Gastroenterology and Oral Pathology Quiz

<p>Self-resolving lesion on labial mucosa (B)</p> Signup and view all the answers

<p>Plummer-Vinson syndrome (A)</p> Signup and view all the answers

<p>Hyperpigmentation around the lips and mouth (B)</p> Signup and view all the answers

<p>Plummer-Vinson syndrome (A)</p> Signup and view all the answers

<p>Spicy food (A)</p> Signup and view all the answers

<p>Lower esophageal sphincter (LES) tone (B)</p> Signup and view all the answers

<p>Hiatal hernia (D)</p> Signup and view all the answers

<p>Burning sensation in the throat/chest (C)</p> Signup and view all the answers

<p>Two-week trial of proton pump inhibitor (PPI) (B)</p> Signup and view all the answers

<p>Proton pump inhibitors (PPIs) (D)</p> Signup and view all the answers

<p>Coughing up milk 2-3 times daily (C)</p> Signup and view all the answers

<p>Thickening feeds and positional changes (B)</p> Signup and view all the answers

<p>Nissen fundoplication (A)</p> Signup and view all the answers

<p>Decreased LH and FSH levels (C)</p> Signup and view all the answers

<p>Secondary active transport (B)</p> Signup and view all the answers

<p>Duodenal ulcer (B)</p> Signup and view all the answers

<p>Clarithromycin, amoxicillin, PPI (B)</p> Signup and view all the answers

<p>Air under the diaphragm (C)</p> Signup and view all the answers

<p>Helicobacter pylori infection (C)</p> Signup and view all the answers

<p>Secretion of proteinaceous substrates that damage the mucosal lining (A)</p> Signup and view all the answers

<p>It can be part of Multiple Endocrine Neoplasia type 1. (D)</p> Signup and view all the answers

<p>Urease breath test (B)</p> Signup and view all the answers

<p>PPIs (B)</p> Signup and view all the answers

<p>Gastric outlet obstruction (B)</p> Signup and view all the answers

<p>Decreased blood flow to the stomach (C)</p> Signup and view all the answers

<p>Increases gastrin levels (A)</p> Signup and view all the answers

<p>Vitamin B12 deficiency (C)</p> Signup and view all the answers

<p>To replenish reduced prostaglandin levels (D)</p> Signup and view all the answers

<p>Increased parasympathetic outflow (A)</p> Signup and view all the answers

<p>ERCP (B)</p> Signup and view all the answers

<p>Obese, middle-aged females (A)</p> Signup and view all the answers

<p>Obstruction of cystic duct by stone (B)</p> Signup and view all the answers

<p>Increased progesterone and decreased biliary peristalsis (D)</p> Signup and view all the answers

<p>Hereditary spherocytosis (B)</p> Signup and view all the answers

<p>Formation of cholesterol stones (B)</p> Signup and view all the answers

<p>Clonorchis sinensis (D)</p> Signup and view all the answers

<p>Splenectomy (C)</p> Signup and view all the answers

<p>Abdominal ultrasound followed by ERCP (A)</p> Signup and view all the answers

<p>Hepatopancreatic ampulla (D)</p> Signup and view all the answers

<p>Head of pancreas cancer (A)</p> Signup and view all the answers

<p>Elevated direct bilirubin and elevated amylase/lipase (A)</p> Signup and view all the answers

<p>Cholangiocarcinoma (A)</p> Signup and view all the answers

<p>Potential for retained stones in the biliary tree (B)</p> Signup and view all the answers

<p>To assess bile duct patency (B)</p> Signup and view all the answers

<p>Weight loss and heavy smoking (C)</p> Signup and view all the answers

Combination of perioral melanosis (lip hyperpigmentation) and hamartomatous colonic polyps.

Type of polyps frequently seen in the colon in Peutz-Jeghers Syndrome.

Hereditary hemorrhagic telangiectasia; characterized by nosebleeds and telangiectasia (small blood vessel dilation).

Triad of iron deficiency anemia, esophageal webs (difficulty swallowing), and angular cheilitis (cracked mouth corners).

Psoriasis can occur on the lips, not just the extensor surfaces.

Painful, self-resolving lesion on the lip's inner lining; idiopathic (unknown cause).

Anemia from low iron levels, can lead to pica (eating non-food items), and koilonychia (spoon-shaped nails).

Small blood vessel dilation, a sign of Osler-Weber-Rendu Syndrome.

Irritation of the esophageal lining by stomach acid, often due to a weakened lower esophageal sphincter (LES).

Obesity, hiatal hernia, and a weak lower esophageal sphincter (LES) can increase risk.

Burning sensation in the chest/throat after eating, possible nocturnal cough, or recurrent pneumonia (without typical esophageal pain).

A 2-week trial of a proton pump inhibitor (PPI) such as omeprazole.

PPIs are more effective for GERD treatment than H2-blockers.

Infant coughs up milk a few times a day, without forceful ejection or bile; no choking/spitting during the first feed

Thickened feeds and positional changes initially, before using PPIs, if required.

Nissen fundoplication is a last resort surgical procedure.

Low body mass index (BMI) or anorexia reduces leptin levels, which decreases GnRH, thus lowering LH and FSH, leading to amenorrhea.

GLUT transporters facilitate sugar movement down their concentration gradient – from high to low concentration – through facilitated diffusion.

SGLT-1 uses secondary active transport, powered by a sodium gradient. The gradient then moves glucose and galactose against their gradient.

Pain from a gastric ulcer occurs immediately after eating due to increased acid secretion.

Pain from duodenal ulcers occurs 1-2 hours after eating, relieved with meals because of pylorus tightening.

H. pylori is responsible for most duodenal ulcers (>95%), but plays a lesser role (over 60%) in gastric ulcers.

H. pylori damages the mucosal lining via its secreted proteins, rather than solely due to increased acid secretion.

H. pylori produces urease, which creates ammonia, enabling its survival in the stomach's acidic environment.

Zollinger-Ellison syndrome is a rare condition characterized by gastrinomas (tumors that produce gastrin) that lead to excessive stomach acid production and peptic ulcers.

The standard treatment for H. pylori infection is a triple therapy regimen including a proton pump inhibitor (PPI), clarithromycin, and amoxicillin.

A perforated duodenal ulcer is a hole in the wall of the duodenum, often caused by H. pylori infection or NSAIDs.

A perforated duodenal ulcer often presents with sudden, severe abdominal pain, rigidity (involuntary guarding), and signs of sepsis (e.g., fever, tachycardia, low blood pressure).

X-rays of the chest and abdomen may show free air under the diaphragm, which is a classic finding in perforated duodenal ulcer.

Cancer of the bile ducts, often associated with risk factors like smoking and parasitic infections (e.g., Clonorchis sinensis).

Nonsteroidal anti-inflammatory drugs (NSAIDs) can cause peptic ulcers by decreasing prostaglandin production, which protects the stomach lining.

A diagnostic and therapeutic procedure that allows visualization of the bile ducts and pancreas using a flexible endoscope.

Sudden, sharp pain in the upper abdomen (epigastrium or right upper quadrant) caused by a gallstone obstructing the cystic duct.

Proton pump inhibitors (PPIs) are first-line treatment for peptic ulcers, but misoprostol (a prostaglandin analogue) can be used specifically for NSAID-induced ulcers.

The presence of gallstones within the gallbladder.

Bile composition that promotes the formation of gallstones, often characterized by high cholesterol levels.

A genetic disorder characterized by abnormally shaped red blood cells (spherocytes), leading to increased red blood cell destruction and a higher risk of gallstones.

Surgical removal of the spleen to reduce the incidence of gallstones in patients with hereditary spherocytosis.

Gallstones primarily composed of bilirubin, commonly found in patients with hereditary spherocytosis and sickle cell disease due to increased red blood cell breakdown.

Presence of gallstones in the common bile duct, causing obstruction of bile flow.

Distinguish choledocholithiasis from pancreatic cancer by considering patient history. If a patient has obstructive jaundice, is a heavy smoker, has had weight loss, or has had a cholecystectomy years prior, it's more likely pancreatic cancer.

Endoscopic retrograde cholangiopancreatography (ERCP) is a common treatment for choledocholithiasis, allowing for stone removal and visualization of the biliary tree.

A specific type of choledocholithiasis where a gallstone obstructs the hepatopancreatic ampulla, leading to pancreatitis.

The junction where the common bile duct and the pancreatic duct meet, opening into the duodenum.

Diagnose via elevated pancreatic enzymes (amylase and lipase) alongside obstructive jaundice (elevated alkaline phosphatase and bilirubin).

Yellowing of the skin and whites of the eyes due to an obstruction in the bile duct.

USMLE expects an abdominal ultrasound to be performed first to evaluate for choledocholithiasis. If the ultrasound confirms stones, follow up with ERCP.