Random Associations

Question 1

Peripheral eosinophilia
elevated CRP
bowel ischemia
IDA

Answer 1

cholesterol embolization

Question 2

dystrophic fingernails
alopecia
many hamartomatous polyps

Answer 2

Cronkit-canada syndrome
(not genetically inheritied)

Question 3

differential for hypertrophic gastric folds

Answer 3

-menetrier’s disease (associated with enteropathy)
-lymphoma
-ZE

Question 4

differential for pulse-temperature dissociation

Answer 4

leptospirosis (fresh water exposure, conjunctival injection, ALI); treat with doxycycline
typhoid fever (salmon colored spot, splenomegaly, ileal perforation, diagnose with blood culture, treat with fluoroquinolone)

Question 5

Rheumatoid arthritis (or inflammatory condition)
heart failure
peripheral neuropathy
renal failure

what are the gi manifestations?

Answer 5

Amyloidosis (AA amyloid)

dysmotility
malabsorption
mucosal lesions that can bleed
diagnose with fat pad or rectal targeting blood vessels; biopsy with congo red stain

Question 6

jaundice at any stage of pregnancy

Answer 6

viral hepatitis until proven otherwise, this is the #1 cause at any stage

Question 7

number needed to treat

Answer 7

1/ARR

Question 8

The “snapping uvula”

Answer 8

fibrovascular polyp
endoscopic resection if <2cm otherwise surgery is needed

Question 9

Medication side effects:
-mesalamine

Answer 9

-mesalamine- pericarditis or pleuritis

Question 10

Early signs of Boerhaave’s

Answer 10

L. sided pleural effusion
mediastinal air
subcutaneous crepitus

Question 11

rare cause of dypshagia
esophogram shows a oblique filling defect in the upper esophagus

Answer 11

dysphagia lusoria
aberrant right subclavian artery

Question 12

what does hemosiderin in the urine mean?

Answer 12

there is intravascular hemolysis

Question 13

PAS+ stain on pathology

Answer 13

Whipples disease
A1AT
MAC infection

Question 14

What does it look like if there is publication bias? what should the plot look like?

Answer 14

asymmetric if bias is presents

if no bias, then the plot is an inverted funnel

Question 15

Difference between gallbladder polyps and stones on ultrasound?

how do you managed polyps?

Answer 15

shadowing w/ a stone
no shadowing with a polyp

if polyp,
-follow with q6 mo ultrasounds
- remove if symptomatic** or >1cm

Question 16

describe gastrin levels, gastric pH, and parietal cell mass for the following:
1. ZE
2. pernicious anemia
3. corpus HP
4. antral HP
5. chronic PPI

Answer 16

1. ZE - high gastrin, low pH, increased parietal cell mass, +secretin stim test >200u increase
2. pernicious anemia - high gastrin, high pH, low parietal cell mass
3. corpus HP- high gastrin, high pH, low parietal cell mass
4. antral HP- high gastrin, low pH, high parietal cell mass
5. chronic PPI - high gastrin, high pH, high parietal cell mass

Question 17

management of superior mesenteric artery embolism

Answer 17

emergent angiography (no CT or endo)

Question 18

weight loss options

Answer 18

BMI >30 alone or 25 to 30 with comorbidities =medications
BMI >35 or 30 to 35 with comorbidities =surgery

Question 19

Blastocystis hominis (B hominis)

Answer 19

associated w/ diarrhea, abdominal pain, and nausea

the significance of B hominis as a pathogen is controversial.

A reasonable approach is to treat immunosuppressed individuals or immunocompetent individuals in whom diagnostics have not identified an alternative diagnosis.

metronidazole, paromomycin, or trimethoprim-sulfamethoxazole.

Question 20

side effect of ribavirin

Answer 20

hemolytic anemia

Question 21

Answer 21

lichen planus

Question 22

granulocytic sarcoma or chloroma

Answer 22

green-appearning luminal nodules
path with myeloperoxidase positivity
high LDH
associated with high risk of AML

Question 23

cryoglobulinemia vs HSP

Answer 23

cryglobulinemia- HCV, RF, low C4, purpuric rash, renal disease

HSP- young adult, abdominal pain, low C4, rash