Amboss pearls

Question 1

most likely causal organism for: Reheated food/ Rice

Answer 1

Bacillus cereus

Question 2

most likely causal organism for:
bloody diarrhea of 2 incubation days after eating contaminated food (raw poultry or unpasteurized milk or contact w infected animals lk dogs

Answer 2

Campylobacter jejuni

Question 3

most likely causal organism for: inflammatory diarrhea +-bloody after contaminated milk or pork.
+- tenderness in the right lower quadrant “pseudo appendicitis”
Couple days of incubation .
Nausa vomit 2 hours after ingestion

Answer 3

Yersinia enterocolitica

Question 4

most likely causal organism for: bloody diarrhea +-N/V
Raw beef, vegetables, milk
2-10d incubation period

Answer 4

Escherichia coli EHEC

Question 5

most likely causal organism for:
1-3h after ingestion N/V
Mayonnaise, canned meats

Answer 5

Staphylococcus aureus

Question 6

most likely causal organism for:
1-4 wk incub period. Loose stools +mucus+bright red blood. Painful defectation. Abdominal pain. cramps. anorecxia wl6 fever,

Answer 6

Entamoeba histolytica

Question 7

most likely causal organism for:
high-grade fever, severe vomiting, and inflammatory (watery-bloody) diarrhea

(poultry, poorly pasteurized eggs, and milk

incubation period is 6–48 hours

Answer 7

Salmonella enteritidis

Question 8

most likely causal organism for:

heat-labile Enterotoxins
watery diarrhea
abdominal cramping, nausea, and possibly vomiting

incubation period of 9 hours to 3 days

most common cause of traveler’s diarrhea.

Answer 8

Enterotoxigenic Escherichia coli

Question 9

most likely causal organism for:

bloody diarrhea. It has an incubation period of 1–3 days

Answer 9

Shigella dysenteriae

Question 10

most likely causal organism for:

16–72 hours after ingestion of undercooked seafood

most common cause of diarrhea in Japan

Answer 10

Vibrio parahaemolyticus

Question 11

Vibrio parahaemolyticus Tx

Answer 11

usually supportive, but administering doxycycline or fluoroquinolones may be considered in severe cases

Question 12

Kehr’s sign

Answer 12

pain to the left shoulder as a result of irritation of the left hemidiaphragm. Occurs because both left phrenic nerve, which innervates the left hemidiaphragm, and the left supraclavicular nerves, which innervate the skin over the shoulder, have common cranial nerve roots (C3 and C4). Most common cause is splenic injury.

Question 13

Cystic fibrosis CxFx

Answer 13

(chronic sinopulmonary disease, exocrine pancreatic insufficiency

frequent infections +-respiratory

Question 14

Cystic fibrosis Dx

Answer 14

. Sweat chloride test, or quantitative pilocarpine iontophoresis, is the gold standard

Defective chloride channels lead to elevated chloride in sweat gland secretions; levels > 60 mmol/L on two or more occasions are diagnostic for this condition

Question 15

Cystic fibrosis Patho

Answer 15

CFTR (cystic fibrosis transmembrane conductance regulator) gene mutations (the most common mutation is DeltaF508). The mutated CFTR gene encodes defective chloride channels in the cell membrane of exocrine glands, leading to hyperviscosity of secretions, blockage of exocrine glands and, subsequently, chronic inflammation with permanent organ damage

Question 16

more specific marker to detect alcohol use disorder.

and the most sensitive marker

Answer 16

, carbohydrate-deficient transferrin (CDT)

It is the optimal AUD marker because it can be detected even weeks after chronic alcohol use.

γ-GT the most sensitive marker for acute consumption

Question 17

lead poisoning: Cx Fx

Answer 17

intestinal colic (cramping abdominal pain), anemia (fatigue, pale conjunctivae), and radial nerve palsy (weakened wrist extension)

Question 18

is an occupational hazard for battery factory workers is

Answer 18

chronic lead poisoning

Question 19

Chronic lead poisoning cx fx

Answer 19

peripheral neuropathy, abdominal colic, anemia, and Burton’s line

Question 20

Dermatitis Herpetiformis Dx

Answer 20

microabscesses in the papillatu dermis are seen on light microscopy.
Inmmunofluorescense shows deposits of IgA at the tips of dermail papillae

Question 21

most common parasite from this source: undercooked meat

Answer 21

Trichinella spiralis

Question 22

most common parasite from this source: freshwater snails

Answer 22

Schistosoma mansoni

Question 23

most common parasite from this source: undercooked fish

Answer 23

Clonorchis sinensis

Question 24

most common parasite from this source: foxes, dogs, cats.

Answer 24

Echinococcus granulosus

Question 25

Li-Fraumeni syndrome Patho

Answer 25

autosomal dominant condition caused by a mutation in the p53 tumor suppressor gene.

Question 26

Li-Fraumeni syndrome Cx Fx

Answer 26

multiple malignancies (e.g., sarcomas, adrenal gland and breast cancer, leukemia)

Question 27

Turcot syndrome =

Answer 27

FAP or Lynch Sx+CNS malignancy

Question 28

Peutz-Jeghers syndrome patho

Answer 28

autosomal dominant condition associated with a mutation in the STK11 gene

Question 29

Peutz-Jeghers syndrome

Answer 29

hamartomatous polyps throughout the gastrointestinal tract (predominantly in the jejunum) and mucocutaneous hyperpigmentation of the lips, buccal mucosas, palms, and soles. increased risk of colorectal CA and extraintestinal too!

Question 30

Toxic megacolon etiologies

Answer 30

Infectious colitis Bacterial: C. difficile (pseudomembranous colitis), Salmonella, Shigella, Campylobacter infections Parasitic: Trypanosoma cruzi (Chagas disease), E. histolytica (amebic dysentery) infections Inflammatory colitis: Ulcerative colitis, Crohn disease

Question 31

chest pain, tachycardia, tachypnea, and crepitus over the chest . Is Cx Fx for?

Answer 31

Esophageal perforation. Hx of very recent endoscopy is frequent too.

Question 32

progressive hepatic dysfunction and cholestasis. + Hx of liver transplant =

Answer 32

CxFx of Chronic transplant rejection Chronic>6m acute <6

Question 33

accelerated coronary artery disease. + Hx of heat transplantation=

Answer 33

Chronic transplant rejection

Question 34

4-cm liver mass with a central hypoattenuated scar on a CT scan, which is diagnostic of

Answer 34

Focal nodular hyperplasia

Question 35

refractory peptic ulcer disease with multiple ulcerations and steatorrhea (foul-smelling, lightly-colored stools). These features suggest:

Answer 35

Gastrinoma or | Zollinger-Ellison syndrome

Question 36

gastrinoma should raise suspicion for

Answer 36

Multiple endocrine neoplasia | MEN 1

Question 37

The acute-onset, severe flank pain, microhematuria on dipstick, and hyperechoic mass on ultrasonography further indicate a

Answer 37

kidney stone.

Question 38

Symptoms of a kidney stone, intermittent arthralgias, abdominal pain, and fatigue further suggest:

Answer 38

primary hyperparathyroidism,

Question 39

primary hyperparathyroidism, occurs in ∼ 90% of individuals with :

Answer 39

MEN 1.

Question 40

Increased levels of PTH and hypercalcemia are the main diagnostic features of

Answer 40

pHPT

Question 41

nonbilious emesis following food intake, early satiety, weight loss, epigastric tenderness, and a succussion splash, all of which indicate

Answer 41

gastric outlet obstruction (GOO).

Question 42

In adults, GOO is caused by _______________________ in the majority of cases.

Answer 42

a malignant obstruction

Question 43

gastric outlet obstruction (GOO). A good initial test and a Dx confirmation test

Answer 43

initial: US Conf: upper endoscopy, especialy in Gastrix CA expected.

Question 44

newborn presents with bilious vomiting, a distended abdomen, and sparse bowel sounds, all of which are consistent with bowel obstruction. The findings of dilated small bowel loops on abdominal x-ray and a microcolon indicate

Answer 44

*Meconium ileus*: failure to pass the first stool and Cystic fibrosis is its cause in > 90% of cases.

Question 45

meconium ileus Dx

Answer 45

Gastrografin enema and it's the treatment too.

Question 46

Neuhauser sign

Answer 46

radiographic finding of a mottled ("soap bubble") appearance in the distal ileum and/or caecum as a result of meconium mixing with swallowed air, often caused by meconium ileus.

Question 47

Meconium Ileus Gastrofarin findings

Answer 47

Neuhauser sign, microcolon, or meconium pellets.

Question 48

IgG antibodies against the hepatitis B core antigen indicate:

Answer 48

either active or inactive chronic infection (think Core for Chronic)

Question 49

The envelope antigen is only present during :

Answer 49

phases of viremia, which occurs in acute or active chronic infections (think Envelope for 'Ective').

Question 50

endoscopic findings of a displaced Z-line above the diaphragmatic hiatus with no evidence of paraesophageal herniation are consistent with

Answer 50

type I hiatal hernia.

Question 51

A pupillary diameter of > 5 mm during eye examination with a light is

Answer 51

abnormally large

Question 52

fever, myalgia, periorbital edema, splinter hemorrhages, eosinophilia, and an increased serum creatine kinase concentration, all of which suggest

Answer 52

an infection with Trichinella spiralis.

Question 53

The consumption of pasteurized dairy products is important for preventing infection with, _________ or ______. each can have this symptoms ______ ______

Answer 53

Listeria monocytogenes CxFx: Healthy adults: self-limiting gastroenteritis (watery diarrhea) Immunocompromised and pregnant: +flue-like symptoms. also Brucella spp. tho it's not frequent in the USA flue-like symptoms.

Question 54

Roundworms (like Trichenella) can be treated with anthelmintic agents such as

Answer 54

albendazole and mebendazole.

Question 55

sclerodactyly, telangiectasias, and the Raynaud phenomenon, the combination of which suggests a diagnosis of

Answer 55

features of CREST syndrome, , part of the systemic sclerosis.

Question 56

systemic sclerosis. what does the C of CREST stand for?

Answer 56

calcinosis cutis (the “C”-feature in CREST), i.e small white calcium deposits on the pressure points of the extremities

Question 57

Achalasia patho

Answer 57

caused by progressive degeneration of the esophageal myenteric plexus, resulting in dysfunctional peristalsis,

Question 58

failure to thrive, lethargy, hepatomegaly, severe fasting hypoglycemia (causing hypoglycemic seizures), hyperlipidemia, and lactic acidosis. are seen in

Answer 58

von Gierke's disease (type a). A result of Glucose 6-phosphatase deficiency

Question 59

This young white man has fatigue, chronic diarrhea, abdominal pain, and thrombocytosis, which suggests and if bloody

Answer 59

inflammatory bowel disease (IBD). UC

Question 60

congenital ventral wall defect that leads to intestinal herniation through the involuted right umbilical vein

Answer 60

Gastroschisis

Question 61

Gastroschisis one good initial test (prenatal)

Answer 61

Alpha-fetoprotein

Question 62

Gastroschisis prenatal confirmatory test

Answer 62

fetal ultrasound will show free-floating bowel without a membranous sac.

Question 63

The most common long-term complication of caustic liquid ingestion is the development of

Answer 63

f esophageal strictures.

Question 64

A tumor in the descending colon with hepatic metastasis would most likely be

Answer 64

an adenocarcinoma, the most common type of colorectal cancer.

Question 65

can cause traveler's diarrhea and typically presents with watery to bloody stools.

Answer 65

Enterotoxigenic Escherichia coli (ETEC)

Question 66

gram-negative rod that causes infection with diarrhea in newborns

Answer 66

Enteropathogenic Escherichia coli

Question 67

causes watery diarrhea, especially in AIDS patients. | , high-volume, watery diarrhea that has persisted for more than two weeks.

Answer 67

Cryptosporidium parvum

Question 68

most common protozoal cause of traveler's diarrhea, THO it is not the most common cause of diarrheal illness among travelers.

Answer 68

Giardia intestinalis

Question 69

may be administered to treat patients with chronic hepatitis C infection (especially genotypes 2 and 3), nowadays typically as an alternative to direct-acting antivirals.

Answer 69

Interferon and ribavirin therapy also can use peginterferon alpha with ribavirin

Question 70

Abdominal pain at night, especially in the epigastric region, can be a symptom of

Answer 70

duodenal peptic ulcer disease (PUD)

Question 71

treatment In patients with uncomplicated symptomatic cholelithiasis who are poor surgical candidates long-term (6–24 months)

Answer 71

oral bile acid dissolution therapy with ursodeoxycholic acid (UDCA) is indicated. In addition to a low-fat diet and UDCA therapy, patients should exercise regularly and avoid lithogenic drugs (e.g., estrogen, fibrates)

Question 72

poorly controlled diabetes presents with subacute flank pain (left or right), fever, and pain with extension of the hip, all of which suggest a

Answer 72

Psoas muscle abscess