GI

GI US Medical PG Question 1: A 3-year-old recent immigrant is diagnosed with primary tuberculosis. Her body produces T cells that do not have IL-12 receptors on their surface, and she is noted to have impaired development of Th1 T-helper cells. Which of the following cytokines would benefit this patient?

• A. IL-4
• B. IL-22
• C. TGF-beta
• D. IL-17
• E. Interferon-gamma (Correct Answer)

GI Explanation: ***Interferon-gamma*** - This patient has an impaired **Th1 response**, which is crucial for controlling intracellular infections like **tuberculosis** by activating macrophages. - **Interferon-gamma** is the primary cytokine produced by **Th1 cells** that activates macrophages, leading to enhanced phagocytosis and killing of intracellular pathogens. *IL-4* - **IL-4** is a key cytokine produced by **Th2 cells**, which primarily drive **humoral immunity** and allergic responses, not cellular immunity against intracellular bacteria. - Its administration would promote a **Th2 response**, which is not beneficial for combating **tuberculosis** and might even suppress the desirable Th1 response. *IL-22* - **IL-22** is mainly involved in **epithelial cell proliferation**, host defense at mucosal surfaces, and tissue repair. - While it has a role in host defense against certain pathogens, it is not the primary cytokine required to compensate for a deficient **Th1 response** in **tuberculosis**. *TGF-beta* - **TGF-beta** is a pleiotropic cytokine with roles in cell growth, differentiation, and immune regulation, often acting as an **immunosuppressant** or driving **Treg differentiation**. - It would not directly compensate for a lack of **Th1 cell function** needed to activate macrophages against **tuberculosis**. *IL-17* - **IL-17** is the signature cytokine of **Th17 cells**, which are important for host defense against **extracellular bacteria** and fungi, primarily by recruiting neutrophils. - While it plays a role in some immune responses, it is not the crucial cytokine to boost in a patient with impaired **Th1 development** against **intracellular M. tuberculosis**.

GI US Medical PG Question 2: A 66-year-old man is brought to the emergency department after a motor vehicle accident. The patient was a restrained passenger in a car that was struck on the passenger side while crossing an intersection. In the emergency department, he is alert and complaining of abdominal pain. He has a history of hyperlipidemia, gastroesophageal reflux disease, chronic kidney disease, and perforated appendicitis for which he received an interval appendectomy four years ago. His home medications include rosuvastatin and lansoprazole. His temperature is 99.2°F (37.3°C), blood pressure is 120/87 mmHg, pulse is 96/min, and respirations are 20/min. He has full breath sounds bilaterally. He is tender to palpation over the left 9th rib and the epigastrium. He is moving all four extremities. His FAST exam reveals fluid in Morrison's pouch. This patient is most likely to have which of the following additional signs or symptoms?

• A. Pain radiating to the back
• B. Gross hematuria
• C. Muffled heart sounds
• D. Free air on chest radiograph
• E. Shoulder pain (Correct Answer)

GI Explanation: ***Shoulder pain*** - The presence of **fluid in Morrison's pouch** (hepatorenal recess) on FAST exam indicates **intra-abdominal bleeding**, likely from a liver or spleen injury. - **Diaphragmatic irritation** due to intra-abdominal hemorrhage often manifests as referred **shoulder pain** (Kehr's sign), especially on the left side with splenic injury or right side with liver injury. *Pain radiating to the back* - While pancreatic injury can cause pain radiating to the back, the primary finding of **fluid in Morrison's pouch** points towards hemoperitoneum, less specifically to pancreatic trauma. - Significant pancreatic injury would likely involve more severe abdominal tenderness and potentially elevated **amylase/lipase**, which are not mentioned here. *Gross hematuria* - **Gross hematuria** would suggest a **renal or urologic injury**, but the patient's primary finding is intra-abdominal fluid in Morrison's pouch, which is more indicative of solid organ injury like the liver or spleen. - Though concurrent injuries are possible in trauma, hepatorenal fluid points specifically to **hemoperitoneum**, not necessarily kidney damage. *Muffled heart sounds* - **Muffled heart sounds** are a component of **Beck's triad** (along with hypotension and jugular venous distension), indicative of **cardiac tamponade** due to fluid around the heart. - There is no clinical information in the stem suggestive of cardiac injury or tamponade; the fluid is specifically mentioned in the abdomen. *Free air on chest radiograph* - **Free air on chest radiograph** (pneumoperitoneum) indicates a **perforated hollow viscus**, such as the bowel or stomach. - The FAST exam finding of fluid in Morrison's pouch is characteristic of **hemoperitoneum** from a solid organ injury, not free air from a perforation.

GI US Medical PG Question 3: A 57-year-old man presents with 2 days of severe, generalized, abdominal pain that is worse after meals. He is also nauseated and reports occasional diarrhea mixed with blood. Apart from essential hypertension, his medical history is unremarkable. His vital signs include a temperature of 36.9°C (98.4°F), blood pressure of 145/92 mm Hg, and an irregularly irregular pulse of 105/min. Physical examination is only notable for mild periumbilical tenderness. Which of the following is the most likely diagnosis?

• A. Diverticular disease
• B. Acute pancreatitis
• C. Gastroenteritis
• D. Crohn's disease
• E. Acute mesenteric ischemia (Correct Answer)

GI Explanation: ***Acute mesenteric ischemia*** - The patient's presentation with **severe, generalized abdominal pain worse after meals**, along with **bloody diarrhea** and **irregularly irregular pulse** (suggesting **atrial fibrillation**), is highly indicative of acute mesenteric ischemia. - Atrial fibrillation can lead to **emboli** that occlude mesenteric arteries, causing rapid onset of **ischemic bowel injury** with disproportionate pain and often minimal findings on physical exam. *Diverticular disease* - While diverticulitis can cause abdominal pain, it is typically localized to the **left lower quadrant** and often associated with fever and leukocytosis, which are absent here. - **Diverticular bleeding** usually presents as painless rectal bleeding, not severe, diffuse abdominal pain with ischemic features. *Acute pancreatitis* - Characterized by severe **epigastric pain radiating to the back**, often associated with nausea and vomiting, but not typically with bloody diarrhea. - Elevated **lipase** and **amylase** levels are diagnostic markers, and an irregularly irregular pulse is not a direct symptom. *Gastroenteritis* - Often causes diffuse abdominal pain, nausea, vomiting, and diarrhea, but the pain is rarely as severe or disproportionate to physical findings as described. - **Bloody diarrhea** can occur, but the rapid onset of severe pain, particularly in the context of possible **embolic source** (atrial fibrillation), makes ischemia more likely. *Crohn's disease* - A chronic inflammatory bowel disease presenting with **abdominal pain**, **diarrhea** (often bloody), and weight loss, developing over weeks to months. - The acute, severe onset of symptoms in this patient does not fit the typical chronic presentation of Crohn's disease.

GI US Medical PG Question 4: An unconscious middle-aged man is brought to the emergency department. He is actively bleeding from the rectum. He has no past medical history. At the hospital, his pulse is 110/min, the blood pressure is 90/60 mm Hg, the respirations are 26/min, and the oxygen saturation is 96% at room air. His extremities are cold. Resuscitation is started with IV fluids and cross-matched blood arranged. His vitals are stabilized after resuscitation and blood transfusion. His hemoglobin is 7.6 g/dL, hematocrit is 30%, BUN is 33 mg/dL, and PT/aPTT is within normal limits. A nasogastric tube is inserted, which drains bile without blood. Rectal examination and proctoscopy reveal massive active bleeding, without any obvious hemorrhoids or fissure. The physician estimates the rate of bleeding at 2-3 mL/min. What is the most appropriate next step in diagnosis?

• A. Exploratory laparotomy with segmental bowel resection
• B. Radiolabeled RBC scan
• C. Colonoscopy
• D. Mesenteric angiography (Correct Answer)
• E. EGD

GI Explanation: ***Mesenteric angiography*** - Mesenteric angiography is indicated for **active lower GI bleeding** when the bleeding rate is high (2-3 mL/min) and colonoscopy is challenging due to massive bleeding. It can localize the source of bleeding and allow for therapeutic embolization. - The patient's presentation with **massive rectal bleeding**, signs of hypovolemia, and the exclusion of upper GI bleeding (bile without blood in NG tube) points to a lower GI source. *Exploratory laparotomy with segmental bowel resection* - This is an **invasive surgical procedure** typically reserved for cases where other less invasive diagnostic and therapeutic methods have failed, or in cases of uncontrolled life-threatening hemorrhage. - Doing an exploratory laparotomy without clear localization of the bleeding site carries significant risks and may lead to unnecessary bowel resections. *Radiolabeled RBC scan* - A radiolabeled RBC scan is a highly sensitive diagnostic tool for **detecting intermittent or slow GI bleeding**, but it requires a very low rate of bleeding (as low as 0.1 mL/min). - Given the patient's **active and massive bleeding** (2-3 mL/min), a more rapid and precise localization method like angiography is preferred. *Colonoscopy* - While colonoscopy is the primary diagnostic tool for lower GI bleeding, it is often **challenging to perform effectively in the presence of massive active bleeding**, as the view can be obscured by blood. - The patient's hemodynamic instability has been corrected, but the high bleeding rate makes a diagnostic colonoscopy difficult. *EGD* - EGD (Esophagogastroduodenoscopy) is used to diagnose **upper GI bleeding**, which has been effectively ruled out by the nasogastric tube draining bile without blood. - This procedure would not be helpful for localizing a lower GI bleeding source.

GI US Medical PG Question 5: A 51-year-old man with a recent diagnosis of peptic ulcer disease currently treated with an oral proton pump inhibitor twice daily presents to the urgent care center complaining of acute abdominal pain which began suddenly less than 2 hours ago. On physical exam, you find his abdomen to be mildly distended, diffusely tender to palpation, and positive for rebound tenderness. Given the following options, what is the next best step in patient management?

• A. Serum gastrin level
• B. Urgent CT abdomen and pelvis (Correct Answer)
• C. H. pylori testing
• D. Abdominal radiographs
• E. Upper endoscopy

GI Explanation: ***Urgent CT abdomen and pelvis*** - The sudden onset of severe abdominal pain, diffuse tenderness, and **rebound tenderness** in a patient with a history of peptic ulcer disease (PUD) suggests a **perforated ulcer**, which is a surgical emergency. - A CT scan is the **most sensitive imaging modality** for detecting **free air** (pneumoperitoneum) and can confirm the diagnosis with >95% sensitivity, helping to localize the perforation and identify complications such as abscess formation. - CT also helps evaluate alternative diagnoses in the acute abdomen and provides detailed anatomic information for surgical planning. *Serum gastrin level* - This test is primarily used in the diagnosis of **Zollinger-Ellison syndrome**, a rare condition characterized by gastrinomas leading to severe, refractory PUD. - It is not indicated in an acute emergency setting with signs of perforation, as it would delay critical diagnostic imaging and management. *H. pylori testing* - **_H. pylori_ infection** is a common cause of PUD, but testing for it is part of routine initial management or follow-up for chronic disease. - Testing would not address the immediate life-threatening complication of suspected perforation and would delay definitive diagnosis. *Abdominal radiographs* - An upright chest X-ray or abdominal radiograph can detect **free air under the diaphragm** in cases of perforation and is a reasonable initial imaging test. - However, plain radiographs have lower sensitivity (75-80%) compared to CT scan and may miss smaller perforations or provide insufficient information about the location and extent of injury. - In modern practice with readily available CT, cross-sectional imaging is preferred for its superior diagnostic accuracy in evaluating the acute abdomen. *Upper endoscopy* - **Upper endoscopy** is a valuable diagnostic and therapeutic tool for stable PUD but is **absolutely contraindicated** in cases of suspected or confirmed hollow viscus perforation. - Introducing an endoscope with air insufflation could worsen the perforation and lead to further contamination of the peritoneal cavity, increasing morbidity and mortality.

GI US Medical PG Question 6: A 42-year-old man presents to the emergency department with abdominal pain. The patient was at home watching television when he experienced sudden and severe abdominal pain that prompted him to instantly call emergency medical services. The patient has a past medical history of obesity, smoking, alcoholism, hypertension, and osteoarthritis. His current medications include lisinopril and ibuprofen. His temperature is 98.5°F (36.9°C), blood pressure is 120/97 mmHg, pulse is 130/min, respirations are 22/min, and oxygen saturation is 97% on room air. The patient is in an antalgic position on the stretcher. His abdomen is rigid and demonstrates rebound tenderness and hypoactive bowel sounds. What is the next best step in management?

• A. CT of the abdomen
• B. Urgent laparoscopy
• C. NPO, IV fluids, and analgesics
• D. Urgent laparotomy (Correct Answer)
• E. Abdominal radiograph

GI Explanation: ***Urgent laparotomy*** - The patient's presentation with **sudden, severe abdominal pain**, a **rigid abdomen**, **rebound tenderness**, and **hypoactive bowel sounds** indicates **acute peritonitis**, most likely from a **perforated viscus**. - In a patient with **frank peritonitis** and clinical signs of perforation, the diagnosis is **made clinically** based on physical examination findings. - **Urgent laparotomy** (exploratory surgery) is the definitive management and should not be delayed for imaging when peritonitis is obvious. - The patient's risk factors (NSAID use, alcoholism) further support peptic ulcer perforation as the likely etiology. *CT of the abdomen* - While CT scan is highly sensitive for identifying perforation and can provide anatomic detail, it is **not necessary when the diagnosis of peritonitis is clinically evident**. - In a patient with **obvious peritonitis**, obtaining a CT scan would **delay definitive surgical treatment** without changing management. - CT is more appropriate for stable patients with **uncertain diagnosis** or equivocal physical findings, not for those with frank peritonitis. *Urgent laparoscopy* - **Laparoscopy** can be used diagnostically and therapeutically in selected cases of abdominal emergencies. - However, in a patient with diffuse peritonitis and suspected perforation, **laparotomy** is generally preferred over laparoscopy as it provides better exposure, faster source control, and easier peritoneal lavage. - Laparoscopy may be considered in stable patients with localized findings, but this patient has signs of diffuse peritonitis. *NPO, IV fluids, and analgesics* - These are **essential supportive measures** and should be initiated immediately as part of resuscitation. - However, they are **adjunctive** to definitive surgical management and do not constitute the "next best step" in a patient requiring emergency surgery. - These measures should be initiated concurrently while preparing for urgent laparotomy. *Abdominal radiograph* - An **upright chest X-ray** or **abdominal radiograph** can show **free air under the diaphragm** (pneumoperitoneum) in cases of perforation. - However, it is **only 50-70% sensitive**, meaning it misses many perforations. - In a patient with **clinical peritonitis**, the absence of free air on X-ray does **not rule out perforation** and should not delay surgery. - Imaging should not delay surgical intervention when peritonitis is clinically evident.

GI US Medical PG Question 7: A 28-year-old male presents to his primary care physician with complaints of intermittent abdominal pain and alternating bouts of constipation and diarrhea. His medical chart is not significant for any past medical problems or prior surgeries. He is not prescribed any current medications. Which of the following questions would be the most useful next question in eliciting further history from this patient?

• A. "Does the diarrhea typically precede the constipation, or vice-versa?"
• B. "Is the diarrhea foul-smelling?"
• C. "Please rate your abdominal pain on a scale of 1-10, with 10 being the worst pain of your life"
• D. "Are the symptoms worse in the morning or at night?"
• E. "Can you tell me more about the symptoms you have been experiencing?" (Correct Answer)

GI Explanation: ***Can you tell me more about the symptoms you have been experiencing?*** - This **open-ended question** encourages the patient to provide a **comprehensive narrative** of their symptoms, including details about onset, frequency, duration, alleviating/aggravating factors, and associated symptoms, which is crucial for diagnosis. - In a patient presenting with vague, intermittent symptoms like alternating constipation and diarrhea, allowing them to elaborate freely can reveal important clues that might not be captured by more targeted questions. *Does the diarrhea typically precede the constipation, or vice-versa?* - While knowing the sequence of symptoms can be helpful in understanding the **pattern of bowel dysfunction**, it is a very specific question that might overlook other important aspects of the patient's experience. - It prematurely narrows the focus without first obtaining a broad understanding of the patient's overall symptomatic picture. *Is the diarrhea foul-smelling?* - Foul-smelling diarrhea can indicate **malabsorption** or **bacterial overgrowth**, which are important to consider in some gastrointestinal conditions. - However, this is a **specific symptom inquiry** that should follow a more general exploration of the patient's symptoms, as it may not be relevant if other crucial details are missed. *Please rate your abdominal pain on a scale of 1-10, with 10 being the worst pain of your life* - Quantifying pain intensity is useful for assessing the **severity of discomfort** and monitoring changes over time. - However, for a patient with intermittent rather than acute, severe pain, understanding the **character, location, and triggers** of the pain is often more diagnostically valuable than just a numerical rating initially. *Are the symptoms worse in the morning or at night?* - Diurnal variation can be relevant in certain conditions, such as inflammatory bowel diseases where nocturnal symptoms might be more concerning, or functional disorders whose symptoms might be stress-related. - This is another **specific question** that should come after gathering a more complete initial picture of the patient's symptoms to ensure no key information is overlooked.

GI US Medical PG Question 8: A 54-year-old man presents with fever, abdominal pain, nausea, and bloody diarrhea. He says that his symptoms started 36 hours ago and have not improved. Past medical history is significant for a left-leg abscess secondary to an injury he sustained from a fall 4 days ago while walking his dog. He has been taking clindamycin for this infection. In addition, he has long-standing gastroesophageal reflux disease, managed with omeprazole. His vital signs include: temperature 38.5°C (101.3°F), respiratory rate 19/min, heart rate 90/min, and blood pressure 110/70 mm Hg. Which of the following is the best course of treatment for this patient’s most likely diagnosis?

• A. Tetracycline
• B. Ciprofloxacin
• C. Trimethoprim-sulfamethoxazole
• D. Erythromycin
• E. Vancomycin (Correct Answer)

GI Explanation: ***Vancomycin*** - The patient's history of recent **clindamycin** use for an abscess, development of **fever, abdominal pain, nausea, and bloody diarrhea**, and use of **omeprazole** (a risk factor), strongly suggests **_Clostridioides difficile_ infection (CDI)**. - **Oral vancomycin** is a first-line treatment for **severe non-fulminant CDI**, which this patient's symptoms (fever, bloody diarrhea) are consistent with. *Tetracycline* - **Tetracycline** is typically used for bacterial infections like **chlamydia, Lyme disease, and rickettsial infections**; it is not effective against _C. difficile_. - It works by **inhibiting bacterial protein synthesis** but does not target the cell wall of _C. difficile_. *Ciprofloxacin* - **Ciprofloxacin**, a fluoroquinolone, is generally **contraindicated in CDI** as it can be a risk factor for developing the infection or exacerbate it due to disruption of gut flora. - While effective against many gram-negative bacteria, it has **no significant activity against _C. difficile_**. *Trimethoprim-sulfamethoxazole* - **Trimethoprim-sulfamethoxazole** is a combination antibiotic used for various bacterial infections, including **UTIs and some respiratory infections**. - It is **not effective against _C. difficile_** and is not recommended for its treatment. *Erythromycin* - **Erythromycin**, a macrolide, is effective against a range of bacterial infections including **atypical pneumonia and skin infections**. - It has **no role in the treatment of _C. difficile_ infection** and its use could potentially further disrupt the gut microbiome.

GI US Medical PG Question 9: An otherwise healthy 56-year-old woman comes to the physician because of a 3-year history of intermittent upper abdominal pain. She has had no nausea, vomiting, or change in weight. Physical examination shows no abnormalities. Laboratory studies are within normal limits. Abdominal ultrasonography shows a hyperechogenic rim-like calcification of the gallbladder wall. The finding in this patient's ultrasonography increases the risk of which of the following conditions?

• A. Gallbladder empyema
• B. Pyogenic liver abscess
• C. Gallbladder carcinoma (Correct Answer)
• D. Hepatocellular carcinoma
• E. Acute pancreatitis

GI Explanation: ***Gallbladder carcinoma*** - The hyperechogenic rim-like calcification of the gallbladder wall described is characteristic of a **porcelain gallbladder**. - A **porcelain gallbladder** significantly increases the risk of developing adenocarcinoma of the gallbladder, making regular surveillance or prophylactic cholecystectomy often recommended. *Gallbladder empyema* - **Gallbladder empyema** is characterized by the presence of pus within the gallbladder, usually due to severe acute cholecystitis with bacterial infection and obstruction. - While it would present with pain, it's typically associated with **fever, leukocytosis**, and more acute, severe symptoms, not primarily a calcified wall. *Pyogenic liver abscess* - **Pyogenic liver abscess** is a collection of pus in the liver, often caused by bacterial infection spreading from the biliary tract or other abdominal infections. - This condition would typically present with **fever, right upper quadrant pain, and abnormal liver function tests**, none of which are indicated by a calcified gallbladder wall. *Hepatocellular carcinoma* - **Hepatocellular carcinoma (HCC)** is a primary liver cancer, most commonly associated with chronic liver diseases like **hepatitis B, hepatitis C, or cirrhosis**. - It is not directly linked to gallbladder calcification and would not be increased by the finding of a porcelain gallbladder. *Acute pancreatitis* - **Acute pancreatitis** is inflammation of the pancreas, often caused by gallstones or alcohol abuse, presenting with severe epigastric pain radiating to the back, nausea, and elevated lipase/amylase. - While gallstones can cause pancreatitis, a calcified gallbladder wall itself does not directly increase the risk of acute pancreatitis compared to the general risk of gallstone disease.

GI US Medical PG Question 10: A 54-year-old woman comes to the physician because of a painful skin lesion on her right leg for 1 month. It initially started out as a small red spot but has rapidly increased in size during this period. She remembers an ant bite on her leg prior to the lesion occurring. She was treated for anterior uveitis 8 months ago with corticosteroids. She has Crohn's disease, type 2 diabetes mellitus, and hypertension. Current medications include insulin, mesalamine, enalapril, and aspirin. She returned from Wisconsin after visiting her son 2 months ago. Her temperature is 37.6°C (98°F), pulse is 98/min, and blood pressure is 126/88 mm Hg. Examination shows pitting pedal edema of the lower extremities. There is a 4-cm tender ulcerative lesion on the anterior right leg with a central necrotic base and purplish irregular borders. There are dilated tortuous veins in both lower legs. Femoral and pedal pulses are palpated bilaterally. Which of the following is the most likely diagnosis?

• A. Pyoderma gangrenosum (Correct Answer)
• B. Basal cell carcinoma
• C. Squamous cell carcinoma
• D. Ecthyma gangrenosum
• E. Blastomycosis

GI Explanation: ***Pyoderma gangrenosum*** - The patient's history of **Crohn's disease**, **anterior uveitis**, and a rapidly progressing, **tender ulcerative lesion** with a **necrotic base** and **purplish irregular borders** are highly characteristic of pyoderma gangrenosum. - The phenomenon of **pathergy** (exacerbation of lesions after minor trauma like a bug bite) further supports this diagnosis. *Basal cell carcinoma* - Typically presents as a **slow-growing lesion** with **pearly borders** and **telangiectasias**, not a rapidly enlarging, tender ulcer with a necrotic base. - It is often associated with sun exposure and rarely presents with the systemic associations seen in this case. *Squamous cell carcinoma* - Usually appears as a **scaly, erythematous patch** or an **indurated nodule** that may ulcerate, but it is generally a chronic lesion and less acutely painful or rapidly progressing. - While it can be aggressive, the clinical presentation and rapid progression with a necrotic center and systemic associations point away from this diagnosis. *Ecthyma gangrenosum* - This condition is caused by **Pseudomonas aeruginosa bacteremia** and is characterized by a central necrotic area surrounded by an erythematous halo, typically in immunocompromised patients. - While there is some overlap in appearance, ecthyma gangrenosum is usually associated with **sepsis** and systemic signs of infection, which are not prominent here. *Blastomycosis* - A **fungal infection** endemic to the Great Lakes region (including Wisconsin), which can cause skin lesions that may be verrucous, ulcerative, or plaque-like. - However, the description of a rapidly progressing, deeply ulcerative lesion with purplish, undermined borders and strong association with inflammatory bowel disease is more consistent with pyoderma gangrenosum.

GI Flashcard 1 of 10

Question: _____ syndrome presents with a grossly black liver, but is otherwise not clinically significant

Answer: Dubin-Johnson

GI Flashcard 2 of 10

Question: _____ gastric ulcers are usually large and irregular with heaped up margins

Answer: Malignant

GI Flashcard 3 of 10

Question: _____ gastritis arises due to imbalance between mucosal defenses and acidic environment

Answer: Acute

GI Flashcard 4 of 10

Question: _____ gastritis occurs due to acidic damage to the stomach mucosa

Answer: Acute

GI Flashcard 5 of 10

Question: Budd-Chiari syndrome results in congestion and necrosis of the _____ zone of the liver

Answer: centrilobular

GI Flashcard 6 of 10

Question: Is the intestinal metaplasia seen with H. pylori gastritis reversible? _____

Answer: Yes (resolves with treatment of infection)

GI Flashcard 7 of 10

Question: Acute mesenteric ischemia may occur due to a thrombotic or embolic occlusion of the _____ artery

Answer: superior mesenteric

Extra Information:   * SMA= top red pole on boat, IMA just below Watch Intestinal Ischemia & Angiodysplasia [https://dashboard.sketchy.com/study/medical/courses/medical-pathophysiology/units/medical-pathophysiology-gi/videos/medical-pathophysiology-gi-small-bowel-disorders-intestinal-ischemia-and-angiodysplasia?utm_source=anki&utm_medium=partnership&utm_campaign=february_update&utm_content=medical]Watch associated Bootcamp video [https://app.bootcamp.com/med-school/gastroenterology/videos/colorectal-pathology?index=7] https://onlinemeded.org/spa/gastroenterology/gi-bleed/acquire?ref=anki 

GI Flashcard 8 of 10

Question: _____ gastritis occurs due to acidic damage to the stomach mucosa

Answer: Acute

Extra Information:   Watch Acute & Chronic Gastritis & Peptic Ulcer Disease [https://dashboard.sketchy.com/study/medical/courses/medical-pathophysiology/units/medical-pathophysiology-gi/videos/medical-pathophysiology-gi-esophageal-and-gastric-disorders-acute-and-chronic-gastritis-and-peptic-ulcer-disease?utm_source=anki&utm_medium=partnership&utm_campaign=february_update&utm_content=medical]Watch associated Bootcamp video [https://app.bootcamp.com/med-school/gastroenterology/videos/esophageal-and-gastric-pathology?index=12] https://onlinemeded.org/spa/psychiatry?ref=anki  Ischemic colitis Colonoscopy A pale mucous membrane and a loss of vascular pattern can be seen. One large and multiple smaller fibrin-covered ulcerations are also visible (green overlay). These findings are consistent with ischemic colitis. Robbins: 

GI Flashcard 9 of 10

Question: Histopathologic findings of Microsporidium include small spores with a(n) _____ or _____ structure

Answer: diagonal

Extra Information:  https://onlinemeded.org?ref=anki 

GI Flashcard 10 of 10

Question: Schistosoma mansoni and japonicum can cause _____ hypertension

Answer: portal

Extra Information:   Watch Trematodes [https://dashboard.sketchy.com/study/medical/courses/medical-microbiology/units/medical-microbiology-parasites/videos/medical-microbiology-parasites-helminths-trematodes-and-cestodes-trematodes?utm_source=anki&utm_medium=partnership&utm_campaign=february_update&utm_content=medical] https://onlinemeded.org/spa/microbiology/helminths/acquire?ref=anki