BLOCK 2 FINAL – GI2

- Gives you classic young person in 40% for growth with malabsorption problem, this is celiacs but asks
what you see, answer is flattening of blunting of intestines.
- Person taking stool softener that is NOT a bulk stimulant, answer is docusate
- Talks about portal vein, guy has jaundice and they take liver sample and in the portal track they have
lymphocytes and plasma cells, answer is viral hepatitis.
- Lesion above gastroesophageal junction and you see picture of glandular cells, the slide shows
adenocarcima, metaplasia is present, what is the predisposing factor, is either barret’s esophagus
- FAP question, basically what would you do if you have a guy with FAP you go in and he has hundreds
of polyps and asks what you do next, answer is total colonostomy removal.
- Patient has right abdominal pain, and you do the hook method and without even breathing has terrible
pain, this is cholecystitis
- Person is obese, elevated cholesterol, what kind of gallstones present, right abdominal pain, these are
cholesterol composite stones (hypercholesterolemia)
- Girl comes in and she has ascites, tells you there is positive shifting dullness, where is it coming from,
serious cystisadenocarcinoma,
- Same presentation as above, about ascites,
- 4yr old baby angioedema proteinuria treated with cortisol and responds, and it is minimal change
disease of kidney
- shows picture of staghorn colicculi and asks what organisms causes it, proteus is answer
- shows staghorn in kidney asking what it will cause and answer is hydronephrosis (check this answer)\
- age 40, mom also has renal impairmtne that was progressive and she is now on dialysis, this is adult
dominant polycystic kidney disease, what would kidney look like, answer is enlarged lobular
- you have person in car accident and later the kidenys start to fail and he has hyaline casts and granular
casts where are they coming from, answer tubular epithelium (called acute tubular necrosis)
- patient given drug and 2 weeks later acute renal failure, what is it called, answer is interstitial
nephritis (acute). Given antibiotics
- person comes with watery diarrhea mucous flakes in it, what bacteria, answer vibrio cholera
- bloody diarrhea, organism is non-motile and no H2s (non-gas producing, non lactose fermenting)
shigella
- ate something from a picnic and now kidney failure, thrombocytopenia and hemolytic anemia (HUS)
what organism E.coli (young kid in this case)
- Person ate at a picnic and had egg salad, 2 hours later nausea and vomiting and then 10 hours later it
resolves, what is it Staph aureus
- Shows angiomyolypoma, shows kidney with fat yellow thing on the side and then shows a histo picture
with clear cells asking what it was, answer is angiomyolypoma, or possibly showing a renal cell
carcinoma (check)
- Papillary formation int eh bladder, asks what the cancer is, answer is transitional
- Patient experiencing epigastric pain and when sitting up and leaning forward, what was the cause,
unsure of the answer (check).
- Have gram negative motile oxidase positive adjacent to the gastric mucosa, they also describe an ulcer,
what was it, H pylori
- Shows picture of diplococcic, person has elevated protein and low glucose and PMNs elevated specific
for bacterial meningitis, either strep pneumo if looked purple, Neisseria if pink
- Tells you he has right lower ab pain you do the knee flexion test, answer is appendicitis
- Two hepatitis questions.
o Positive HBsAg, anti-HBC. Had an acute infection four years ago. Ans: chronic Hep B.
o Which likely to be infected? Ans: Baby with ENS.
- Babbini question. Loop diuretic use. What does it inhibit? Ans: Na+/K/Cl channel.
- Person is anorexic. BMI=20, lost a lot of weight. What do you NOT give? Ans: Sodium.
- Person wants to have a 2,000calorie diet. 30% will be fat, 55% will be carbs, 54g protein. How many
calories will be fat? Answer unknown. (Bobby says 600)
- Ondansetron. Patient on chemo given antiemetic. What is the mechanism? Antagonist of the 5-HT.
Subtype 3.
- Given a picture slide with green fluorescent outlines. Slide for membranous proliferative disorder.
Know what that looks like.
- Patient has FAP. 100s of polyps on colon. What do you do? Ans: Colontectomy. (Remove colon).

BLOCK 2
1. Kid with minimal proteinuria was given a glucocorticoid and the proteinuria resolved after a few
weeks  Minimal Change Disease
2. 40 year old women had a long term problem with fatty stools and gas and on biopsy they found
flattened papillae in the jejunm  Celiac's
3. Man was found to have like 150 polyps in his colon and it asked what would be the next thing you
do  remove the entire colon.
4. Person has cancer just proximal to the esophageal gastric junction what is the main risk factor 
Barrett's esophagus
5. Person is suffering from chronic gastritis, endoscopy shows a bacteria in the antral area of the
stomach what is it  H. Pylori
6. Bolus of insulin vs. IV insulin
7. Something about hyperpigmented spots on the oral mucosa and lips associated with GI stuff 
Peutz-Jeuger Syndrome
8. Crohn's disease that is not responding to other medications so give Infliximab and asks what
endogenous compound will be affected  TNF-alpha
9. Asked what bug that caused UTI was urease positive  Proteus
10. Showed a picture of a staghorn caluculi and asked what would happen  hydronephrosis
11. Somebody ate something at a picnic and had GI symptoms 1 hour later what was the cause 
Staph Aureus
12. A kid ate a picnic and then got GI symptoms, thrombocytopenia, and kidney issues. Recognize its
HUS-so EHEC E. Coli
13. Someone who traveled to some remote place and got bloody diarrhea. The bug was non-motile
and did not ferment lactose  Shigella
14. Gave someone furosemide and asked what it worked on  Na+/K+/Cl- (it's a loop diuretic)
15. Described an ATN with granular casts and asked what was being deposited in the casts  tubular
epithelial cells
16. Described a biliary tracts with lymphocyte infiltrations and granulomas  primary biliary
cirrhosis
17. Said there is a cancer in the head of the pancreas what kind of cancer is it most likely to be.
Options were: different cancers of endocrine cells (they are NOT in head), carcinoma with cysts,
or adenocarcinoma  Adenocarcinoma
18. 2O something female has epigastric pain that is associated with bouts of constipation and diarrhea
and it is occurs sporadically usually associated with stress.  Irritable Bowel Syndrome
19. Someone went camping, brought prepackaged food, but drank from the stream had diarrhea a
week later with some malabsorption  Giardia Lambia
20. Diarrhea in an AIDS patient  C. parvus. (I don’t think its microsporidium.)
21. Gave a scenario of a person with proteinuria, hyperlipidemia, and hypoalbuminemia and then
gave and IF picture  Membranous Nephropathy. They were trying to trick you between that and
Goodpastures because Membranous has a similar IF but it is a granular pattern.
22. Cancer patient who needed an antiemetic medication and it asked what the MOA of action
would be  Med would be Ondansetron which is a 5-HT3 antagonist
23. 35 year old male has elevated creatinine levels and his mom had a history of kidney failure and
had to start dialysis at age of 40. What would the gross appearance of the kidney be?  Choices:
Large & smooth, large & lobular, small & necrotic, small & smooth  Large & Lobular. ADPKD.
24. Described an impetigo disease in a kid and asked if there was a non-infective process what organ
could be affected  kidney
a. Not sure about this one. I thought that it was heart, because it was strep, and clearly you
could have endocarditis. We will never know.
25. Described failure of one kidney that showed diffuse scaring, lymphocytic infiltration of
glomerulus, tubular swelling and asked the cause  Chronic polynephritis
26. Person starts with having difficulty swallowing solids and then slowly begins to have problem
swallowing softer foods what is the likely problem? Some answer choices were SCC of esophagus,
achalasia, loss of innervation by.
27. Cholera infection and you want to give supportive treatment but you don't have enough IVs for
everyone, what is needed to help Na+ absorption in the gut: Magnesium, Iron, Glucose, Gut
Motility Inhibitor
28. What could you give to soften the stools but not change bulk or increase? Docusoft.
29. Said a stone blockage lead to pancreatitis where would the stone have to be? Answers: Common
bile duct, hepatic bile duct, cystic duct, the opening into duodenummajor papilla because that’s
the last part. It would have to be something that blocked the pancreas.
30. Picture of a glomeruli with dark deposits. It said it was a 10 year old boy with oliguria and asked
what was elevated in his serum: glucose, albumin, creatinine, ?
31. 12 year old boy with severe periumbilical pain, only mild pain when pushed on the RLQ but severe
pain when push on LLQ and try to flex R hip against resistance. DiagnosisAppendicitis.
32. Patient with abdomen pain that is severe and radiates to the back with a history of chronic alcohol
use asked what other signs would be diagnostic? Diffuse abdomen tenderness, ecchymosis of the
flanks, …?
33. Man who drinks frequently drinks had a two day binge and now has pain in his epigastric region.
Pancreatitis?
34. Picture of acute interstitial nephritis. Has lots of eosinophils. Stem also mentions drug use.
35. Person has suspected ascites, how do you test?  shifting dullness
36. Person is going on a crazy diet and is cutting down to 2000 calories a day. They need to get a
certain protein (they tell you like 52 g?) and then says needs the correct amount of calories from
fat and carbohydrates and that the ratio of calories of fat to carbs should equal 30:55 and asks how
many calories should come from fat? Answer choices were 510, 340, 600 etc