

Back 2

Carbon tetrachloride

Front 3

Hirschprung's disease most commonly presents in what area of the bowel?

Back 3

Rectosigmoid region

Front 4

Benign hamartous polyps, hyperpigmentation of the skin and mucous membranes, especially the lips are suggestive of what disease?

Back 4

Peutz-Jegher's syndrome aka hereditary intestinal polyposis syndrome

Front 5

Mutations in DCC, p53, K-ras, and APC occur in what disease of the colon?

Back 5

Familial adematous polyposis

Front 6

What is the causative agent in enterocolitis caused by broad spectrum antibiotic use?

Back 6

Clostridium difficile

Front 7

A patient with Crohn's disease forms an abnormal connection between her colon and vagina due to the disease. What is the term for this connection?

Back 7

Fistula

Front 8

What GI diseases are associated with pyoderma gangrenosum?

Back 8

IBD (Crohn's, UC)

Front 9

A 12 year old boy is brought to the ED at midnight with pain in the periumbilical region. Palpation of the abdomen reveals that the point of maximum tenderness is between the navel and the anterior superior iliac spine in the right lower quadrant. What is the most likely diagnosis?

Back 9

Appendicitis

Front 10

The point of maximum tenderness in appendicitis is known as what?

Back 10

McBurney's point

Front 11

A 3 year old child develops enteritis. Shortly after the child develops hemolytic uremic syndrome. What is the most likely causative organism of the enteritis?

Back 11

Hemorrhagic E. coli (O157:H7)

Front 12

What is a precursor of all of the following: bile salts, steroids, and vitamin D?

Back 12

Cholesterol

Front 13

Painful subcutaneous nodes, malaise, fever, hepatosplenomegaly, pancytopenia, and abrupt hemorrhagic death are characteristic of what disease?

Back 13

Histocytic cytophagic panniculitis

Front 14

What glands in the duodenum produce large quantities of alkaline mucus that neutralizes gastric juice?

Back 14

Brunner's glands

Front 15

A 14 year old girl presents with increased serum bilirubin and vague nonspecific complaints. Labs show an increase in unconjugated bilirubin with normal LFTs and negative hepatitis screens. There is no evidence of liver abnormality or of hemolysis. What is the most likely diagnosis?

Back 15

Gilbert's disease (benign condition characterized by increase in unconjugated bilirubin)

Front 16

Hepatitis D always occurs with what other co-infection?

Back 16

Hepatitis B

Front 17

A 25 year old woman visited India on an expedition. Upon returning home, she was found to have a high fever, jaundice, malaise, and anorexia. Her stools were light gray and her urine was amber colored. What is the most likely diagnosis?

Back 17

Hepatitis D AND B (D has to have B to exist)

Front 18

A 30 year old male presents with jaundice, pruritus, and weight loss. On exam he exhibits signs of cirrhosis and portal HTN. He denies a history of alcohol ingestion. His past medical history is significant for UC. What is the most likely diagnosis?

Back 18

Primary sclerosing cholangitis (may present with cirrhosis or hepatosplenomegaly)

Front 19

Methyl alcohol is metabolized to what substances following ingestion?

Back 19

Formaldehyde and formic acid

Front 20

Gray baby syndrome is commonly related to administration of what drug?

Back 20

Chloramphenicol (results from high blood levels due to immature hepatic function, can be fatal)

Front 21

Non digestable items found in the stomach, frequently containing hair are called what?

Back 21

Bezoars

Front 22

What bacteria is implicated in duodenal ulcers?

Back 22

Helicobacter pylori

Front 23

A 56 year old alcoholic man comes into the emergency room vomiting blood. History is significant for a prolonged episode of vomiting. Endoscopy demonstrates a lateral tear of the stomach at the level of the gastroesophageal junction. What is the most likely diagnosis?

Back 23

Mallory Weiss syndrome

Front 24

What type of surgery might a patient be undergoing if you have identified Calot's triangle?

Back 24

Cholecystectomy

Front 25

Name the 3 arteries associated with the celiac trunk.

Back 25

Common hepatic, left gastric, splenic

Front 26

A gastrinoma is also known by what name?

Back 26

Zollinger-Ellison syndrome

Front 27

What disease is the Ranson criteria used for?

Back 27

Acute pancreatitis

Front 28

In the US, the most common cause of acute pancreatitis is gallstones, what is the number 2 cause?

Back 28

Alcohol

Front 29

What are the 4 F's associated with gallbladder disease?

Back 29

Forty, fat, fertile, female (also farting and fair)

Front 30

A periumbilical node indicating abdominal carcinoma is called?

Back 30

Sister Mary Joseph node

Front 31

Virchow's node indicates what?

Back 31

Metastatic carcinoma of the stomach (this is left supraclavicular node enlargement)

Front 32

Name the components of Charcot's triad in acute cholecystitis.

Back 32

Fever, jaundice, RUQ pain

Front 33

What condition is characterized by clinical manifestations such as dysphagia, a sense of a lump in the neck; moreover it may fill up with food, causing regurgitation, cough, halitosis, and involuntary gurgling noises when swallowing?

Back 33

Zenker diverticulum

Front 34

What structure marks the terminal end of the duodenum?

Back 34

Ligament of Treitz

Front 35

what makes up the Hesselbach triangle? And what is the most common disorder associated with it?

Back 35

superolateral border-inferior epigastric vessels |medial border - rectus sheath- | inferior border- inguinal ligament. (inguinal hernias. Hernias withing the triangle are said to be direct. Hernias lateral to the triangle borders are indirect)

Front 36

generalized hamartomatous multiple polyposis of the interstinal tract, consistently involving the jejunum, associated with melanin spots of the lips, buccal mucosa, and fingers; autosomal dominant inheritance, caused by mutation in the serine/theonine kinase gene on chromosome 19p

Back 36

Peutz-Jegher's syndrome aka hereditary intestinal polyposis syndrome

Front 37

this type of intoxication present with tremors, ataxia, altered mental status, nausea, vomiting and hypotension. Muscle rigidity is not common

Back 37

lithium toxicity

Front 38

RLQ pain with leg extension

Back 38

Psoas sign (Appendicitis)

Front 39

RLQ pain with internal hip rotation

Back 39

Obturator sign (Appendicitis)

Front 40

Rebound tenderness in the RUQ is what sign?

Back 40

Murphy's sign (cholecystitis)

Front 41

esophageal perforation

Back 41

Boorhave's syndrome