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Ganglion cysts/Bible cysts/Bible bumps

Ganglion cysts/Bible cysts/Bible bumps are lumps (tumor or swelling) within the back of hand at wrist joint mainly occurs to joints or tendons. They look like cyst containing a thick ,sticky ,clear ,colorless jellylike substance. They used to be more prominent when the wrist is flexed forward. These cysts may feel form of spongy by depending on their's size.More common in female .Most prevalent range between 20-40 years old rarely occurs children younger than 10 years. Causes unknown, trauma , "Herniation hypothesis", post traumatic degeneration of connective tissues, and inflammation, repeated mechanical stress, facet arthrosis , myxoid degeneration of peri -aticular fibrous tissues and liquefaction with chronic damage. Symptoms usually appears as bump that changes size usually soft,1-3 cm in diameter ,dose not mobile swelling appear over time or suddenly ,smaller in size and may even go away . And comes back in another time some causes pain, and some

krok 2 (Gasteroenterology) with explanation part 10

91). A 64-year-old patient has been referred to planned hospitalization for general weakness, poor appetite, progressive jaundice which appeared over 3 weeks ago and wasn’t accompanied by pain syndrome. Objectively: body temperature is at the rate of 36,8oC,Ps-78/min, abdomen is soft and painless, the symptoms of peritoneal irritation are present, palpation reveals a dramatically enlarged, tense gallbladder . What disease are these symptoms typical for? A.Cancer of the pancreatic head B.Duodenal ulcer C.Acute cholecystitis D.Chronic cholecystitis E.Lamblia-induced cholecystitis Explanation : Elderly is risk factor. weight is alarm sign for cancer. enlarged, tense gallbladder due to bile outflow obstruction by pancreatic head cancer. 92).A patient is 31 years old. Double-contrast barium swallow revealed a filling defect on the posterior wall in the middle segment of esophagus . The defect looked like a well-de

krok 2 (Gasteroenterology) with explanation part 9

81). 4 hours after having meals a patient with signs of malnutrition and steatorrhea experiences stomach pain, especially above navel and to the left of it. Diarrheas take turns with constipation lasting up to 3-5 days. Palpation reveals moderate painfulness in the choledochopancreatic region. The amylase rate in blood is stable. X-ray reveals some calcifications located above navel. What is the most likely diagnosis? A. Chronic pancreatitis B. Chronic gastroduodenitis C. Duodenal ulcer D. Zollinger-Ellison syndrome E. Chronic calculous cholecystitis Explanation: Chronic pancreatitis leads to Deficiency of pancreatic enzyme (lipase) which is essential for conversion of triglyceride to monoglycerides and free fatty acids which is absorbed. Due to lipase deficiency cause natural fat in stool i.e steatorrhea . X-ray reveals calcifications above naval is pathognomonic sign. 82). A 51-year-old female patient complains of frequent defecation and liquid blood

krok 2 (Gasteroenterology) with explanation part 8

71). 4 hours after having meals a patient with signs of malnutrition and steatorrhea experiences stomach pain, especially above navel and to the left of it. Diarrheas take turns with constipation lasting up to 3-5 days. Palpation reveals moderate painfulness in the choledochopancreatic region. The amylase rate in blood is stable. X-ray reveals some calcifications located above navel. What is the most likely diagnosis? A. Chronic pancreatitis B. Chronic gastroduodenitis C. Duodenal ulcer D. Zollinger-Ellison syndrome E. Chronic calculous cholecystitis Explanation :steato 72). A 43-year-old female patient complains of unstable defecation with frequent constipations , abdominal swelling, headache, sleep disturbance. Body weight is unchanged . What disease are these clinical presentations typical for? A. Irritable colon syndrome B. Chronic enteritis C. Chronic pancreatitis D. Chronic atrophic gastritis E. Colorectal cancer Explanation : Diagnostic C riteria for Ir

krok 2 (Gasteroenterology) with explanation part 5

41). A 48 year old man complains of fatique and shortness of breath. His Ht is 32%, and Hb - 103 g/l. Peripheral blood smear reveals macrocytosis. Serum vitamin B12 level is 90 pg/ml (normal is 170 to 940); serum folate level is 6 ng/ml (normal is 2 to 14). Possible causes to consider include all of the following EXCEPT: A. Colonic diverticulitis B. Vegetarianism C. Regional enteritis D. Pancreatitis E. Fish tapeworm infection Explanation : Cause of vitamin B12 deficiency include: Vegetarianism (low dietary content), Regional enteritis ( B12 readily absorbed in the last part of the small intestine i.e ileum ) Pancreatitis ( Vitamin B12 bind two carrier proteins haptocorrin [R binder] and intrinsic factor, but only its binding to intrinsic factor allows its absorption and R binder is removed by pancreatic enzyme which is defficient in pancreatitis ), Fish tapeworm infection ( parasite absorbing 80% or more of the host's B12 intake ) 42). A 41 year old patient wa

krok 2 (Gasteroenterology) with explanation part 4

31). A patient is 65 y.o. He has been a smoker for 40 years . Hew has lost 10 kg during the last 3 months. Complains of pain in the epigastric area after taking meals, diarrhea, jaundice. Physical examination revealed enlarged, painless gallbladder . Feces are light-coloured and clay-like. Blood analysis revealed increased level of whole and direct bilirubin, alkaline phosphotase and glutaminepyruvate transferase. Clinical urine analysis showed positive bilirubin reaction and negative urobilinogene reaction. Where is the initial process that caused these changes? A. In pancreas B. In common bile duct C. In liver D. In duodenum E. In gallbladder Explanation : Feces is light color it means patient has obstructive jaundice that is caused by cancer developed on pancreatic head. Gallbladder enlarged due to bile flow obstruction by pancreatic head cancer. Elderly, smoking is risk factor. weight is alarm sign for cancer. 32). A 75 y.o. man has acute pain in the pa