Internal Medicine Jeopardy Game

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Basil Farmer
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1 Internal Medicine Jeopardy Game Ziad Mattar, M.D. Chief Medical Resident University of Toledo Single Double Date Final

2 Single Diarrhea GERD Urgent Matters Gallery Action & Reaction Double Final

3 I 100Q The nail findings of severe iron deficiency anemia Koilonychia Topic I 100 Question

4 I 200Q This radiographic finding of submucosal hemorrhage and edema in the colon is seen in cases of this condition Mesenteric Ischemia Topic I 200 Question

5 I 300Q This organism, acquired through ingestion of contaminated beef may cause bloody diarrhea and HUS E. Coli 0157:H7 Topic I 300 Question

6 I 400Q This organism causes a chronic diarrhea in AIDS patients with weight loss, abdominal cramps fever and peripheral eosinophilia Isospora Belli Topic I 400 Question

7 I 500Q An elevated fecal osmotic gap suggests this type of diarrheal disease Osmotic Diarrhea Topic I 500 Question

8 II 100Q This fundoplication operation is a surgical approach for the treatment ofgerd Nissen Topic II 100 Question

9 II 200Q Barrett s esophagus is associated with this type of cell metaplasia Columnar epithelium Topic II 200 Question

10 II 300Q Name 3 extra-esophageal manifestations of GERD Asthma, Cough, Hoarseness/Laryngitis, dental erosions Topic II 300 Question

11 II 400Q A mucosal ring found at the gastro-esophageal junction and may cause dysphagia Schatzki s ring Topic II 400 Question

12 II 500Q A 63 yo pt c/o dysphagia for solid food that gradually progress to include liquids. Barium swallow shows stricture in the esophagus. Management? a) A trial of Omeprazole c) EGD for biopsy b) NG tube for feeding d) EGD for dilatation Topic II 500 Question

13 III 100Q What is the fecal osmotic gap? Na- 39 mmol/l K- 96 mmol/l x (Na+K) = 10 Topic III 100 Question

14 III 200Q The appropriate treatment for a patient with ulcerative colitis and high-grade dysplasia Proctocolectomy Topic III 200 Question

15 III 300Q Patient with T-cell mediated inflammatory reaction to gluten who presents with itching may have this associated dermatologic condition Dermatitis Herpetiformis Topic III 300 Question

16 III 400Q A 43 yo alcoholic c/o large bowel volume diarrhea and weight loss. Xylose tolerance test shows low urine xylose. What is next best test? a) Barium enema c) Small bowel biopsy b) Small bowel series d) CT scan pancreas Topic III 400 Question

17 III 500Q A 42 yo pt with lactose intolerance c/o large vol diarrhea. Stool fat is 40gm/24hrs. Xylose test shows blood level of 40 mg% after 1 hr and 5 hrs urine excretion of 8gm. What will you do? a) Small bowel biopsy c) Restrict lactose b) Plain abdominal film d) Give lactase tablets Topic III 500 Question

18 IV 100Q Patient septic and frank blood per rectum. Diagnosis? Necrotizing enterocolitis Topic IV 100 Question

19 IV 200Q Peripheral smear Diagnosis? Gastric Ulcer finding in lead poisoning Topic IV 200 Question

20 IV 300Q What is the initial treatment of this condition? Ca channel blocker/ Nitrates Topic IV 300 Question

21 IV 400Q Name of bug? Entamoeba Histolytica Topic IV 400 Question

22 IV 500Q Diagnosis? Achalasia Topic IV 500 Question

23 V 100Q Epigastric pain in patient with bloating and watery diarrhea 6 times/day. Cause? a) Giardia b) Campylobacter Jejuni c) Shigella d) Yersinia Topic V 100 Question

24 V 200Q Non-bloody diarrhea, epigastric pain and eosinophilia occur in in a sales executive returning from Peru. Flagyl is tried but it did not help. MCV is low. Diagnosis? a) E.Coli c) Yersinia b) Giardia d) Strongyloides Topic V 200 Question

25 V 300Q A 33 yo pt gets watery diarrhea after a trip to Mexico. Stools smear reveals presence of leukocytes and curved organisms. Which is the causative organism? a) Giardia c) Campylobacter Jejuni b) Toxigenic E. Coli d) Vibrio Cholerae Topic V 300 Question

26 V 400Q A 34 yo F develops bloody diarrhea followed by sepsis and nodules on her legs. What is the cause of this disease? a) Vibrio Vulnificus c) Salmonella b) Shigella d) Yersinia Topic V 400 Question

27 V 500Q A 26 yo F presents with 36 hrs non-bloody diarrhea. She admits swimming in seawater in New Orleans while on vacation on vacation. What is the cause? a) Giardia c) Toxigenic E. Coli b) V. Para-hemolyticus d) Hurricane Katrina Topic V 500 Question

28 Double Electrical Rhythm I Am Treatment Liver or Viral Do you Know? Final

29 VI 200Q A. Fib Topic VI 200 Question Go To Double

30 VI 400Q AVNRT Topic VI 400 Question Go To Double

31 VI 600Q Cardiac Tamponade Topic VI 600 Question Go To Double

32 VI 800Q Hepertrophic Obstructive Cardiomyopathy Topic VI 800 Question Go To Double

33 VI 1000Q Long QT Topic VI 1000 Question Go To Double

34 VII 200Q Which of the following does NOT cause painful mouth ulcer: a) Aphtous Ulcer b) Behcet s c) Reiter s sundrome d) Pemphigus Vulgaris Topic VII 200 Question

35 VII 400Q What is the gold standard test for fat malabsorption? 24-hr fecal collection Topic VII 400 Question Go To Double

36 VII 600Q Which of the following sets of blood test is compatible with Celiac disease? Condition Serum Ca Phosphorus Alk Phos PTH A low high high high B Low Low High high C nl nl very high nl CRF Paget s Topic VII 600 Question Go To Double

37 VII 800Q Chest pain occurs after retching and vomiting. X-ray of chest shows left pleural effusion. Next Step? b) CPK c) Endoscopy a) Gastrografin study d) CT scan chest Topic VII 800 Question Go To Double

38 VII 1000Q A 41 yo patient with duodenal ulcer treated for H.Pylori gastritis, however he returns with same symptoms. Which of the following would best indicate repeat infection with H. Pylori? a) Breath urease test b) Gastric contents for H. Pylori culture c) IgG serological test for H. Pylori d) Duodenal aspirate for H. Pylori Topic VII 1000 Question Go To Double

39 VIII 200Q A 41 yo pt with Crohn s disease develops perianal fistula. Which of the following will most likely to heal it? a) Metronidazole b) Methotrexate c) Steroids d) Surgery Topic VIII 200 Question Go To Double

40 VIII 400Q Which of the following drugs used in Crohn s disease is steroids-sparing? a) Metronidazole b) 6-MP c) Sulfasalazine d) 5-ASA Topic VIII 400 Question Go To Double

41 VIII 600Q Recurrent oxalate renal stones occur in a patient with Crohn s disease. What is the cause of renal stones.? a) Increased oxalate absorption b) Decreased oxalate excretion by the kidneys c) Decreased absorption of Na oxalate from the colon d) Increased Ca intake Topic VIII 600 Question Go To Double

42 VIII 800Q A hospitalized patient, while on ABX, gets diarrhea that is positive for C. difficile. Flagyl is started and the diarrhea goes away in 3 days. Flagyl is continued for 7 days and patient discharged. Two days later, he gets diarrhea again. What is the step? a) PO Flagyl c) PO Vanco b) IV Flagyl d) PO Cholestyramine Topic VIII 800 Question Go To Double

43 VIII 1000Q A 34 yo F presents c/o bloody diarrhea with RLQ tenderness and painful leg nodules. What is your possible diagnosis? Crohn s / Yersinia Topic VIII 1000 Question Go To Double

44 IX 200Q Which test in Hepatitis B indicates maximum infectivity? a) HBc Ab b) HBs Ag c) HBe Ag d) HBs Ab Topic IX 200 Question Go To Double

45 IX 400Q A patient with history of hepatitis develops periarteritis nodosa. Which hepatitis was it? Hepatitis B Topic IX 400 Question Go To Double

46 IX 600Q A 31 yo F comes with anorexia and modestly elevated AST and ALT but mildly elevated Alk Phos. Hep A, B and C are negative. What is your next step? a) Anti-smooth muscle Ab c) ERCP b) Anti-mitochondrial Ab d) EGD Topic IX 600 Question Go To Double

47 IX 800Q A 53 yo pt is actively bleeding from esophageal varices. What is the next step? a) Endoscopic sclerotherapy b) Endoscopic band ligation c) Octreotide and Somatostation infusion and enoscopic therapy d) TIPS Topic IX 800 Question Go To Double

48 IX 1000Q A patient develops arthralgia and purpuric lesions on the legs. There is a past history of hepatitis. What hepatitis was it? Hepatitis C Topic IX 1000 Question Go To Double

49 Congratulations Congratulations Congratulations

INVESTIGATIONS OF GASTROINTESTINAL DISEAS

INVESTIGATIONS OF GASTROINTESTINAL DISEAS Lecture 1 and 2 دز اسماعيل داود فرع الطب كلية طب الموصل Radiological tests of structure (imaging) Plain X-ray: May shows soft tissue outlines like liver, spleen,