DDx Practice Quiz week 7-8

A patient presents with acute waves of sharp constricting abdominal pain that "takes the breath away" is most likely due to: Choose all that apply a:biliary colic b:diverticulitis c:renal colic d:appendicitis

A and C are correct

Which of the following metabolic conditions are causes of extra-abdominal pain? choose all that apply a:hypercalcemia b:diabetis ketoacidosis c:alcoholic ketoacidosis d:herpes zoster

A,B,C area all correct

What is the leading cause of excess Crohn disease related mortality? a:GI cancer b:fistulizing Crohn disease c:bowel obstruction d:the presence of granulomas

A:GI cancer

Which of the following is a cause of acute constipation? a:adynamic ileus b:colonic tumor c:CNS disorder d:metabolic disorders

A:adynamic ileus

A patient presents with RLQ pain. What are the possible differential diagnosis? Pick all that apply. a:cecal diverticulitis b:meckel diverticulum c:mittelschmerz d:appendicitis e:ischemic colitis

A:cecal diverticulitis b:meckel diverticulum c:Mittelschmeerz A,B,C all correct

All of the following should be considered with patients severe abdominal pain that is out of proportion to physical findings: Choose all that apply: a:perforated viscus b:peritonitis c:kidney stone d:pancreatitis

All are correct

In comparing Chron to Ulcerative Colitis, Crohn demonstrates all of the following: Pick all that apply: a:absess b:fistula c:Mass d:gross rectal bleeding is always present

All are correct except D.

The most common initial manifestation(subjective) of Crohn disease is(pick all that apply) a:Chronic diarrhea b:Fever c:abdominal pain d:abdominal tenderness e:anorexia/weight loss

All are correct except d:Abdominal tenderness

Which of the following is recommended for patients with large symptomatic gallstones? a:stone dissolution using ursodexycholic acid b:cholecystectomy c:stone framgentation using extracorporeal shock wave therapy d:expectant management

B:cholecystectomy

When imaging is deemed necessary to confirm appendicitis in children with atypical or equivocal findings, which of the following imaging studies is safest? a:contrast enhanced MRI of the abdomen b:graded compression ultrasonagraphy of the abdomen c:abdominal x-ray d:contrast enhanced CT of the abdomen

B:graded ultrasonagraphy

In a patient with suspected gallstones, which of the following is the most reliable diagnostic tool? a:elimination diet b:ultrasonography c:GI x-ray series d:liquid profile

B:ultrasonography

Most gallstones comprise which of the following? a:calcium stearate b:calcium carbonate c:cholesterol d:bile

C:Cholesterol

Which of the following is NOT a risk factor for gallstones? a:female sex b:family history c:American Indian ethnicity d:Younger age

D: Younger age

When associated with nausea and vomiting, which of the following raises suspicion of a more serious etiology of chronic constipation? a:changes in color of stool b:abdominal pain c:occasional bouts of diarrhea d:distended, tympanic abdomen

D:distended, tympanic abdomen

An adult patient presents with LLQ and suprapubic pain and tenderness. There is a palpable sigmoid: the pain is often accompanied with nauesea, vomiting and fever. What do you suspect? a:meckels diverticula b:proctitis c:appendicitis d:diverticulitis

D:diverticulitis

Which of the following tests has a senstivity and specificity of >90% for acute pancreatitis? a:serum lipase level b:serum amylase level c:amylase:creatine clearance ratio test d:urine trypsinogen-2dipstick test

D:urine trypsinogen-2dipstick test

An adult patient presents with acute RLQ and LLQ pain. There is nausea, vomiting and abdominal distension. What are teh possible differential diagnosis? Pick all that apply: a:diverticulitis b:Bowel obstruction c:Colon/Ovarian cancer d:Appendicitis e:IBS

Guess what. All are true.

TRUE Or False: Crohn's disease is a chronic transmural inflammatory bowel disease that usually affects the distal ileum and colon but may occur in any part of teh GI tract of teh GI tract.

Guess what. TRUE.

TRUE Or FALSE: A pateint with Crohn disease has the small bowel involved in 80% of the cases.

TRUE

TRUE Or FALSE: Acute Meckel diverticulitis is characterized by abdominal pain and tenderness typically localized below or adjacent to the umbilicus:it is often accompanied by vomiting and is similar to that of appendicitis.

TRUE

TRUE Or FALSE:A patient with ulcerative colitis has the disease mainly confined to the colon.

TRUE

TRUE Or FALSE:Diverticulitis is inflammation and/or infection of a diverticulum, which can result in swelling of the bowel wall, peritonitis, perforation, fistula, or abscess.

TRUE

True or False: Abdominal pain is of particular concern in patients who are very young or very old and those who have HIV infection or are taking immunosuppressants (including corticosteroids).

TRUE

True or False: While the location and pattern of abdominal pain can provide important clues, its time is particularly useful when determining its cause?

TRUE

Severe acute abdominal pain and a silent abdomen suggests which of the following? a:peritonitis b:appendicitis c:abdominal aortic aneurysm d:renal colic

a:peritonitis

Basic treatment of acute pancreatitis includes early fluid resuscitation, analgesia, and which of the following? a:antibiotics b:enteral nutrition c:endoscopic retrograde cholangiopancreatography d:total parenteral nutrition

b:enteral nutrition

Prognosis is worse for which of the following patients with appendicitis? a:pediatric patients b:patients with advancing age c:patients with terminal ileitis d:obese patients

b:patients with advancing age.

The MOST SERIOUS CAUSE of peritonitis is: a:pancreatitis b:perforation of the GI tract c:PID d:appendicitis

b:perforation of the GI tract

Celiac disease should be strongly considered in which of the following scenarios? a:the patient has coexisting anorexia and bulimia b:the patient has iron deficiency but no apparent GI bleed c:the patient has chronic diarrhea but claims to be able to tolerate gluten rich foods d:patient has known intolerance

b:the patient has iron deficiency but no apparent GI bleed

In some patients with ulcerative colitis, the stool may be normal or hard and dry, but a rectal discharges of mucus loaded with RBCs and WBCs accompany or occur between bowel movements. This finding suggests which of the following? a:ulceration has extended proximaly b:lceration is confined to the rectosigmoid c:toxic colitis has occurred d:entire colon is involved

b:ulceration is confined to the rectosigmoid

High pitched peristalsis or borborygmi in rushes in a patient with acute abdominal pain and distention suggests which of the follow? a:peritonitis b:pancreatitis c:bowel obstruction d:renal colic

c:bowel obstruction

According to the Rome criteria, irritable bowel syndrome(IBS) is identified by abdominal pain lasting > 3 days/month for the past 3 months, along with which of the following? a:discomfort that is associated with eating certain foods b:discomfort that is related to urination c:discomfort that is related to defacation d:discomfort that is associated with exercise

c:discomfort that is related to defacation

Which condition is a contraindication to appendectomy? a:bowel cancer b:morbid obesity(>40kg) c:inflammatory bowel disease involving the cecum d:a perforated appendix

c:inflammatory bowel disease involving the cecum

Chronic abdominal pain that is associated with fever, flank pain, and dark or bloody urine are symptoms suggestive of: a: endometriosis b:chronic hepatitis c:renal calculi d:ovarian cancer

c:renal calculi

Which of the following is the most common cause of acute pancreatitis? a:smoking b:viral infection c:alcoholism d:gallstones

d:gallstones

Ischemic colitis can be differentiated from acute mesenteric ischemia because ischemic colitis does which of the following? a:is associated with pancreatitis b:causes right quadrant pain c:occurs mainly in children d:involves only small vessels and causes mainly mucosal necrosis and bleeding

d:involves only small vessels and causes mainly mucosal necrosis and bleeding

Abdominal pain that causes the patient to writhe around trying to get comfortable suggests which of the following? a:pancreatitis b:abdominal aortic aneurysm c:appendicitis d:renal colic

d:renal colic

A patient presents with pain in the abdomen. The pain is described as vague, dull and nauseating. It is poorly localized This pain is likely: a:dermatomal b:referred pain c:somatic pain d:visceral pain

d:visceral pain