[qwiz style=” width: 100% !important; !important; min-height: auto !important; border-width: 4px !important; border-color: #0099cc !important; ” align=”center” spacing=”5″]
[h] Gastroenterology Flashcards
[i] Master EL Husseiny’s Essentials of Gastroenterology in just 2 hours.
[q] …….. gives rise to the esophagus, stomach, liver, gallbladder, pancreas, and upper duodenum. These organs are supplied by ……
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFRoZSBmb3JlZ3V0LCB0aGUgY2VsaWFjIHRydW5rLg==
Cg==Cg==[Qq][q] ….. give rise to lower duodenum, small intestine, ascending colon, and proximal 2/3 of the transverse colon. These organs are supplied by …..
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFRoZSBtaWRndXQsIHRoZSBzdXBlcmlvciBtZXNlbnRlcmljIGFydGVyeSAoU01BKS4=
Cg==Cg==[Qq][q] …… give rise to the distal third of the transverse colon, descending, and sigmoid colon. These organs are supplied by ….
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFRoZSBoaW5kZ3V0LCB0aGUgaW5mZXJpb3IgbWVzZW50ZXJpYyBhcnRlcnkgKElNQSku
Cg==Cg==[Qq][q] This midgut rotation allows for the proper placement and fixation of the intestine in the abdominal cavity on a wide-based mesentery. Abnormal rotation and fixation of the midgut early during fetal life results in intestinal malrotation. Two main manifestations of this condition are ……. and ……?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEludGVzdGluYWwgb2JzdHJ1Y3Rpb24gKGR1ZSB0byBjb21wcmVzc2lvbiBieSB0aGUgYWRoZXNpdmUgYmFuZHMpIGFuZCBtaWRndXQgdm9sdnVsdXMgKGludGVzdGluYWwgaXNjaGVtaWEgZHVlIHRvIHR3aXN0aW5nIGFyb3VuZCB0aGUgYmxvb2QgdmVzc2Vscyku
Cg==Cg==[Qq][q] Failure of Rostral fold closure results in ……?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFN0ZXJuYWwgZGVmZWN0cw==[Qq]
[q] Failure of Lateral fold closure results in ……?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IE9tcGhhbG9jZWxlLCBnYXN0cm9zY2hpc2lzLg==[Qq]
[q] Failure of Caudal fold closure results in ……?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEJsYWRkZXIgZXhzdHJvcGh5Lg==[Qq]
[q] What is the most likely diagnosis?
A newborn child born with bowel herniation with no sac covering on the right of the umbilicus?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEdhc3Ryb3NjaGlzaXMgKGNvbmdlbml0YWwgYWJkb21pbmFsIHdhbGwgZGVmZWN0KS4=
Cg==Cg==R2FzdHJvc2NoaXNpcyByZXN1bHRzIGluIHRoZSBib3dlbCBiZWluZyBleHBvc2VkIHRvIGFtbmlvdGljIGZsdWlkIHdoaWNoIGNhdXNlcyBpbmZsYW1tYXRpb24gYW5kIGVkZW1hIG9mIHRoZSBib3dlbCB3YWxsLiBHYXN0cm9zY2hpc2lzIGlzIGFzc29jaWF0ZWQgd2l0aCBpbmNyZWFzZWQgcmlzayBvZiBjb21wbGljYXRpb24u
[Qq][q] What is the most likely diagnosis?
A newborn child born with bowel herniation surrounded by peritoneum, Karyotype testing of the patient shows trisomy 13?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IE9tcGhhbG9jZWxlLiBJdCByZXN1bHRzIGZyb20gZmFpbHVyZSBvZiB0aGUgR0kgc2FjIHRvIHJldHJhY3QgYXQgMTAtMTIgd2Vla3MgZ2VzdGF0aW9uLg==
Cg==Cg==[Qq][q] What is the most likely diagnosis?
African American newborn that was born prematurely presenting with soft, non-tender bulge covered by skin that protrudes during crying, coughing, or straining?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IENvbmdlbml0YWwgdW1iaWxpY2FsIGhlcm5pYS4gQW4gdW1iaWxpY2FsIGhlcm5pYSBpcyBkdWUgdG8gaW5jb21wbGV0ZSBjbG9zdXJlIG9mIHRoZSBhYmRvbWluYWwgbXVzY2xlcyBhcm91bmQgdGhlIHVtYmlsaWNhbCByaW5nIGF0IGJpcnRoLg==[Qq]
[q] What is the most likely diagnosis?
A newborn child presenting with vomiting with first feeding, choking/coughing and cyanosis, mother has history of polyhydramnios in her prenatal period, Coiling of the NG tube seen on CXR and an inability to pass it into the stomach, abdomen x-rays shows prominent gastric bubble?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEVzb3BoYWdlYWwgYXRyZXNpYSAoRUEpIHdpdGggZGlzdGFsIHRyYWNoZW9lc29waGFnZWFsIGZpc3R1bGEgKFRFRiku
Cg==Cg==[Qq][q] What is the most likely diagnosis?
2 months age old male child presenting with Nonbilious projectile vomiting after formula feeding+ during examination there is palpable mass the size of an olive felt in the epigastric region + abdominal auscultation reveals a succussion splash sound + ABG shows hypochloremic, hypokalemic metabolic alkalosis?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEh5cGVydHJvcGhpYyBweWxvcmljIHN0ZW5vc2lzLg==
Cg==Cg==[Qq][q] What is the most likely diagnosis?
A newborn child presenting with bilious vomiting and dilation of stomach and proximal duodenum + “double bubble” on x-ray and no distal intestinal gas + Prenatal ultrasound shows polyhydramnios + karyotype analysis of the child shows trisomy 21?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IER1b2RlbmFsIGF0cmVzaWEuIExhY2sgb3IgYWJzZW5jZSBvZiBhcG9wdG9zaXMgKHByb2dyYW1tZWQgY2VsbCBkZWF0aCkgdGhhdCBsZWFkcyB0byA=aW1wcm9wZXIgY2FuYWxpemF0aW9uIG9mIHRoZSBsdW1lbiBvZiB0aGUgZHVvZGVudW0=ICYjODIxMjsmZ3Q7IGR1b2RlbmFsIGF0cmVzaWEu
Cg==[Qq]
[q] What is the most likely diagnosis?
A newborn child presenting with bilious vomiting and dilation of stomach, duodenum and jejunum + “triple bubble” on x-ray and no distal intestinal gas + Prenatal ultrasound shows polyhydramnios + history of maternal use of cocaine?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEplanVuYWwgYW5kIGlsZWFsIGF0cmVzaWEuIEF0cmVzaWEgb2YgdGhlIGplanVudW0gb3IgaWxldW0gaXMgdGhvdWdodCB0byBvY2N1ciBkdWUgdG8gYSA=dmFzY3VsYXIgYWNjaWRlbnQgaW4gdXRlcm8=IHRoYXQgY2F1c2VzIG5lY3Jvc2lzIGFuZCByZXNvcnB0aW9uIG9mIHRoZSBmZXRhbCBpbnRlc3RpbmUsIHNlYWxpbmcgb2ZmIGFuZCBsZWF2aW5nIGJlaGluZCBibGluZCBwcm94aW1hbCBhbmQgZGlzdGFsIGVuZHMgb2YgaW50ZXN0aW5lIChib3dlbCBkaXNjb250aW51aXR5IG9yIOKAnGFwcGxlIHBlZWzigJ0pLg==
Cg==[Qq]
[q] If a major vessel is occluded, (such as the superior mesenteric artery), the area of intestinal wall necrosis is large. This causes the formation of a blind-ending proximal jejunum with dissolution of a long length of small bowel and absence of the associated dorsal mesentery. The terminal ileum distal to the atresia assumes a spiral configuration around an ileocolic vessel. This specific appearance is known as ……?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IMKgJiM4MjIwO2FwcGxlLXBlZWwmIzgyMjE7IG9yICYjODIyMDtDaHJpc3RtYXMgdHJlZSYjODIyMTsgZGVmb3JtaXR5Lg==
Cg==Cg==[Qq][q] ……. arises in the dorsal mesentery of stomach (hence is mesodermal) but has foregut supply.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFNwbGVlbi4=[Qq]
[q] Pancreas is derived from (foregut, midgut, hindgut)?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGZvcmVndXQu[Qq]
[q] ………. contribute to uncinate process and main pancreatic duct.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFZlbnRyYWwgcGFuY3JlYXRpYyBidWQu[Qq]
[q] ….. alone becomes the body, tail, isthmus, and accessory pancreatic duct.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IERvcnNhbCBwYW5jcmVhdGljIGJ1ZC4=[Qq]
[q] Pancreas divisum occurs when the ventral and dorsal pancreatic buds ……; the pancreatic secretions are instead drained via two separate duct systems.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEZhaWwgdG8gZnVzZS4gTW9zdGx5IGFzeW1wdG9tYXRpYywgYnV0IG1heSBjYXVzZSBjaHJvbmljIGFiZG9taW5hbCBwYWluIGFuZC9vciBwYW5jcmVhdGl0aXMu
Cg==Cg==[Qq][q] ….. leads to an annular pancreas, a rare congenital anomaly that can compress the duodenal lumen, causing duodenal stenosis or result in obstructed pancreatic drainage (acute or chronic pancreatitis).
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEFibm9ybWFsIG1pZ3JhdGlvbiBvZiB0aGUgdmVudHJhbCBwYW5jcmVhdGljIGJ1ZC4=
Cg==Cg==[Qq][q] What is the most likely diagnosis?
A newborn child presenting with inability to pass meconium + during examination there is abnormal development of anorectal structures.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEltcGVyZm9yYXRlIGFudXMu
Cg==Cg==[Qq][q] …… occurs due to complete failure of the vitelline duct to close. Meconium discharge from the umbilicus is seen soon after birth.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFBlcnNpc3RlbnQgdml0ZWxsaW5lIGR1Y3QsIG9yIHZpdGVsbGluZSBmaXN0dWxhLg==
Cg==Cg==[Qq][q] …… results from a partial closure of the vitelline duct, with the patent portion open at the umbilicus.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFZpdGVsbGluZSBzaW51cy4=
Cg==Cg==[Qq][q] ……. forms if peripheral portions of the vitelline duct (connected to the ileum and umbilicus) obliterate, but the central part remains.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFZpdGVsbGluZSBkdWN0IGN5c3QgKGVudGVyb2N5c3QpLg==
Cg==Cg==[Qq][q] What is the most likely diagnosis?
3 years old male child presenting with colicky abdominal pain and “currant jelly” stools + 99mmTc-pertechnetate scan detects Accumulation of pertechnetate in the right lower abdominal quadrant + imaging shows outpouching 2 inches in length, 2 feet from the ileocecal valve?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IE1lY2tlbCYjODIxNztzIGRpdmVydGljdWx1bS4=[Qq]
[q] In contrast to false diverticula, which contain mucosa and submucosa only, …… is a true diverticulum, consisting of all three parts of the intestinal wall: mucosa, submucosa, and muscularis.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IE1lY2tlbCYjODIxNztzIGRpdmVydGljdWx1bS4=
Cg==Cg==[Qq][q] Meckel’s diverticulum is an example of ……?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEVjdG9weSAoYWxzbyBjYWxsZWQgaGV0ZXJvdG9weSkuICYjODIyMDtFY3RvcHkmIzgyMjE7IGlzIGEgdGVybSB0aGF0IGlkZW50aWZpZXMgbWljcm9zY29waWNhbGx5IGFuZCBmdW5jdGlvbmFsbHkgbm9ybWFsIGNlbGxzL3Rpc3N1ZXMgZm91bmQgaW4gYW4gYWJub3JtYWwgbG9jYXRpb24gZHVlIHRvIGVtYnJ5b25pYyBtYWxkZXZlbG9wbWVudC4=[Qq]
[q] What is the most likely diagnosis?
A newborn child presenting with inability to pass meconium within 48 hours of birth, bilious vomiting and abdominal distention, the tone of the anal sphincter is increased + The submucosa of rectum was biopsied and shows absence of ganglionic cells?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEhpcnNjaHNwcnVuZyBkaXNlYXNlLg==
Cg==Cg==VGhlIGFycmVzdCBvZiBtaWdyYXRpb24gb2YgbmV1cmFsIGNyZXN0IGNlbGxzIGNhdXNlcyBIaXJzY2hzcHJ1bmcgZGlzZWFzZSwgaW4gd2hpY2ggYSBzZWdtZW50IG9mIGNvbG9uIGlzIGRlcHJpdmVkIG9mIGdhbmdsaW9uIGNlbGxzLg==
[Qq]Since neural crest cells migrate caudally, the rectum is always involved in Hirschsprung disease.
[q] …….. lines the body wall and covers the retroperitoneal organs on one surface and is very sensitive to somatic pain and is innervated by the lower intercostal nerves and the ilioinguinal and the iliohypogastric nerves of the lumbar plexus.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFBhcmlldGFsIGxheWVyIChQYWluIHNlbnNpdGl2ZSkgb2YgcGVyaXRvbmV1bS4=
Cg==Cg==[Qq][q] …… encloses the surfaces of the intraperitoneal organs and usually forms double-layered peritoneal membranes (mesenteries) that suspend parts of the GI tract from the body wall.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFRoZSB2aXNjZXJhbCBsYXllciBvZiBwZXJpdG9uZXVtLg==[Qq]
[q] ….. is the potential space located between the parietal and visceral peritoneal layers. The 90° rotation and the shift of the embryonic mesenteries divide tit into 2 sacs (lesser sac, greater sac).
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFRoZSBwZXJpdG9uZWFsIGNhdml0eS4=
Cg==Cg==[Qq][q] – The only communication between the lesser sac and the greater sac is ……..?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHRoZSBlcGlwbG9pYyBmb3JhbWVuIChvZiBXaW5zbG93KS4=
Cg==Jm5ic3A7
Cg==[Qq]
[q] …… are suspended by a mesentery and are almost completely enclosed in visceral peritoneum. They are mobile.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEludHJhcGVyaXRvbmVhbCBvcmdhbnMu
Cg==Cg==[Qq][q] ….. are partially covered on one side with parietal peritoneum. They are immobile or fixed.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFJldHJvcGVyaXRvbmVhbCBvcmdhbnMu
Cg==Jm5ic3A7
Cg==[Qq]
[q] Which type of gastrointestinal ligaments?
Connects: Liver to lesser curvature of Stomach.
Structures Contained: Gastric arteries.
Part of lesser omentum.
Separates greater and lesser sacs on the right.
May be cut during surgery to access lesser sac.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEdhc3Ryb2hlcGF0aWMgbGlnYW1lbnQu
Cg==Cg==[Qq][q] Which type of gastrointestinal ligaments?
Connects: Liver to duodenum.
Structures Contained: Portal triad (proper hepatic artery, portal vein, common bile duct).
May be compressed between thumb and index finger placed in omental foramen to control bleeding (Pringle maneuver).
Borders the omental foramen, which connects the greater and lesser sacs.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEhlcGF0b2R1b2RlbmFsIGxpZ2FtZW50Lg==
Cg==Jm5ic3A7
Cg==[Qq]
[q] Which type of gastrointestinal ligaments?
Connects: Liver to anterior abdominal Wall.
Structures Contained: Ligamentum teres hepatis (derivative of fetal umbilical vein).
Derivative of ventral mesentery.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEZhbGNpZm9ybSBsaWdhbWVudC4=
Cg==Cg==[Qq][q] Which type of gastrointestinal ligaments?
Connects: Greater curvature and transverse colon.
Structures Contained: Gastroepiploic arteries.
Part of greater omentum.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEdhc3Ryb2NvbGljIGxpZ2FtZW50Lg==
Cg==Cg==[Qq][q] Which type of gastrointestinal ligaments?
Connects: Greater curvature and spleen.
Structures Contained: Short gastrics, left gastroepiploic vessels.
Separates greater and lesser sacs on the left.
Part of greater omentum.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEdhc3Ryb3NwbGVuaWMgbGlnYW1lbnQu
Cg==Cg==[Qq][q] Which type of gastrointestinal ligaments?
Connects: Spleen to posterior abdominal Wall.
Structures Contained: Splenic artery and vein, tail of Pancreas.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFNwbGVub3JlbmFsIGxpZ2FtZW50Lg==[Qq]
[q] The adjustable gastric band is an inflatable silicone device placed around the gastric cardia. It is intended to slow the passage of food, increasing satiety and limiting the amount of food consumed. To encircle the upper stomach, the gastric band must pass through ……..?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHRoZSBsZXNzZXIgb21lbnR1bS4=
Cg==Cg==[Qq][q] In the setting of traumatic liver injury with persistent bleeding, occlusion of the hepatoduodenal ligament can be performed to identify the vascular source (the Pringle maneuver). If liver bleeding does not cease when the portal triad is occluded, it is likely that there has been injury to ….. or …….?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHRoZSBpbmZlcmlvciB2ZW5hIGNhdmEgb3IgaGVwYXRpYyB2ZWlucy4=
Cg==Cg==[Qq][q] What is the most likely diagnosis?
35 years old patient who has recent weight loss of more than 50 kg presenting with vomiting, abdominal pain and distension + Narrowing of the aortomesenteric angle < 15?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFN1cGVyaW9yIG1lc2VudGVyaWMgYXJ0ZXJ5IHN5bmRyb21lLiBPY2N1cnMgd2hlbiB0aGUgdHJhbnN2ZXJzZSBwb3J0aW9uIG9mIHRoZSBkdW9kZW51bSBpcyBlbnRyYXBwZWQgYmV0d2VlbiB0aGUgU01BIGFuZCBhb3J0YSwgY2F1c2luZyBzeW1wdG9tcyBvZiBwYXJ0aWFsIGludGVzdGluYWwgb2JzdHJ1Y3Rpb24u
Cg==Cg==[Qq][q] What is the most likely diagnosis?
35 years old patient who has recent weight loss of more than 50 kg presenting with abdominal (flank) pain and gross hematuria + Narrowing of the aortomesenteric angle < 15?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IE51dGNyYWNrZXIgc3luZHJvbWUu
Cg==Cg==[Qq][q] Name Two areas of the colon that have dual blood supply from distal arterial branches (“watershed regions”) → susceptible in colonic ischemia following an episode of hypotension (Ischemic colitis is a common complication of vascular surgery)?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]
Cg==JiM4MjExOyBTcGxlbmljIGZsZXh1cmU6IFNNQSBhbmQgSU1BLg==
CiYjODIxMTsgUmVjdG9zaWdtb2lkIGp1bmN0aW9uOiB0aGUgbGFzdCBzaWdtb2lkIGFydGVyaWFsIGJyYW5jaCBmcm9tIHRoZSBJTUEgYW5kIHN1cGVyaW9yIHJlY3RhbCBhcnRlcnku
Cg==[Qq]
[q] Small bowel malignancies are rare; if they occur in the third part of the duodenum, anterior tumor invasion could compromise ……?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHRoZSBzdXBlcmlvciBtZXNlbnRlcmljIHZlc3NlbHMu
Cg==Cg==[Qq][q] Short gastric and left gastroepiploic branches of the stomach are branches of …… artery.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFRoZSBzcGxlbmljIGFydGVyeS4=
Cg==Cg==[Qq][q] The right gastric and right gastroepiploic branches of the stomach are branches of …… artery.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFRoZSBjb21tb24gaGVwYXRpYyBhcnRlcnku
Cg==Cg==[Qq][q] The short gastric arteries have very poor anastomoses, and the tissue supplied by them is vulnerable to ischemic injury following ……..?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHNwbGVuaWMgYXJ0ZXJ5IGJsb2NrYWdlLg==[Qq]
[q] Chronic portal hypertension leads to dilation of small, pre-existing vascular channels between the portal and systemic circulations. These dilated collateral vessels (portosystemic anastomoses) commonly form in the anterior abdomen —> ……., lower rectum —> …… , and inferior end of the esophagus —> ….
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGNhcHV0IG1lZHVzYWUsIGFub3JlY3RhbCB2YXJpY2VzLCBlc29waGFnZWFsIHZhcmljZXMu
Cg==Jm5ic3A7
Cg==[Qq]
[q] Treatment with a ……. between the portal vein and hepatic vein relieves portal hypertension by shunting blood to the systemic circulation, bypassing the liver. Can precipitate hepatic encephalopathy.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHRyYW5zanVndWxhciBpbnRyYWhlcGF0aWMgcG9ydG9zeXN0ZW1pYyBzaHVudCAoVElQUyku
Cg==Cg==[Qq][q] The dilated collateral vessels (portosystemic anastomoses) in Esophageal varices are ….. and …..?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IExlZnQgZ2FzdHJpYyDihpQgYXp5Z29zLg==
Cg==Cg==[Qq][q] The dilated collateral vessels (portosystemic anastomoses) in Caput medusae are ….. and …..?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFBhcmF1bWJpbGljYWwg4oaUIHNtYWxsIGVwaWdhc3RyaWMgdmVpbnMgb2YgdGhlIGFudGVyaW9yIGFiZG9taW5hbCB3YWxsLg==
Cg==Cg==[Qq][q] The dilated collateral vessels (portosystemic anastomoses) in Anorectal varices are ….. and …..?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFN1cGVyaW9yIHJlY3RhbCDihpQgbWlkZGxlIGFuZCBpbmZlcmlvciByZWN0YWwu
Cg==Cg==[Qq][q] ………. can increase pressure in the short gastric veins and cause gastric varices only in the fundus. The rest of the stomach and esophagus are usually not affected (isolated gastric varices).
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFNwbGVuaWMgdmVpbiB0aHJvbWJvc2lzLg==
Cg==Cg==VGhlIHZhcmljZXMgYXJlIGNvbW1vbmx5IGR1ZSB0byBwb3J0YWwgaHlwZXJ0ZW5zaW9uLCB3aGljaCBjYW4gYmUgYSBjb21wbGljYXRpb24gb2YgY2lycmhvc2lzLiBHYXN0cmljIHZhcmljZXMgY2FuIGFsc28gYmUgc2VlbiB3aXRoIHNwbGVuaWMgdmVpbiB0aHJvbWJvc2lzIGR1ZSB0byBjaHJvbmljIHBhbmNyZWF0aXRpcywgcGFuY3JlYXRpYyBjYW5jZXIsIGFuZCBhYmRvbWluYWwgdHVtb3JzLg==
[Qq]
[q] External hemorrhoids originate below the dentate line, are covered by modified squamous epithelium and have cutaneous (somatic) nervous innervation from the inferior rectal nerve, a branch of …….?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHRoZSBwdWRlbmRhbCBuZXJ2ZS4=
Cg==Cg==[Qq][q] Internal hemorrhoids originate above the dentate line and are covered by columnar epithelium. They have autonomic innervation from the …….., which is only sensitive to stretch and not pain, temperature, or touch.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGluZmVyaW9yIGh5cG9nYXN0cmljIHBsZXh1cy4=
Cg==Cg==[Qq][q] The type of epithelium of esophagus is ……..?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IE5vbmtlcmF0aW5pemVkIHN0cmF0aWZpZWQgc3F1YW1vdXMgZXBpdGhlbGl1bS4=[Qq]
[q] The surface of stomach is lined by ….. epithelium.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHNpbXBsZSBjb2x1bW5hci4=[Qq]
[q] Oxyntic or parietal cells secrete ….. into the stomach lumen in response to histamine, gastrin, and acetylcholine. These cells also secrete ….. (a glycoprotein necessary for absorption of vitamin B12).
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEhDbCwgaW50cmluc2ljIGZhY3Rvci4=
Cg==Cg==[Qq][q] ….. secrete pepsinogen, an enzyme precursor that is stored in secretory (zymogen) granules before its induced secretion. Low pH, in the stomach lumen, converts pepsinogen to pepsin.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IENoaWVmIG9yIHBlcHRpYyBjZWxscy4=
Cg==Cg==[Qq][q] ….. are lymphoid aggregates specific to the ileum in lamina propria and submucosa.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFBleWVyIHBhdGNoZXMu[Qq]
[q] Excess gastric acid secretion, such as seen in Helicobacter pylori infection, can cause increased production of secretin that, over time, can lead to hyperplasia of ……
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHRoZSBzdWJtdWNvc2FsIGdsYW5kcy4=[Qq]
[q] When stimulated during liver injury, …… may release type I collagen and other matrix components into the space of Disse, contributing to scarring of the liver in some diseases (cirrhosis due to ethanol).
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEhlcGF0aWMgc3RlbGxhdGUgKEl0bykgY2VsbHMu[Qq]
[q] Zone …. is affected 1st by viral hepatitis.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFpvbmUgSSAocGVyaXBvcnRhbCB6b25lKS4=
Cg==Cg==[Qq][q] Zone …. is the zone affected by Yellow fever.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]wqBab25lIElJIChpbnRlcm1lZGlhdGUgem9uZSku
Cg==Cg==[Qq][q] Zone …. is affected 1st by viral ischemia, Contains cytochrome P-450 system, Most sensitive to metabolic toxins (ethanol, CCl4, halothane, rifampin, acetaminophen).
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFpvbmUgSUlJOiBwZXJpY2VudHJhbCB2ZWluIChjZW50cmlsb2J1bGFyKSB6b25lLg==
Cg==Cg==[Qq][q] What is the most likely diagnosis?
Newborn child presenting with respiratory distress (tachypnea, cyanosis, retractions), accompanied by absent breath sounds on left side of the chest + barrel-shaped chest and scaphoid abdomen + Bowel sounds are heard in chest + chest x-ray shows intrathoracic bowel loops and a displaced cardiac silhouette.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IENvbmdlbml0YWwgRGlhcGhyYWdtYXRpYyBoZXJuaWEu[Qq]
[q] ……. is a defect in the diaphragm that results from incomplete fusion of the pleuroperitoneal folds during fetal development.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IENvbmdlbml0YWwgZGlhcGhyYWdtYXRpYyBoZXJuaWEgKENESCku[Qq]
[q] What is the most likely diagnosis?
27 years old patient with history of chronic cough presenting with heartburn, regurgitation, epigastric/chest pain + imaging shows Gastroesophageal junction is displaced upward as gastric cardia slides into hiatus “hourglass stomach”.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFNsaWRpbmcgaGlhdGFsIGhlcm5pYS4=
Cg==Cg==VGhlIGRpc3RhbCBlc29waGFndXMgaXMgbm9ybWFsbHkgYXR0YWNoZWQgY2lyY3VtZmVyZW50aWFsbHkgdG8gdGhlIGRpYXBocmFnbSBieSB0aGUgcGhyZW5vZXNvcGhhZ2VhbCBtZW1icmFuZSBhdCB0aGUgZ2FzdHJvZXNvcGhhZ2VhbCAoR0UpIGp1bmN0aW9uOyBkaXNydXB0aW9ucyBpbiBtZW1icmFuZSBpbnRlZ3JpdHkgY2FuIHJlc3VsdCBpbiBoZXJuaWEgZm9ybWF0aW9uIHdoaWNoIHR5cGljYWxseSByZXN1bHRzIGZyb20gcmVwZXRpdGl2ZSBzdHJlc3Mgb24gdGhlIG1lbWJyYW5lIChjb3VnaGluZywgdm9taXRpbmcpLg==
[Qq][q] In …….., gastroesophageal junction is usually normal but gastric fundus protrudes into the thoracic cavity.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFBhcmFlc29waGFnZWFsIGhpYXRhbCBoZXJuaWEu
Cg==Cg==[Qq][q] What is the most likely diagnosis?
3 years old male child presenting with bulge on the groin that increases during straining + the herniated bowel goes through the internal (deep) inguinal ring, external (superficial) inguinal ring, and into the scrotum. Enters internal inguinal ring lateral to inferior epigastric vessels + Covered by all 3 layers of spermatic fascia?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEluZGlyZWN0IGluZ3VpbmFsIGhlcm5pYS4=
Cg==Cg==RmFpbHVyZSBvZiBvYmxpdGVyYXRpb24gb2YgdGhlIHByb2Nlc3N1cyB2YWdpbmFsaXMgbGVhZHMgdG8gYSBwZXJzaXN0ZW50IGNvbm5lY3Rpb24gYmV0d2VlbiB0aGUgc2Nyb3R1bSBhbmQgdGhlIHBlcml0b25lYWwgY2F2aXR5IHRocm91Z2ggdGhlIGluZ3VpbmFsIGNhbmFsLg==
[Qq]If the opening is small and allows for fluid leakage only, hydrocele occurs. Diagnosis is by transillumination of the scrotum and scrotal ultrasound, which reveal fluid (only) in the tunica vaginalis sac.
[q] What is the most likely diagnosis?
55 years old male patient presenting with bulge on the groin that increases during straining + the herniated bowel goes through the external (superficial) inguinal ring only, medial to inferior epigastric vessels, and Covered by external spermatic fascia?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IERpcmVjdCBpbmd1aW5hbCBoZXJuaWEu
Cg==VXN1YWxseSBpbiBvbGRlciBtZW4gZHVlIHRvIGFuIGFjcXVpcmVkIHdlYWtuZXNzIGluIHRoZSB0cmFuc3ZlcnNhbGlzIGZhc2NpYS4=
Cg==[Qq]
[q] What is the most likely diagnosis?
35 years old female patient presenting with bulge on the groin that increases during straining + the herniated bowel Protrudes below inguinal ligament through femoral canal below and lateral to pubic tubercle?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEZlbW9yYWwgaGVybmlhLg==
Cg==Cg==[Qq][q] Any abdominal process (ruptured spleen, peritonitis, hemoperitoneum) irritating the sensory fibers around the diaphragm can cause referred shoulder pain via …… to the C3-C5 shoulder region (Kehr sign).
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHRoZSBwaHJlbmljIG5lcnZlLg==[Qq]
[q] As the inferior epigastric artery runs superiorly and medially up the abdomen, it provides blood supply to …….?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHRoZSBsb3dlciBhbnRlcmlvciBhYmRvbWluYWwgd2FsbC4=
Cg==Cg==[Qq][q] If the rectus abdominis is transected horizontally, …… must be identified and ligated bilaterally to prevent bleeding complications (hematoma).
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHRoZSBpbmZlcmlvciBlcGlnYXN0cmljIGFydGVyaWVzLg==
Cg==Cg==[Qq][q] If the appendix cannot be identified by palpation during an appendectomy, it can be located by following ……. to its origin at the cecal base.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHRoZSB0ZW5pYWUgY29saS4=
Cg==Cg==[Qq][q] What is the most likely diagnosis?
25 years old patient presenting with vomiting, distended abdomen with hyperactive bowel sound + abdominal x-rays is below.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFNtYWxsIGJvd2VsIG9ic3RydWN0aW9uLg==[Qq]
[q] What is the most likely diagnosis?
25 years old patient presenting with vomiting, distended abdomen with hyperactive bowel sound + abdominal x-rays is below.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IExhcmdlIGJvd2VsIG9ic3RydWN0aW9uLg==[Qq]
[q] Pneumoperitoneum is air or gas in the peritoneal cavity; it can be seen as free air under the diaphragm in an upright chest x-ray. The most common cause is a ……?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHBlcmZvcmF0ZWQgZHVvZGVuYWwgdWxjZXIu[Qq]
[q] On abdominal CT scan, the pancreas can be identified by its head in close association with …..?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHRoZSBzZWNvbmQgcGFydCBvZiB0aGUgZHVvZGVudW0u
Cg==Cg==[Qq][q] ….. can be identified on cross-sectional scans lying medial to (or just within) the right lobe of the liver and anterior to the inferior vena cava.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFRoZSBwb3J0YWwgdmVpbi4=
Cg==Jm5ic3A7
Cg==[Qq]
[q] An abdominal CT scan should be performed in stable patients with blunt abdominal trauma to exclude the possibility of ……
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]cmV0cm9wZXJpdG9uZWFsIGhlbWF0b21hLg==
Cg==Cg==[Qq][q] IVC filters are designed to prevent the embolization of DVT from the legs to the lung vasculature (pulmonary embolism), and are used in patients who have contraindications to anticoagulation. The inferior vena cava is formed by the union of …… and …… at the level of L4-L5.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHRoZSByaWdodCBhbmQgbGVmdCBjb21tb24gaWxpYWMgdmVpbnMu
Cg==Cg==[Qq][q] ……… presents as recurrent pre-/periprandial pain and swelling in affected gland.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFNpYWxvbGl0aGlhc2lzLg==[Qq]
[q] …… most commonly due to an obstructing stone (sialolithiasis) leading to Staphylococcus aureus infection; usually unilateral.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFNpYWxhZGVuaXRpcy4=[Qq]
[q] ……. is the most common tumor of the salivary gland. Usually arises in parotid; presents as a mobile, painless, circumscribed mass at the angle of the jaw. Composed of stromal (cartilage) and epithelial tissue.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFBsZW9tb3JwaGljIGFkZW5vbWEu[Qq]
[q] ……. is the 2nd most common tumor of the salivary gland. Almost always arises in the parotid. Benign cystic tumor with abundant lymphocytes and germinal centers (lymph node-like stroma).
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFdhcnRoaW4gdHVtb3IgKHBhcGlsbGFyeSBjeXN0YWRlbm9tYSBseW1waG9tYXRvc3VtKS4=[Qq]
[q] ……. is the most common malignant tumor of the salivary gland. Usually arises in the parotid; commonly involves the facial nerve. Composed of mucinous and squamous cells.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IE11Y29lcGlkZXJtb2lkIGNhcmNpbm9tYS4=
Cg==Cg==[Qq][q] What is the most likely diagnosis?
32 years old patient presenting with dysphagia for poorly chewed food, upper endoscopy shows thin protrusion of esophageal mucosa in the upper esophagus.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEVzb3BoYWdlYWwgd2ViLg==[Qq]
[q] …….. is characterized by severe iron deficiency anemia, esophageal web, and beefy-red tongue due to atrophic glossitis. Increased risk of esophageal squamous cell carcinoma.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFBsdW1tZXItVmluc29uIHN5bmRyb21lLg==[Qq]
[q] ……. is formed at gastroesophageal junction, typically due to chronic acid reflux. Can present with dysphagia.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFNjaGF0emtpIHJpbmdzLg==
Cg==Cg==[Qq][q] What is the most likely diagnosis?
18 years old patient presenting with dysphagia, halitosis, and regurgitation of food particles + foul-smelling breath (halitosis) + history of recurrent aspiration pneumonia.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFplbmtlciBkaXZlcnRpY3VsdW0uIE91dHBvdWNoaW5nIG9mIHBoYXJ5bmdlYWwgbXVjb3NhIHRocm91Z2ggYW4gYWNxdWlyZWQgZGVmZWN0IGluIHRoZSBwb3N0ZXJpb3IgcGhhcnluZ2VhbCBjb25zdHJpY3RvciBtdXNjbGVzIChDcmljb3BoYXJ5bmdlYWwgbXVzY2xlIGR5c2Z1bmN0aW9uICku
Cg==Jm5ic3A7
Cg==[Qq]
[q] Zenker diverticulum is (true or false) diverticulum.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGZhbHNlIGRpdmVydGljdWx1bSBjb25zaXN0cyBvbmx5IG9mIG11Y29zYS4=[Qq]
[q] What is the most likely diagnosis?
32 years old patient with repetitive retching and vomiting due to alcoholism presenting with hematemesis + ABG shows metabolic alkalosis + upper endoscopy shows Longitudinal laceration of mucosa at the gastroesophageal (GE) junction?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IE1hbGxvcnktV2Vpc3Mgc3luZHJvbWUu
Cg==Cg==TWFsbG9yeS1XZWlzcyB0ZWFycyBhcmUgY2F1c2VkIGJ5IGhpZ2ggaW50cmFnYXN0cmljIHByZXNzdXJlIGJlaW5nIHRyYW5zbWl0dGVkIHRvIHRoZSBlc29waGFndXMgdGhyb3VnaCBhIHRpZ2h0IGxvd2VyIGVzb3BoYWdlYWwgc3BoaW5jdGVyLg==
[Qq]Risk of Boerhaave syndrome: rupture of esophagus (transmural tear) leading to air in the mediastinum and subcutaneous emphysema (crepitus in the neck region or chest wall).
[q] What is the most likely diagnosis?
21 years old patient presenting with Dysphagia to both solids and liquids at the same time + Food regurgitation and aspiration + Manometry findings include uncoordinated or absent peristalsis with high LES resting pressure + – Bird-beak’ sign on barium swallow study?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEFjaGFsYXNpYS4=
Cg==Cg==RHVlIHRvIGRhbWFnZWQgcG9zdGdhbmdsaW9uaWMgaW5oaWJpdG9yeSBuZXVyb25zIGluIHRoZSBteWVudGVyaWMgcGxleHVzICh3aGljaCBjb250YWluIE5PIGFuZCBWSVApLiBHYW5nbGlvbiBjZWxscyBvZiBteWVudGVyaWMgcGxleHVzIGFyZSBsb2NhdGVkIGJldHdlZW4gdGhlIGlubmVyIGNpcmN1bGFyIGFuZCBvdXRlciBsb25naXR1ZGluYWwgbGF5ZXJzIG9mIHRoZSBtdXNjdWxhcmlzIHByb3ByaWEgYW5kIGFyZSBpbXBvcnRhbnQgZm9yIHJlZ3VsYXRpbmcgYm93ZWwgbW90aWxpdHkgYW5kIHJlbGF4aW5nIHRoZSBMRVMu
[Qq]
[q] What is the most likely diagnosis?
25 years old, obese patient with long history of smoking presenting with heartburn and regurgitation, nocturnal cough, and sore throat + symptoms are relieved after taking omeprazole?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEdhc3Ryb2Vzb3BoYWdlYWwgcmVmbHV4IGRpc2Vhc2UgKEdFUkQpLg==
Cg==Jm5ic3A7
Cg==[Qq]
[q] What is the most likely diagnosis?
Patient with long history of GERD presenting with Worsening of baseline GERD symptoms and the development of odynophagia (painful swallowing)?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEVyb3NpdmUgZXNvcGhhZ2l0aXMuIEdFUkQgaXMgdGhlIG1vc3QgY29tbW9uIGNhdXNlIG9mIGVzb3BoYWdpdGlzLg==[Qq]
[q] What is the most likely diagnosis?
Patient with long history of GERD presenting with dysphagia and a sensation of food getting stuck in the esophagus?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEVzb3BoYWdlYWwgc3RyaWN0dXJlLg==[Qq]
[q] What is the most likely diagnosis?
Patient with long history of GERD presenting with metaplastic columnar epithelium that replaces the normal stratified squamous epithelium in the distal esophagus with no change in baseline GERD manifestations.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEJhcnJldHQgZXNvcGhhZ3VzIGlzIGEgcHJlLW1hbGlnbmFudCBjb25kaXRpb24gdGhhdCBpbmNyZWFzZXMgdGhlIHJpc2sgb2YgYWRlbm9jYXJjaW5vbWEgb2YgdGhlIGVzb3BoYWd1cyBieSAzMC00MCB0aW1lcy4gQWRlbm9jYXJjaW5vbWFzIGRldmVsb3AgdGhyb3VnaCB0aGUgcHJvZ3Jlc3Npb24gZnJvbSBpbnRlc3RpbmFsIG1ldGFwbGFzdGljIGVwaXRoZWxpdW0g4oaSIGR5c3BsYXNpYSDihpIgbWFsaWduYW5jeS4=[Qq]
[q] What is the most likely diagnosis?
26 years old patient presenting with dysphagia and chest pain. This chest pain mimic unstable angina; thus, complete cardiac work-up was done and cardiac cause may was ruled out + Esophageal manometry studies show disorganized non-peristaltic contractions of the body of esophagus + “corkscrew” esophagus is seen on barium esophagogram.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IERpZmZ1c2UgZXNvcGhhZ2VhbCBzcGFzbS4=
Cg==Cg==VGhlIHBhdGhvZ2VuZXNpcyBvZiBERVMgbGlrZWx5IGludm9sdmVzIGltcGFpcmVkIGluaGliaXRvcnkgbmV1cm90cmFuc21pc3Npb24gd2l0aGluIHRoZSBlc29waGFnZWFsIG15ZW50ZXJpYyBwbGV4dXMu
[Qq]
[q] What is the most likely diagnosis?
26 years old patient with history of HIV and low CD4 count presenting with dysphagia, odynophagia?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEluZmVjdGlvdXMgZXNvcGhhZ2l0aXMu
Cg==Cg==T3ZlciA5MCUgb2YgZXNvcGhhZ2VhbCBpbmZlY3Rpb25zIGluIHBhdGllbnRzIHdpdGggQUlEUyBhcmUgY2F1c2VkIGJ5IENhbmRpZGEuIEVtcGlyaWMgdGhlcmFweSB3aXRoIGZsdWNvbmF6b2xlIGlzIHRoZSBiZXN0IGNvdXJzZSBvZiBhY3Rpb24uIElmIGZsdWNvbmF6b2xlIGRvZXMgbm90IGltcHJvdmUgc3ltcHRvbXMsIHRoZW4gZW5kb3Njb3B5IGlzIHBlcmZvcm1lZC4=
[Qq]
[q] What is the most likely diagnosis?
Patients experience sudden-onset odynophagia and retrosternal pain that cause difficulty swallowing after taking bisphosphonates?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFBpbGwgZXNvcGhhZ2l0aXMu[Qq]
[q] What is the most likely diagnosis?
30 years old patient with history of asthma presenting with swallowing difficulty and food impaction + esophageal biopsy shows inflammatory infiltrate with abundant eosinophils?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEVvc2lub3BoaWxpYyBFc29waGFnaXRpcy4=[Qq]
[q] ….. is the most common type of esophageal carcinoma in America.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEVzb3BoYWdlYWwgQWRlbm9jYXJjaW5vbWEu[Qq]
[q] …… arises from preexisting Barrett esophagus; usually involves the lower one-third of the esophagus.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEVzb3BoYWdlYWwgQWRlbm9jYXJjaW5vbWEu[Qq]
[q] ……. is a malignant proliferation of squamous cells; most common esophageal cancer worldwide.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEVzb3BoYWdlYWwgU3F1YW1vdXMgY2VsbCBjYXJjaW5vbWEu[Qq]
[q] The most significant risk factors for the development of SCC in the United States include ……. and ……?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGNpZ2FyZXR0ZSBzbW9raW5nIGFuZCBhbGNvaG9sIGludGFrZS4=[Qq]
[q] What is the most likely diagnosis?
55 years old male with long history of smoking presenting with progressive dysphagia (start with solid food dysphagia and gradually progress to liquid dysphagia), weight loss, pain, and hematemesis + histology shows flattened polyhedral or ovoid epithelial cells with eosinophilic cytoplasm, keratin nests or “pearls” within or between cells, and intercellular bridging.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEVzb3BoYWdlYWwgU3F1YW1vdXMgY2VsbCBjYXJjaW5vbWEu
Cg==Jm5ic3A7
Cg==[Qq]
[q] …… occurs at the highest frequency in the middle third of esophagus. Lymphatics drain to mediastinal nodes; metastatic disease may present with mediastinal lymphadenopathy.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFNDQy4=[Qq]
[q]…….. occurs at the highest frequency in the lower third of esophagus. Lymphatics drain caudally to the gastric and celiac nodes; metastatic disease may present with abdominal lymphadenopathy.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEFkZW5vY2FyY2lub21hLg==[Qq]
[q] In patients who have undergone total gastrectomy, ……… becomes necessary.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFZlcnkgaGlnaC1kb3NlIG9yYWwgb3IgcGFyZW50ZXJhbCB2aXRhbWluIEIxMi4=
Cg==SW4gcGF0aWVudHMgd2hvIGhhdmUgdW5kZXJnb25lIHRvdGFsIGdhc3RyZWN0b215LCBJRiBjYW4gbm8gbG9uZ2VyIGJlIHByb2R1Y2VkIGFuZCB2aXRhbWluIEJJMiBjYW5ub3QgYmUgZWZmZWN0aXZlbHkgYWJzb3JiZWQuIFRoZXJlZm9yZSwgdmVyeSBoaWdoLWRvc2Ugb3JhbCBvciBwYXJlbnRlcmFsIHZpdGFtaW4gQjEyIGJlY29tZXMgbmVjZXNzYXJ5Lg==[Qq]
[q] Gastrin ↑ acid secretion primarily through its effects on …… leading to histamine release rather than through its direct effect on parietal cells.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEVudGVyb2Nocm9tYWZmaW4tbGlrZSAoRUNMKSBjZWxscy4=[Qq]
[q]…….. is a somatostatin analog used to treat acromegaly, carcinoid syndrome, and variceal bleeding.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IE9jdHJlb3RpZGUu[Qq]
[q] In cholecystitis, fatty foods increase …… production and pain occurs when an inflamed and/or obstructed gallbladder contracts.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IENDSy4=
Cg==Cg==[Qq][q] ……… stimulates the release of bicarbonate-rich secretions from the exocrine pancreas, which is the major source of acid-neutralizing bicarbonate entering the duodenum, allowing pancreatic enzymes to function.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFNlY3JldGluLg==[Qq]
[q] What is the most likely diagnosis?
23 years old patient presenting with Epigastric discomfort or pain, nausea, and vomiting after taking NSAIDS + upper endoscopy shows mucosal defects that do not fully extend through the muscularis mucosa (limited to the mucosal layer)?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEFjdXRlIGdhc3RyaXRpcy4=
Cg==Jm5ic3A7
Cg==[Qq]
[q] Acidic damage to the stomach mucosa occurs due to imbalance between mucosal defenses and acidic environment. In case of sever burn is called ………, in cases of increased intracranial pressure is called ……, in cases of ICU patients is called …….?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEN1cmxpbmcgdWxjZXIsIEN1c2hpbmcgdWxjZXIsIHN0cmVzcyB1bGNlci4=
Cg==Cg==[Qq][q] What is the most likely diagnosis?
22 years old female presenting with Megaloblastic anemia, Achlorhydria with increased gastrin levels and antral G-cell hyperplasia + Histology shows Atrophy of mucosa with intestinal metaplasia + Blood test is positive for antibodies against parietal cells and intrinsic factor?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IENocm9uaWMgYXV0b2ltbXVuZSBnYXN0cml0aXMu
Cg==Cg==SXQgaXMgZHVlIHRvIGF1dG9pbW11bmUgZGVzdHJ1Y3Rpb24gb2YgZ2FzdHJpYyBwYXJpZXRhbCBjZWxscywgd2hpY2ggYXJlIGxvY2F0ZWQgaW4gdGhlIHN0b21hY2ggYm9keSBhbmQgZnVuZHVzLg==[Qq]
[q] The combination of lower extremity paresthesias, macrocytic red blood cells (RBCs), and gastric body and fundal atrophy is highly suggestive of ……….?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFBlcm5pY2lvdXMgYW5lbWlhIChQQSk=[Qq]
[q]….. is the most common site of chronic gastritis due to H pylori.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEFudHJ1bS4=
Cg==Cg==[Qq][q] The pathogenesis of Chronic H pylori gastritis is related to Chronic antral inflammation that leads to a …….?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGRlY3JlYXNlIGluIHRoZSBudW1iZXIgb2Ygc29tYXRvc3RhdGluLXByb2R1Y2luZyBjZWxscyAoZGVsdGEgY2VsbHMpLg==
Cg==Cg==[Qq][q] What is the most likely diagnosis?
33 years old patient presenting with epigastric pain that improves with meals + Diagnostic endoscopic biopsy shows ulcer within the first part of the duodenum with hypertrophy of Brunner glands?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IER1b2RlbmFsIHVsY2VyLg==
Cg==SXQgaXMgYWxtb3N0IGFsd2F5cyBkdWUgdG8gSCBweWxvcmkgKCZndDsgOTUlKTsgcmFyZWx5LCBtYXkgYmUgZHVlIHRvIFpFIHN5bmRyb21lLg==
Cg==[Qq]
[q] What is the most likely diagnosis?
Patient presenting with multiple ulcers in the distal duodenum and jejunum that is resistant to treatment with triple therapy?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFpvbGxpbmdlciBFbGxpc29uIHN5bmRyb21lIChHYXN0cmlub21hKS4=[Qq]
[q] What is the most likely diagnosis?
33 years old patient presenting with epigastric pain that worsens with meals + Diagnostic endoscopic biopsy shows ulcer on the lesser curvature of the antrum?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEdhc3RyaWMgdWxjZXIu
Cg==Cg==JiM4MjExOyBJdCBpcyB1c3VhbGx5IGR1ZSB0byBIIHB5bG9yaSAoNzUlKTsgb3RoZXIgY2F1c2VzIGluY2x1ZGUgTlNBbERzIGFuZCBiaWxlIHJlZmx1eC4=
[Qq]
[q] What is the best next step in management?
55 years old male patient presenting with gastric ulcer > 3mm, irregular with heaped up margins.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEJpb3BzeSBpcyByZXF1aXJlZCB0byBydWxlIG91dCBtYWxpZ25hbmN5Lg==[Qq]
[q] Helicobacter pylori is typically found in greatest concentration in the ……. As a result, biopsy of the prepyloric area would have the greatest yield of the organism.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHByZXB5bG9yaWMgYXJlYSBvZiB0aGUgZ2FzdHJpYyBhbnRydW0u
Cg==Cg==[Qq][q] Ulcers located on the anterior wall of the duodenal bulb are more prone to ………; those on the posterior wall are more likely to cause …….?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHBlcmZvcmF0aW9uLCBoZW1vcnJoYWdlLg==
Cg==Cg==[Qq][q] When an ulcer penetrates the posterior duodenal wall, it is likely to erode into …….. artery, which perfuses both the pylorus and the proximal part of the duodenum.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHRoZSBnYXN0cm9kdW9kZW5hbC4=
Cg==Cg==[Qq][q] Most gastric ulcers arise along the lesser curvature of the stomach, usually at the transitional zone between the gastric corpus (body) and antrum. ……. run along the lesser curvature and are likely to be penetrated by ulcers, causing gastric bleeding.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFRoZSBsZWZ0IGFuZCByaWdodCBnYXN0cmljIGFydGVyaWVzLg==
Cg==Cg==[Qq][q] Chronic epigastric pain that suddenly worsens and becomes diffuse with a pneumoperitoneum (upright chest x-ray shows free air under the right diaphragm which is best seen between the liver and the diaphragm) is concerning for likely …….?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHBlcmZvcmF0ZWQgcGVwdGljIHVsY2VyIGRpc2Vhc2UgKFBVRCku[Qq]
[q] What is the most likely diagnosis?
33 years old patient presenting with diarrhea, nausea, vomiting, and abdominal cramps, flushing, hypotension, tachycardia + pruritus, urticaria + skin biopsy shows mast cell proliferation?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFN5c3RlbWljIG1hc3RvY3l0b3Npcy4=
Cg==Cg==[Qq][q] What is the most likely diagnosis?
23 years old patient presenting with Weight loss, Anorexia, Vomiting, Epigastric pain, Edema + abdominal CT shows hypertrophied gastric rugae that look like brain gyri?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IE3DqW7DqXRyaWVyIGRpc2Vhc2Uu[Qq]
[q] …….. is the most common type of Gastric adenocarcinoma.
It closely resemble colon cancers. They tend to grow as nodular, polypoid, and well-demarcated masses. Risk factors include intestinal metaplasia (due to H pylori and autoimmune gastritis), nitrosamines in smoked foods (Japan), and blood type A.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEludGVzdGluYWwtdHlwZSBhZGVub2NhcmNpbm9tYXMu[Qq]
[q] ……… is characterized by signet ring cells that diffusely infiltrate the gastric wall (due to loss of the cell adhesion protein E-cadherin); desmoplasia results in thickening of stomach wall causing a “leather-bottle stomach” (linitis plastica).
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IERpZmZ1c2UgdHlwZSAoU2lnbmV0LXJpbmcgY2FyY2lub21hKS4=[Qq]
[q] The most important factors that influence survival rate are …… and ……?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHRoZSBkZXB0aCBvZiBpbnZhc2lvbiB0aHJvdWdoIHRoZSBnYXN0cmljIHdhbGwgYW5kIHdoZXRoZXIgcmVnaW9uYWwgbHltcGggbm9kZXMgYXJlIGludm9sdmVkLg==[Qq]
[q] Acanthosis nigricans is associated with …… and ……?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEluc3VsaW4gcmVzaXN0YW5jZSAoSHlwZXJpbnN1bGluZW1pYSksIHVuZGVybHlpbmcgR0kgY2FuY2VyIChHYXN0cmljIGFkZW5vY2FyY2lub21hKS4=[Qq]
[q] The abrupt appearance of multiple seborrhoeic keratoses that rapidly increase in their size and number may be associated with …….?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHVuZGVybHlpbmcgZ2FzdHJpYyBhZGVub2NhcmNpbm9tYS4=[Qq]
[q] The classic finding of mucin-producing, signet-ring neoplastic cells in the ovarian stroma (bilateral) is described as …… and is one of the most common types of metastatic ovarian cancer.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEtydWtlbmJlcmcgdHVtb3Iu[Qq]
[q] Iron is absorbed as Fe2 in ……
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGR1b2RlbnVtLiBJcm9uIEZpc3QsIEJyby4=[Qq]
[q] Folate is absorbed in …….
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGplanVudW0uIElyb24gRmlzdCwgQnJvLg==[Qq]
[q] B12 is absorbed in ……
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHRlcm1pbmFsIGlsZXVtLiBJcm9uIEZpc3QsIEJyby4=[Qq]
[q] Fats are typically the most severely affected macronutrient in generalized malabsorption, and testing the stool for fat with …… stain is the most sensitive strategy for screening for malabsorptive disorders (Stool should normally contain no measurable fat).
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFN1ZGFuIElJSS4=[Qq]
[q] What is the most likely diagnosis?
18 years old patient presenting with diarrhea, steatorrhea,
bloating, and abdominal distension with ↓ stool pH and elevated stool osmolality upon consumption of milk products + increased breath hydrogen content > 20 ppm compared with baseline + Light and electron microscopic examination of the bowel mucosa shows normal intestinal mucosa.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IExhY3Rvc2UgaW50b2xlcmFuY2Uu
Cg==Cg==RGVjcmVhc2VkIGZ1bmN0aW9uIG9mIHRoZSBsYWN0YXNlIGVuenltZSBmb3VuZCBpbiB0aGUgYnJ1c2ggYm9yZGVyIG9mIGVudGVyb2N5dGVzLg==[Qq]
[q] What is the most likely diagnosis?
12 years old patient presenting with chronic diarrhea, steatorrhea, bloating, abdominal distension, and failure to thrive + Serologic testing is positive for lgA anti-endomysial, anti-deamidated gliadin peptide antibodies and anti-tissue transglutaminase antibodies + Duodenal biopsy reveals flattening of the mucosa with loss of villi, hyperplasia of crypts, and chronic inflammatory infiltration of the lamina propria with lymphocytes + Small, herpes-like vesicles are symmetrically distributed and extremely pruritic?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IENlbGlhYyBkaXNlYXNlLg==
Cg==V2l0aCBzdHJpY3QgYWRoZXJlbmNlIHRvIGEgZ2x1dGVuLWZyZWUgZGlldCwgc3ltcHRvbSByZXNvbHV0aW9uIG9jY3VycyB3aXRoaW4gd2Vla3MgYW5kIGlzIGZvbGxvd2VkIGJ5IG5vcm1hbGl6YXRpb24gb2YgaGlzdG9sb2d5IGFuZCBhbnRpYm9keSBsZXZlbHMu
Cg==Jm5ic3A7
[Qq][q] What is the most likely diagnosis?
32 years old patient presenting with diarrhea, steatorrhea, bloating, abdominal distension, polyarthritis, psychiatric and cardiac abnormalities + histologic findings include small intestine mucosa containing enlarged, foamy macrophages packed with both rod-shaped bacilli and PAS-positive, diastase-resistant granules that appears in magenta color?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFdoaXBwbGUgZGlzZWFzZS4=
Cg==V2hpcHBsZSBkaXNlYXNlIGlzIGEgcmFyZSBzeXN0ZW1pYyBpbGxuZXNzIGNhdXNlZCBieSB0aGUgZ3JhbS1wb3NpdGl2ZSBhY3Rpbm9teWNldGUgVHJvcGhlcnltYSB3aGlwcGVsaWkgdGhhdCBpbnZvbHZlcyB0aGUgc21hbGwgaW50ZXN0aW5lLCBqb2ludHMsIGFuZCBjZW50cmFsIG5lcnZvdXMgc3lzdGVtLg==[Qq]
[q] ……. is sometimes used to test for brush border absorptive function independent of pancreatic function in cases where it is necessary to determine if malabsorption is due to pancreatic or intestinal pathology?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEQteHlsb3NlLg==
Cg==Cg==[Qq][q] Small intestinal bacterial overgrowth (SIBO) is characterized by overproduction of ………., associated with nausea, bloating, abdominal discomfort, and malabsorption.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHZpdGFtaW4gSyBhbmQgZm9sYXRlLg==[Qq]
[q] ……… is a chronic inflammatory condition of the gut that can involve any part of the GI tract from the mouth to the anus, but most classically a disease of the small bowel, with the terminal ileum is one of the most common locations.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IENyb2huJiM4MjE3O3MgZGlzZWFzZS4=[Qq]
[q] What is the most likely diagnosis?
35 years old patient presenting with bouts of abdominal pain, non-bloody diarrhea, malaise, and fever + Endoscopy shows inflamed, edematous mucosa with linear ulcers of the terminal ileum + Biopsy shows non-caseating granulomas and an inflammatory infiltrate that involves all layers of the intestinal wall (transmural) are found, Normal-looking mucosal areas intervene between the areas involved in pathologic process, leading to “cobblestone appearance”?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IENyb2hu4oCZcyBkaXNlYXNlLg==
Cg==Cg==[Qq][q] ….. explains the two most common complications of Crohn’s disease (strictures, and fistulas)?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFRyYW5zbXVyYWwgaW5mbGFtbWF0aW9uLg==
Cg==Cg==[Qq][q] …… is the type of inflammatory bowel disease associated with stones (cholesterol gall stones and oxalate kidney stones).
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IENyb2hu4oCZcyBkaXNlYXNlLg==[Qq]
[q] What is the most likely diagnosis?
35 years old patient presenting with bouts of abdominal pain, bloody diarrhea, malaise, and fever + Endoscopy shows inflamed, edematous mucosa with pseudopolyps of the colon + Biopsy shows an inflammatory infiltrate that is limited to the mucosa and submucosa only, Mucosal damage is continuous. There are no areas of normal mucosa between the affected segments?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFVsY2VyYXRpdmUgY29saXRpcy4=
Cg==Cg==[Qq][q] What is the most likely diagnosis?
55 Years old patient with history of ulcerative colitis presenting with abdominal pain and distention, along with fever, diarrhea, and signs of shock (decreasing BP, increasing HR) + Plain abdominal radiography shows colonic dilatation, especially in the transverse colon with a >5.5cm diameter of the colon. Fluid levels is seen in the large bowel?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFRveGljIG1lZ2Fjb2xvbi4=
Cg==QmFyaXVtIGNvbnRyYXN0IHN0dWRpZXMgYW5kIGNvbG9ub3Njb3B5IGFyZSBjb250cmFpbmRpY2F0ZWQgZHVlIHRvIHJpc2sgb2YgcGVyZm9yYXRpb24u[Qq]
[q] What is the most likely diagnosis?
25 years old female presenting with Recurrent abdominal pain, diarrhea and change in stool consistency + symptoms become prominent with stress of the exams without any organic explanation of her symptoms?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IElycml0YWJsZSBib3dlbCBzeW5kcm9tZS4=[Qq]
[q] What is the most likely diagnosis?
3 years old child presenting with colicky, intermittent abdominal pain, nausea, vomiting, and “currant jelly” stools that contain blood and mucus + During examination there is palpable tubular “sausage-shaped” mass in the right upper quadrant + Ultrasound/CT may show a doughnut sign or target sign.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEludHVzc3VzY2VwdGlvbi4=
Cg==Cg==[Qq][q] The most typical location for intussusception is at the ……
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IElsZW9jb2xpYyBqdW5jdGlvbi4=[Qq]
[q] What is the most likely diagnosis?
50 years old who had abdominal surgery 5 days ago presenting with nausea, vomiting, abdominal distension, failure to pass flatus or stool (obstipation) and hypoactive or absent bowel sounds + abdominal x-rays shows dilated gas-filled loops of bowel with no transition point?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFBhcmFseXRpYyAoYWR5bmFtaWMpIGlsZXVzLg==
Cg==Jm5ic3A7
Cg==[Qq]
[q] What is the most likely diagnosis?
A newborn child presenting with failure to pass meconium within the first 48 hours + Administration of hyperosmolar enema (Gastrografin) break up the inspissated meconium and dissolve the obstruction?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IE1lY29uaXVtIGlsZXVzLg==
Cg==TWVjb25pdW0gaWxldXMgaXMgdmlydHVhbGx5IGRpYWdub3N0aWMgZm9yIGN5c3RpYyBmaWJyb3NpcyAoQ0YpLg==[Qq]
[q] What is the most likely diagnosis?
A newborn child who was born prematurely presenting with abdominal distension, gastric retention, tenderness, rectal bleeding, and visible intestinal loops lacking peristalsis + radiographic finding of gas within the wall of the intestine (pneumatosis intestinalis)?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IE5lY3JvdGl6aW5nIGVudGVyb2NvbGl0aXMu[Qq]
[q] Acute inflammation of the appendix can be due to obstruction by ….. in adults or …….. in children.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGZlY2FsaXRoLCBseW1waG9pZCBoeXBlcnBsYXNpYS4=[Qq]
[q] What is the most likely diagnosis?
14 years old patient presenting with migratory, vague periumbilical pain, fever, nausea, vomiting, and anorexia. The pain becomes sharp and localizes to the RLQ + During examination: there is pain with palpation at McBumey point, RLQ pain with deep palpation of the LLQ + CBC shows leukocytosis?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEFjdXRlIGFwcGVuZGljaXRpcy4=
Cg==Cg==[Qq][q] ………. is the most common appendiceal tumors.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IENhcmNpbm9pZCB0dW1vci4=[Qq]
[q] What is the most likely diagnosis?
26 years old patient presenting with cutaneous flushing, secretory diarrhea, dyspnea with wheezing, and pulmonic stenosis + Increased level of the 5-HIAA (5-hydroxyindoleacetic acid) in a 24-hour urine sample?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IENhcmNpbm9pZCB0dW1vci4=[Qq]
[q] Acute mesenteric ischemia is the acute occlusion of mesenteric arteries, most commonly ………..?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHRoZSBzdXBlcmlvciBtZXNlbnRlcmljIGFydGVyeS4=[Qq]
[q] What is the most likely diagnosis?
44 years old patient with history of atrial fibrillation presenting with acute-onset, severe, midabdominal pain out of proportion to physical examination findings + Labs show increased lactic acid and leukocytosis?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEFjdXRlIG1lc2VudGVyaWMgaXNjaGVtaWEu[Qq]
[q] Chronic mesenteric ischemia results from atherosclerotic disease of 2 or more mesenteric vessels. Most cases are due to atherosclerotic changes of the ….. or …….?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGNlbGlhYyBvciBzdXBlcmlvciBtZXNlbnRlcmljIGFydGVyaWVzLg==[Qq]
[q] What is the most likely diagnosis?
60 years old patient, diabetic, hypertensive presenting with crampy postprandial epigastric pain within the first hour of eating and slowly resolves over the next 2 hours. , food aversion, and weight loss?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IENocm9uaWMgbWVzZW50ZXJpYyBpc2NoZW1pYS4=[Qq]
[q] What is the most likely diagnosis?
51 years old patient present presenting with acute abdominal pain and lower gastrointestinal bleeding (hematochezia) following an episode of hypotension during repair of an abdominal aortic aneurysm?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IENvbG9uaWMgaXNjaGVtaWEu[Qq]
[q] The most commonly involved segments of the colon during colonic ischemia include ……. at the “watershed” line between the territory of the superior and inferior mesenteric arteries and …… at the watershed between the sigmoid artery and superior rectal artery.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHRoZSBzcGxlbmljIGZsZXh1cmUsIHRoZSByZWN0b3NpZ21vaWQganVuY3Rpb24u
Cg==Jm5ic3A7
Cg==[Qq]
[q] What is the most likely diagnosis?
60 years old patient presenting with recurrent, painless gastrointestinal bleeding (hematochezia), Endoscopy shows Tortuous dilation of vessels found in right-sided colon?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEFuZ2lvZHlzcGxhc2lhLg==[Qq]
[q] What is the most likely diagnosis?
60 years old patient presenting with recurrent, painless gastrointestinal bleeding (hematochezia), Endoscopy shows outpouching of the mucosa of the sigmoid colon?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IENvbG9uaWMgZGl2ZXJ0aWN1bGEu
Cg==Cg==[Qq][q] Colonic diverticula are considered (true or false) diverticulum.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEZhbHNlIGRpdmVydGljdWx1bSAoT3V0cG91Y2hpbmdzIG9mIG11Y29zYSBhbmQgc3VibXVjb3NhIHRocm91Z2ggdGhlIG11c2N1bGFyaXMgcHJvcHJpYSku[Qq]
[q] What is the most likely diagnosis?
60 years old patient presenting with appendicitis-like symptoms in the left lower quadrant + CBC shows leukocytosis
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEFjdXRlIGRpdmVydGljdWxpdGlzLg==
Cg==Cg==[Qq][q] …….. composed of well-differentiated mucosal cells that form glands and crypts. Occasionally evolves into serrated polyps and more advanced lesions.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEh5cGVycGxhc3RpYyBwb2x5cHMu[Qq]
[q] …….. consist of mucosal glands, smooth muscle and connective tissue. They may occur sporadically or in Peutz-Jeghers syndrome or juvenile polyposis.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEhhbWFydG9tYXRvdXMgcG9seXBzLg==[Qq]
[q] …….. are seen in ulcerative colitis and Crohn disease. They are composed of regenerating intestinal mucosa.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEluZmxhbW1hdG9yeSBwc2V1ZG9wb2x5cHMu[Qq]
[q] …….. are small, usually < 5 mm. Look similar to normal mucosa. Clinically insignificant.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IE11Y29zYWwgcG9seXBzLg==[Qq]
[q] …… are typically composed of lipomas or lymphoid aggregates that bulge up into the mucosa.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFN1Ym11Y29zYWwgcG9seXBzLg==[Qq]
[q] ……… is composed of dysplastic colonic mucosal cells that form tubular-shaped glands.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFR1YnVsYXIgYWRlbm9tYS4=
Cg==R3JlYXRlc3QgcmlzayBmb3IgcHJvZ3Jlc3Npb24gZnJvbSBhZGVub21hIHRvIGNhcmNpbm9tYSBpcyByZWxhdGVkIHRvIHNpemUgJmd0OyAyIGNtLCBzZXNzaWxlIGdyb3d0aCwgYW5kIHZpbGxvdXMgaGlzdG9sb2d5Lg==
Cg==[Qq]
[q] ……… is dysplastic epithelial cells form villi-like projections that extend from the polyp surface down to the stroma.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFZpbGxvdXMgYWRlbm9tYS4=
Cg==Cg==R3JlYXRlc3QgcmlzayBmb3IgcHJvZ3Jlc3Npb24gZnJvbSBhZGVub21hIHRvIGNhcmNpbm9tYSBpcyByZWxhdGVkIHRvIHNpemUgJmd0OyAyIGNtLCBzZXNzaWxlIGdyb3d0aCwgYW5kIHZpbGxvdXMgaGlzdG9sb2d5Lg==[Qq]
[q] ……. show a mixture of dysplastic epithelial cells that form villi-like projections that extend from the polyp surface down to the stroma and colonic mucosal cells that form tubular-shaped glands.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFR1YnVsby12aWxsb3VzIGFkZW5vbWFzLg==
Cg==R3JlYXRlc3QgcmlzayBmb3IgcHJvZ3Jlc3Npb24gZnJvbSBhZGVub21hIHRvIGNhcmNpbm9tYSBpcyByZWxhdGVkIHRvIHNpemUgJmd0OyAyIGNtLCBzZXNzaWxlIGdyb3d0aCwgYW5kIHZpbGxvdXMgaGlzdG9sb2d5Lg==[Qq]
[q] The initial appearance of small adenomatous polyps is attributed to the mutation of the ….. that regulates cell growth and adhesion. Its mutation leads to uncontrolled cell proliferation.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEFQQyB0dW1vciBzdXBwcmVzc29yIGdlbmUu
Cg==Cg==[Qq][q] Mutation of the …… protooncogene is thought to Increase in the size of the polyps. This mutation leads to the appearance of a protein that stimulates unregulated cell growth.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEstcmFzLg==
Cg==Cg==[Qq][q] Malignant transformation of adenoma into carcinoma requires mutation of two genes …… and …….?
[c]IFNob3cgbWXCoC B0aGUgYW5zd2Vy[Qq]
[f]IHA1MyBhbmQgRENDLg==
Cg==Cg==[Qq][q] …… is caused by a germline mutation (autosomal dominant) to the tumor suppressor gene ……. on chromosome 5. Thousands of adenomatous polyps arise starting after puberty; pancolonic; always involves rectum.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEZBUCwgYWRlbm9tYXRvdXMgcG9seXBvc2lzIGNvbGkgKEFQQyku
Cg==Q29sb24gYW5kIHJlY3R1bSBhcmUgcmVtb3ZlZCBwcm9waHlsYWN0aWNhbGx5OyBvdGhlcndpc2UsIGFsbW9zdCBhbGwgcGF0aWVudHMgZGV2ZWxvcCBjYXJjaW5vbWEgYnkgNDAgeWVhcnMgb2YgYWdlIChUaGUgbGlmZXRpbWUgcmlzayB0aGF0ICZndDsxIG9mIHRoZXNlIHBvbHlwcyB3aWxsIHRyYW5zZm9ybSB0byBpbnZhc2l2ZSBjb2xvbiBjYW5jZXIgaXMgbmVhcmx5IDEwMCUpLg==[Qq]
[q] ……… is FAP + retroperitoneal fibromatosis + osteomas.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEdhcmRuZXIgc3luZHJvbWUu
Cg==Rmlicm9tYXRvc2lzIGlzIGEgbmVvcGxhc3RpYyBwcm9saWZlcmF0aW9uIG9mIGZpYnJvYmxhc3RzOyBhcmlzZXMgaW4gcmV0cm9wZXJpdG9uZXVtIChkZXNtb2lkKSBhbmQgbG9jYWxseSBkZXN0cm95cyB0aXNzdWUu
Cg==[Qq]Osteoma is a benign tumor of bone that usually arises in the skull.
[q] …… is FAP or Lynch syndrome + malignant CNS tumor (medulloblastoma, glioma).
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFR1cmNvdCBzeW5kcm9tZS4=[Qq]
[q] ……. is Autosomal dominant syndrome featuring numerous hamartomas throughout GI tract, along with hyperpigmented macules (freckle-like spots) on mouth, lips, hands, genitalia.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEFzc29jaWF0ZWQgd2l0aCDihpEgcmlzayBvZiBicmVhc3QgYW5kIEdJIGNhbmNlcnMgKGNvbG9yZWN0YWwsIHN0b21hY2gsIHNtYWxsIGJvd2VsLCBwYW5jcmVhdGljKS4=[Qq]
[q] ……… is Autosomal dominant syndrome in children (typically < 5 years old) featuring numerous hamartomatous polyps in the colon, stomach, small bowel.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEp1dmVuaWxlIHBvbHlwb3NpcyBzeW5kcm9tZS4=[Qq]
[q] …….. is Autosomal dominant mutation of DNA mismatch repair genes (MSH2, MLH1) with subsequent microsatellite instability.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEx5bmNoIHN5bmRyb21lIChoZXJlZGl0YXJ5IG5vbnBvbHlwb3NpcyBjb2xvcmVjdGFsIGNhbmNlciku
Cg==[Qq]
[q] …….. is the 3rd most common site of cancer and 3rd most common cause of cancer-related death.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IENvbG9yZWN0YWwgY2FyY2lub21hLg==[Qq]
[q] (Right or Left sided colon cancer) tend to infiltrate the intestinal wall and encircle the lumen; hence, they present with symptoms of partial intestinal obstruction. Change in the stool caliber, constipation, cramping abdominal pain, abdominal distention, nausea, and vomiting occur?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IExlZnQtc2lkZWQgY29sb24gY2FuY2VycyAocmVjdG9zaWdtb2lkIGNvbG9uKS4=
Cg==UmlnaHQgc2lkZSBibGVlZHM7IGxlZnQgc2lkZSBvYnN0cnVjdHMgKG5hcnJvd2VyIGx1bWVuKS4=[Qq]
[q] (Right or Left sided colon cancer) usually grow as exophytic masses. Patients generally do not develop intestinal obstruction because the right-sided colon has a larger caliber than the left. Right-sided colon cancers usually present with manifestations of iron deficiency anemia (fatigue and pallor) due to the ongoing blood loss.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFJpZ2h0LXNpZGVkIGNvbG9uIGNhbmNlcnMgKGFzY2VuZGluZyBjb2xvbiku
Cg==UmlnaHQgc2lkZSBibGVlZHM7IGxlZnQgc2lkZSBvYnN0cnVjdHMgKG5hcnJvd2VyIGx1bWVuKS4=[Qq]
[q]….. is a serum tumor marker that is useful for assessing treatment response and detecting recurrence of colon cancer; not useful for screening.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IENhcmNpbm9lbWJyeW9uaWMgYW50aWdlbiAoQ0VBKS4=[Qq]
[q] Long-standing ulcerative colitis is associated with an increased risk of colorectal cancer. …….. and ……… are the most significant risk factors.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFRoZSBkdXJhdGlvbiBhbmQgZXh0ZW50IG9mIGNvbGl0aXMu
Cg==Cg==[Qq][q] What is the most likely diagnosis?
42 Years old patient with long history of alcohol use presenting with Epigastric abdominal pain that radiates to the back, Nausea and vomiting, Elevated serum lipase and amylase, Hypocalcemia?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEFjdXRlIHBhbmNyZWF0aXRpcy4=
Cg==Jm5ic3A7
Cg==[Qq]
[q] hypertriglyceridemia causes acute pancreatitis via …….?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGRpcmVjdCB0aXNzdWUgdG94aWNpdHku
Cg==SWYgc2VydW0gdHJpZ2x5Y2VyaWRlIGxldmVscyByaXNlIHRvICZndDsxMDAwIG1nL2RsLCB0aGUgY29uY2VudHJhdGlvbiBvZiBmcmVlIGZhdHR5IGFjaWRzIGV4Y2VlZHMgdGhlIGJpbmRpbmcgY2FwYWNpdHkgb2YgYWxidW1pbiBhbmQgbGVhZHMgdG8gZGlyZWN0IGluanVyeSB0byB0aGUgcGFuY3JlYXRpYyBhY2luYXIgY2VsbHMuIFRodXMsIGh5cGVydHJpZ2x5Y2VyaWRlbWlhIGNhdXNlcyBhY3V0ZSBwYW5jcmVhdGl0aXMgdmlhIGRpcmVjdCB0aXNzdWUgdG94aWNpdHku[Qq]
[q] ………… is a collection of fluid rich in enzymes and inflammatory debris. Its walls consist of granulation tissue and fibrosis. Unlike true cysts, pseudocysts are not lined by epithelium.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFBhbmNyZWF0aWMgcHNldWRvY3lzdC4=[Qq]
[q] What is the most likely diagnosis?
42 Years old patient with long history of alcohol use presenting with Epigastric abdominal pain that radiates to the back, malabsorption with steatorrhea and fat-soluble vitamin deficiencies, Dystrophic calcification of pancreatic parenchyma on CT?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IENocm9uaWMgcGFuY3JlYXRpdGlzLg==
Cg==RGlhcnJoZWEsIHdlaWdodCBsb3NzLCBhbmQgZXBpZ2FzdHJpYyByZWdpb24gY2FsY2lmaWNhdGlvbnMgaW4gYSBwYXRpZW50IHdpdGggY2hyb25pYyBhbGNvaG9saXNtIHN1Z2dlc3QgY2hyb25pYyBwYW5jcmVhdGl0aXMgd2l0aCByZXN1bHRpbmcgcGFuY3JlYXRpYyBleG9jcmluZSBpbnN1ZmZpY2llbmN5IGFuZCBtYWxhYnNvcnB0aW9uLg==[Qq]
[q] ……. is the most important environmental risk factor for pancreatic cancer; it doubles the risk.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFNtb2tpbmcu[Qq]
[q] What is the most likely diagnosis?
70 years old patient presenting with Epigastric abdominal pain and weight loss, Obstructive jaundice with pale stools and dark urine, palpable but nontender gallbladder during examination?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFBhbmNyZWF0aWMgY2FyY2lub21hLg==[Qq]
[q] Spider angiomata, testicular atrophy and decreased body hair in the cirrhotic patient are due to ………?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGh5cGVyZXN0cmluaXNtLg==
Cg==Cg==[Qq][q] Varices and ascites in the cirrhotic patient are due to ………?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHBvcnRhbCBoeXBlcnRlbnNpb24u
Cg==Cg==[Qq][q] Increased …….. are indicators of hepatocellular damage, and increased …….. indicate biliary injury.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGFzcGFydGF0ZSBhbWlub3RyYW5zZmVyYXNlIChBU1QpIGFuZCBhbGFuaW5lIGFtaW5vdHJhbnNmZXJhc2UgKEFMVCksIGFsa2FsaW5lIHBob3NwaGF0YXNlIGFuZCBnYW1tYS1nbHV0YW15bCB0cmFuc3BlcHRpZGFzZS4=
Cg==[Qq]
[q] ………. are reflective of liver function and are of greatest prognostic significance in patients with cirrhosis.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFNlcnVtIGFsYnVtaW4gbGV2ZWxzLCBiaWxpcnViaW4gbGV2ZWxzLCBhbmQgcHJvdGhyb21iaW4gdGltZS4=
Cg==Cg==SHlwb2FsYnVtaW5lbWlhLCBlbGV2YXRlZCBiaWxpcnViaW4gbGV2ZWxzLCBhbmQgcHJvbG9uZ2VkIFBUIGFyZSBzaWducyBvZiBpbmFkZXF1YXRlIGxpdmVyIGZ1bmN0aW9uIChsaXZlciBmYWlsdXJlKSBhbmQgaW5kaWNhdGUgYSBwb29yIHByb2dub3NpcyBpbiBjaXJyaG90aWMgcGF0aWVudHMu
[Qq]
[q] What is the most likely diagnosis?
55 years old patient with history of liver cirrhosis presenting with altered mental status, asterixis and flapping tremors after variceal bleeding?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEhlcGF0aWMgZW5jZXBoYWxvcGF0aHku
Cg==Cg==[Qq][q] In patients with hepatic encephalopathy, lowering of blood ammonia levels is typically accomplished with oral administration of a …….. or …… which is nonabsorbable antibiotic cause destruction of gut bacteria → less conversion of dietary protein to ammonia.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGRpc2FjY2hhcmlkZSAobGFjdHVsb3NlKSBhbmQgcmlmYXhhbWluZSwgbmVvbXljaW4u
Cg==Cg==QmFjdGVyaWFsIGFjdGlvbiBvbiBsYWN0dWxvc2UgcmVzdWx0cyBpbiBhY2lkaWZpY2F0aW9uIG9mIGNvbG9uaWMgY29udGVudHMsIHdoaWNoIHRoZW4gY29udmVydHMgYWJzb3JiYWJsZSBhbW1vbmlhIGludG8gbm9uYWJzb3JiYWJsZSBhbW1vbml1bSBpb25zLCB0cmFwcGluZyB0aGUgYW1tb25pYSBpbiB0aGUgc3Rvb2wgYW5kIGluY3JlYXNpbmcgZmVjYWwgbml0cm9nZW4gZXhjcmV0aW9uLg==[Qq]
[q] What is the most likely diagnosis?
55 years old patient with history of liver cirrhosis and ascites presenting with fevers, chills, abdominal pain, ileus, or worsening encephalopathy + Paracentesis shows ascitic fluid absolute neutrophil count (ANC) > 250 cells/mm3?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFNwb250YW5lb3VzIGJhY3RlcmlhbCBwZXJpdG9uaXRpcy4=[Qq]
[q] What is the most likely diagnosis?
55 years old patient with history of polycythemia vera presenting with hepatomegaly, ascites, varices, abdominal pain, liver failure, no JVD, and mottled appearance of the liver?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEJ1ZGQtQ2hpYXJpIHN5bmRyb21lLg==
Cg==Cg==[Qq][q] What is the most likely diagnosis?
55 years old patient presenting with portal hypertension, splenomegaly, and varicosities at portocaval anastomoses with normal liver?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFBvcnRhbCB2ZWluIHRocm9tYm9zaXMu
Cg==Cg==[Qq][q] What is the most likely diagnosis?
12 years old child presenting with vomiting, hepatomegaly, hypoglycemia, altered mental status + Light microscopy of a liver biopsy shows microvesicular steatosis, the presence of small fat vacuoles in the cytoplasm of hepatocytes + Electron microscopy findings include swelling, a decreased number of mitochondria and glycogen depletion + mother tells you that she gave him over the counter drug after having fever and flu symptoms?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]UmV5ZSBzeW5kcm9tZS4=[Qq]
[q]…….. is Fatty change, hepatitis, and/or cirrhosis that develop without exposure to alcohol (or other known insult). Associated with Metabolic syndrome (insulin resistance); obesity.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IE5vbmFsY29ob2xpYyBmYXR0eSBsaXZlciBkaXNlYXNlLg==[Qq]
[q] What is the most likely diagnosis?
45 years old male patient presenting with micronodular cirrhosis + diabetes mellitus + and bronze discolration of the skin + Labs show ↑ ferritin, ↓ TIBC, ↑ serum iron, and ↑ % saturation + Liver biopsy reveals accumulation of brown pigment in hepatocytes with positive Prussian blue stain.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEhlbW9jaHJvbWF0b3Npcy4=
Cg==Cg==VHJlYXRtZW50OiByZXBlYXRlZCBwaGxlYm90b215LCBpcm9uIChGZSkgY2hlbGF0aW9uIHdpdGggZGVmZXJhc2lyb3gsIGRlZmVyb3hhbWluZSwgZGVmZXJpcHJvbmUu
[Qq][q] What is the most likely diagnosis?
35 years old male patient presenting with liver cirrhosis + behavioral changes, dementia, chorea, and Parkinsonian symptoms + granular deposition of copper within Descemet’s membrane in the cornea on slit lamp examination + Labs show ↑ urinary copper, ↓ serum ceruloplasmin, and ↑ copper on liver biopsy?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFdpbHNvbiBkaXNlYXNlLg==
Cg==VHJlYXRtZW50IGlzIGxpZmUtbG9uZyBhbmQgZm9jdXNlcyBvbiByZW1vdmluZyBhY2N1bXVsYXRlZCBjb3BwZXIgaW4gdGhlIHRpc3N1ZXMgYW5kIHByZXZlbnRpbmcgaXRzIHJlLWFjY3VtdWxhdGlvbi4gRmlyc3QtbGluZSBtZWRpY2F0aW9ucyBpbmNsdWRlIGNvcHBlciBjaGVsYXRvcnMgc3VjaCBhcyBELXBlbmljaWxsYW1pbmUgYW5kIHRyaWVudGluZS4=[Qq]
[q] What is the most likely diagnosis?
31 years old patient presenting with symptoms of emphysema although he is not smoker + unexplained liver disease + liver biopsy shows intracellular granules, These globules stain reddish-pink with the periodic acid-Schiff reaction (arrows) and resist digestion by diastase.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEFscGhhLTEgYW50aXRyeXBzaW4gKEExQVQpIGRlZmljaWVuY3ku
Cg==Cg==[Qq][q] High levels of dietary aflatoxin intake have been strongly associated with hepatocellular carcinoma. ….. mutations have been identified in most individuals who developed hepatocellular carcinoma.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHA1My4=[Qq]
[q] Individuals with stable, compensated cirrhosis who suddenly decompensate without apparent reason should be carefully evaluated for ………., especially when serum AFP levels are also elevated.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGhlcGF0b2NlbGx1bGFyIGNhcmNpbm9tYS4=
Cg==Cg==[Qq][q]……. are the most common malignant neoplasms of the adult liver and are 20 times more common than hepatocellular carcinoma.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IE1ldGFzdGFzZXMu
Cg==Cg==[Qq][q] ……. is a Benign tumor of hepatocytes. Associated with oral contraceptive use; regresses upon cessation of drug.
[c]IFNob3cgbWXvgqcgQmVuaWduIHR1bW9yIG 9mIGhlcGF0b2N5dGVzLiB0aGUgYW5zd2Vy[Qq]
[f]IEhlcGF0aWMgYWRlbm9tYS4=[Qq]
[q] ….. is the most common benign liver tumor, typically presenting in adults 30-50 years of age. Microscopically, these tumors consist of cavernous, blood-filled vascular spaces of variable size lined by a single epithelial layer (arrow).
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IENhdmVybm91cyBoZW1hbmdpb21hLg==
Cg==Cg==[Qq][q] ……. is a Malignant tumor of endothelial origin; associated with exposure to arsenic, vinyl chloride.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEFuZ2lvc2FyY29tYS4=[Qq]
[q] What is the most likely diagnosis?
14 years old patient presenting with mild unconjugated hyperbilirubinemia thought to be provoked by fasting, physical exertion with no apparent liver disease and without overt hemolysis but there is decrease in UDP glucuronyl transferases activity?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEdpbGJlcnQgc3luZHJvbWUu
Cg==Cg==R2lsYmVydCBzeW5kcm9tZSBpcyBhIGNvbW1vbiBmYW1pbGlhbCBkaXNvcmRlciBvZiBiaWxpcnViaW4gZ2x1Y3Vyb25pZGF0aW9uIGluIHdoaWNoIHRoZSBwcm9kdWN0aW9uIG9mIFVEUCBnbHVjdXJvbnlsIHRyYW5zZmVyYXNlcyAoZW56eW1lcyB0aGF0IG1lZGlhdGUgZ2x1Y3Vyb25pZGF0aW9uIG9mIHZhcmlvdXMgc3Vic3RhbmNlcykgaXMgcmVkdWNlZCBhbmQgaW1wYWlyZWQgYmlsaXJ1YmluIHVwdGFrZS4=
[Qq]
[q] What is the most likely diagnosis?
A newborn child presenting with bilirubin encephalopathy and neurological impairment + Indirect bilirubin level 25 mg/dl with Absent UDP-glucuronosyltransferase?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IENyaWdsZXItTmFqamFyIHN5bmRyb21lLg==
Cg==Cg==[Qq][q] …….. is characterized by a defect in the hepatic excretion of bilirubin glucuronides across the canalicular membrane, predominantly conjugated chronic hyperbilirubinemia. Grossly, the liver is strikingly black (Dark).
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IER1YmluLUpvaG5zb24gc3luZHJvbWUu
Cg==Jm5ic3A7
Cg==[Qq]
[q] …….. is similar to dubin johnson syndrome, but milder in presentation without black (Regular) liver.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFJvdG9yIHN5bmRyb21lLg==
Cg==Cg==[Qq][q] Heme oxygenase converts heme to……., a pigment that causes the greenish color to develop in bruises several days after an injury.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGJpbGl2ZXJkaW4u[Qq]
[q] ……… is the most common indication for pediatric liver transplantation?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEJpbGlhcnkgYXRyZXNpYS4=[Qq]
[q] What is the most likely diagnosis?
A newborn child presenting with conjugated hyperbilirubinemia, acholic (light) stools and dark urine, and hepatomegaly + Laboratory findings include increased levels of direct bilirubin, alkaline phosphatase, and gamma-glutamyl transferase + Liver biopsy shows Marked intrahepatic bile ductule proliferation, Portal tract edema and fibrosis, Parenchymal cholestasis?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEJpbGlhcnkgYXRyZXNpYS4=
Cg==Cg==SWYgYmlsaWFyeSBkcmFpbmFnZSBpcyBub3QgcmVzdG9yZWQgc3VyZ2ljYWxseSwgYmlsZSBzdGFzaXMgd2lsbCBjYXVzZSBkZXZlbG9wbWVudCBvZiBiaWxpYXJ5IGNpcnJob3NpcyBieSA2IG1vbnRocyBvZiBsaWZlLg==
[Qq][q] …….. is the most common type (90%), especially in the U.S. Usually radiolucent (10% are radiopaque due to associated calcium).
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IENob2xlc3Rlcm9sIHN0b25lcy4=[Qq]
[q] ……… increases cholesterol synthesis by upregulating hepatic HMG-CoA reductase activity, which causes the bile to become supersaturated with cholesterol.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEVzdHJvZ2VuLg==[Qq]
[q]…….. reduces bile acid secretion and slows gallbladder emptying. When the gallbladder is hypomotile or there is more cholesterol than bile salts, the cholesterol precipitates into insoluble crystals that eventually form to make gallstones.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFByb2dlc3Rlcm9uZS4=[Qq]
[q] Suppression of ………. activity (through fibrate medications such as bezafibrate, fenofibrate, and ciprofibrate) reduces the conversion of cholesterol into bile acids, resulting in an increased concentration of cholesterol within the bile.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGNob2xlc3Rlcm9sIDfOsS1oeWRyb3h5bGFzZS4=
Cg==Cg==[Qq][q] ……. is gallstones that is composed of bilirubin. Usually radiopaque. Risk factors include extravascular hemolysis (increased bilirubin in bile) and biliary tract infection (E coli, Ascaris lumbricoides, and Clonorchis sinensis).
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEJpbGlydWJpbiBzdG9uZXMu[Qq]
[q]……… pigment stones typically arise secondary to infection of the biliary tract, which results in the release of β-glucuronidase by injured hepatocytes and bacteria.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEJyb3duLg==[Qq]
[q] A prolonged course of total parenteral nutrition (TPN) is often complicated by the formation of gallstones. The pathogenesis of TPN-induced gallstones is thought to be due to Biliary stasis from absent enteral stimulation secondary to decreased ……. release.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGNob2xlY3lzdG9raW5pbi4=[Qq]
[q] …….. improve cholesterol solubility by reducing the amount of cholesterol secreted into the bile and increasing biliary bile acid concentration.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEh5ZHJvcGhpbGljIGJpbGUgYWNpZHMgKHVyc29kZW94eWNob2xpYyBhY2lkKS4=[Qq]
[q] What is the most likely diagnosis?
34 years old female presenting with colicky pain in the right upper quadrant radiating to the right shoulder and back, often triggered by ingestion of fatty food, accompanied by nausea and vomiting + symptoms usually resolve within 4 hours?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEJpbGlhcnkgY29saWMu[Qq]
[q] What is the most likely diagnosis?
34 years old female presenting with right upper quadrant pain and tenderness, fever, vomiting, and leukocytosis. During abdominal examination there is worsening of right upper quadrant pain with inspiration that sometimes causes the patient to suddenly hold his breath + U/S shows gallstones, thick-walled gallbladder, and pericholecystic fluid.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEFjdXRlIGNhbGN1bG91cyBjaG9sZWN5c3RpdGlzLg==
Cg==Cg==[Qq][q] What is the most likely diagnosis?
It is crucial to have a high index of suspicion for acalculous cholecystitis when managing those patients at increased risk, as an insidious presentation is linked to higher rates of ……. and ……..?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGdhbmdyZW5lIGFuZCBwZXJmb3JhdGlvbi4=
Cg==Cg==TW9ydGFsaXR5IHJhdGVzIHJhbmdlIHdpZGVseSBmcm9tIDEwLTkwJSwgZGVwZW5kaW5nIG9uIHBhdGllbnQgY29uZGl0aW9uIGFuZCBob3cgcXVpY2tseSB0aGUgZGlhZ25vc2lzIGlzIGVzdGFibGlzaGVkLg==[Qq]
[q] What is the most likely diagnosis?
34 years old female presenting with long history of gallstones presenting with abdominal pain/distension, nausea/vomiting, high- pitched (tinkling) bowel sounds, and tenderness to palpation + Abdominal x-ray shows dilated loops of bowel with air-fluid levels and gas in the biliary tree (pneumobilia)?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEdhbGxzdG9uZSBpbGV1cy4=
Cg==Cg==[Qq][q] …….. is recommended for those with porcelain gallbladders because 11-33% of this patient population will eventually develop gallbladder carcinoma.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IENob2xlY3lzdGVjdG9teS4=
Cg==Cg==[Qq]Porcelain gallbladder is a term used to describe the calcium-laden gallbladder wall with bluish color and brittle consistency often associated with chronic cholecystitis.
[q] What is the most likely diagnosis?
34 years old female presenting with long history of gallstones presenting with Fever, jaundice, and right upper quadrant abdominal pain, Confusion and hypotension + Laboratory results usually show leukocytosis and neutrophilia in addition to elevations in alkaline phosphatase, gamma-glutamyl transpeptidase, and direct bilirubin?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEFzY2VuZGluZyBjaG9sYW5naXRpcy4=[Qq]
[q] Administration of mu opioid analgesics, such as morphine, can cause ……. of smooth muscle cells in the sphincter of Oddi, leading to spasm and an increase in common bile duct pressures.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGNvbnRyYWN0aW9uLg==[Qq]
[q] What is the most likely diagnosis?
25 years old patient presenting with history of ulcerative colitis pruritus, jaundice with elevated conjugated bilirubin, dark urine, light-colored stool, hepatosplenomegaly + onion skin” bile duct fibrosis → alternating strictures and dilation with “beading” of intra- and extrahepatic bile ducts on magnetic resonance cholangiopancreatography (MRCP) + p-ANCA ⊕, ↑ IgM.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFByaW1hcnkgc2NsZXJvc2luZyBjaG9sYW5naXRpcy4=
Cg==Cg==[Qq][q] What is the most likely diagnosis?
25 years old patient presenting with history of Hashimoto thyroiditis pruritus, jaundice with elevated conjugated bilirubin, dark urine, light-colored stool, hepatosplenomegaly + lymphocytic infiltrate + granulomas → destruction of the intrahepatic bile ducts and cholestasis + Anti-mitochondrial antibody ⊕, ↑ IgM?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFByaW1hcnkgYmlsaWFyeSBjaG9sYW5naXRpcy4=
Cg==Cg==UHJldmlvdXNseSBrbm93biBhcyBwcmltYXJ5IGJpbGlhcnkgY2lycmhvc2lzLg==
[Qq]
[q] What is the most likely diagnosis?
21 years old patient presenting with longitudinal tears in the anal canal distal to the dentate line at the posterior midline + chronic constipation with high anal pressures and passage of hard stools, There is exquisite pain with defecation and blood streaks covering the stools?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEFuYWwgZmlzc3VyZS4=
Cg==Jm5ic3A7
Cg==[Qq]
[q] …….. cause reversible block of histamine H2-receptors —> ↓ H secretion by parietal cells. Used for treatment of Peptic ulcer, gastritis, mild esophageal reflux. Has antiandrogenic effects and can cross blood-brain barrier
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEhpc3RhbWluZSBIMiBibG9ja2Vycy4=
Cg==Q2ltZXRpZGluZSwgcmFuaXRpZGluZSwgZmFtb3RpZGluZSwgbml6YXRpZGluZS4gVGFrZSBIMiBibG9ja2VycyBiZWZvcmUgeW91IGRpbmUu[Qq]
[q] …….. cause irreversible inhibition of H/K ATPase in stomach parietal cells. Used for treatment of – Peptic ulcer, gastritis, esophageal reflux, Zollinger-Ellison syndrome, component of therapy for H pylori, stress ulcer prophylaxis. ↑ risk of C difficile infection, pneumonia, acute interstitial nephritis.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFByb3RvbiBwdW1wIGluaGliaXRvcnMgKE9tZXByYXpvbGUsIGxhbnNvcHJhem9sZSwgZXNvbWVwcmF6b2xlLCBwYW50b3ByYXpvbGUsIGRleGxhbnNvcHJhem9sZSku[Qq]
[q] ……. is antacid that cause Constipation, Hypophosphatemia; Osteodystrophy, Proximal muscle weakness, Seizures as a side effect.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEFsdW1pbnVtIGh5ZHJveGlkZS4=[Qq]
[q] ……. is antacid that cause Hypercalcemia (milk-alkali syndrome), rebound acid ↑. Can chelate and ↓ effectiveness of other drugs (tetracycline) as a side effect.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IENhbGNpdW0gY2FyYm9uYXRlLg==[Qq]
[q] ……. is antacid that cause Diarrhea, hyporeflexia, hypotension, cardiac arrest as a side effects.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IE1hZ25lc2l1bSBoeWRyb3hpZGUu[Qq]
[q] …….. Bind to ulcer base, providing physical protection and allowing HCO3 secretion to reestablish pH gradient in the mucous layer. Can be used in quadruple therapy for H pylori gastritis.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEJpc211dGgu[Qq]
[q] ….. is a PGE1 analog, ↑ production and secretion of gastric mucous barrier, ↓ acid production. Used for Prevention of NSAID-induced peptic ulcers (NSAIDs block PGE1 production) and Maintenance of a PDA.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IE1pc29wcm9zdG9sLg==[Qq]
[q] …….. is a Long-acting somatostatin analog; inhibits secretion of various splanchnic vasodilatory hormones. Used for treatment of Acute variceal bleeds, acromegaly, VIPoma, carcinoid tumors.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IE9jdHJlb3RpZGUu[Qq]
[q] …….. is a 5-HT3 antagonist; ↓ vagal stimulation. Used for treatment of Control vomiting postoperatively and in patients undergoing cancer chemotherapy. Cause – Headache, constipation, QT interval prolongation, serotonin syndrome as side effects.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IE9uZGFuc2V0cm9uLg==
Cg==Cg==[Qq][q] …….. is a D2 receptor antagonist, ↑ resting tone, contractility, LES tone, motility. Used for treatment of Diabetic and postoperative gastroparesis, antiemetic, persistent GERD. Contraindicated in patients with small bowel obstruction or Parkinson disease (due to D2-receptor blockade).
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IE1ldG9jbG9wcmFtaWRlLg==
Cg==Cg==[Qq][q] ……. is a NK1 (neurokinin-1) receptor blocker in brain. Used as Antiemetic for chemotherapy-induced nausea and vomiting.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEFwcmVwaXRhbnQu
Cg==Cg==[Qq][q] ……. is Soluble fibers draw water into gut lumen, forming a viscous liquid that promotes peristalsis. Cause bloating as side effect.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEJ1bGstZm9ybWluZyBsYXhhdGl2ZXMgKFBzeWxsaXVtLCBtZXRoeWxjZWxsdWxvc2UpLg==[Qq]
[q] ………. are nonabsorbable or poorly absorbable substances that attract water into the intestinal lumen, thus distending the intestinal wall and increasing peristalsis. The laxative effect is usually fairly rapid. Cause Diarrhea, dehydration as side effects.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IE9zbW90aWMgbGF4YXRpdmVzIChNYWduZXNpdW0gaHlkcm94aWRlLCBtYWduZXNpdW0gY2l0cmF0ZSwgcG9seWV0aHlsZW5lIGdseWNvbCwgbGFjdHVsb3NlKS4=[Qq]
[q] …….. is laxative that work by Enteric nerve stimulation → colonic contraction. Cause Diarrhea and melanosis coli as side effects.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFN0aW11bGFudHMgKFNlbm5hKS4=[Qq]
[q] …….. is laxative that work by Promoting incorporation of water and fat into stool. Cause Diarrhea as side effect.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEVtb2xsaWVudHMgKERvY3VzYXRlKS4=[Qq]
[q] ……… is an Agonist at μ-opioid receptors; slows gut motility with Poor CNS penetration (low addictive potential). Used for treatment of Diarrhea. Cause Constipation and nausea as side effects.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IExvcGVyYW1pZGUu[Qq]
[q] ………. is a combination of sulfapyridine (antibacterial) and 5-aminosalicylic acid (anti-inflammatory). Activated by colonic bacteria. Used for treatment of Ulcerative colitis, Crohn disease (colitis component).
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFN1bGZhc2FsYXppbmUu[Qq]
[q] ……. inhibits gastric and pancreatic lipase → ↓ breakdown and absorption of dietary fats. Used for treatment of Weight loss. Cause Abdominal pain, flatulence, bowel urgency/frequent bowel movements, steatorrhea; ↓ absorption of fat-soluble vitamins
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IE9ybGlzdGF0Lg==[Qq]
[q] ………. improve cholesterol solubility by reducing the amount of cholesterol secreted into the bile and increasing biliary bile acid concentration.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFVyc29kZW94eWNob2xpYyBhY2lkLiBVc2VkIGZvciB0cmVhdG1lbnQgb2YgUHJpbWFyeSBiaWxpYXJ5IGNpcnJob3NpcywgZ2FsbHN0b25lIHByZXZlbnRpb24gb3IgZGlzc29sdXRpb24u[Qq]
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