Internal Medicine Essentials for Clerkship Students

Gastroenterology Section

Approach to Abdominal Pain (Chapter 13)

Small Bowel Obstruction - View an abdominal X-ray showing small bowel obstruction.

Pneumoperitoneum - View an abdominal x-ray showing free air beneath the diaphragms.

Thumprinting - Plain abdominal x-ray showing "thumbprinting," a finding associated with ischemic colitis.

Toxic Megacolon - Plain abdominal x-ray showing a toxic megacolon.

Diverticular Abscess - CT scan showing a diverticular abscess complicating acute diverticulitis.

Approach to Diarrhea (Chapter 14)

Laboratory Evaluation of Noninfectious Diarrhea - Use this table to guide the evaluation of noninfectious diarrhea.

Giardia - View a scanning electron micrograph of in vitro-grown Giardia trophozoites to see their morphology.

Celiac Disease - See a representative histological section of small bowel mucosa.

Dermatitis Herpetiformis - View the skin lesions of dermatitis herpetiformis associated with celiac disease.

Diseases of the Gallbladder and Bile Ducts (Chapter 15)

Pneumobilia - View an x-ray showing air in the biliary tree.

Normal Gallbladder - View an ultrasound study of a normal gallbladder.

Gallstones - View an ultasound study of gallstones.

Acute Pancreatitis (Chapter 16)

Pancreatic Calcifications - View a CT scan showing pancreatic calcifications.

Interstitial Pancreatitis - View a CT can showing interstitial pancreatitis.

Necrotizing Pancreatitis - View a CT scan showing necrotizing pancreatitis.

Gastroesophageal Reflux Disease (Chapter 17)

Barrett's Esophagus - See the endoscopic view of Barrett's mucosa.

Erosive Esophagitis - See the endoscopic view of erosive esophagitis.

Candida Esophagitis - See the endoscopic view of Candida esophagitis.

Peptic Ulcer Disease (Chapter 18)

Peptic Ulcer Etiology - Review a table listing the causes of peptic ulcer disease.

Helicobacter pylori - Review a table of commonly used tests for the detection of Helicobacter pylori infection.

Visible Vessel - View a visible vessel at the base of a peptic ulcer.

Dyspepsia (Chapter 19)

Dyspepsia Algorithm - Use this algorithm to manage the patient with dyspepsia.

Gastrointestinal Bleeding (Chapter 20)

Ischemic Colitis - Plain abdominal x-ray showing "thumbprinting," a finding associated with ischemic colitis.

Ischemic Colitis - Colonoscopic view of ischemic colitis involving the sigmoid colon.

Hereditary Hemorrhagic Telangiectasias - View telangiectasias associated with hereditary hemorrhagic telangiectasias (Osler-Weber-Rendu syndrome).

Visible Vessel - View a visible vessel at the base of a peptic ulcer.

Gastric Antral Vascular Ectasias (GAVE) - The endoscopic view of vascular dilatation in the gastric mucosal lining.

Radiation Proctitis - Proctoscopic view of radiation proctitis.

Viral Hepatitis (Chapter 21)

Hepatitis A - View a typical serological course for acute hepatitis A.

Hepatitis B - View a typical serological course for acute hepatitis B.

Hepatitis B - View a typical serological course for chronic hepatitis B.

Transaminase Elevations- View a differential diagnosis of transaminase elevations.

Kayser-Fleischer Ring - Slit lamp view of Kayser-Fleischer ring associated with Wilson's disease.

Porphyria cutanea tarda - Typical lesions of porphyria cutanea tarda associated with hepatitis C.

Cirrhosis (Chapter 22)

Alcohol Screening Tests - View screening tests to detect alcohol abuse problems.

Esophageal Varices - View the endoscopic appearance of bleeding esophageal varices.

Ascites - View a patient with massive ascites due to alcoholic cirrhosis.

Spider angioma - View a spider angioma in a patient with alcoholic cirrhosis.

Gynecomastia - View gynecomastia in a male patient with cirrhosis.

Parotid Enlargement - View typical parotid enlargement associated with longstanding alcohol abuse.

Dupuytren's Contracture - View an example of a patient with Dupuytren's contractures associated with longstanding alcohol abuse.

Palmar Erythema - View an example of palmar erythema.

White Nails - View clubbing and white nails associated with cirrhosis.

Cirrhosis Discriminate Score (CDS) - Use the CDS to predict the presence of cirrhosis by using noninvasive tests.

MEDL Scoring System - Model for End-Stage Liver Disease (MELD) is a validated chronic liver disease scoring system that uses noninvasive laboratory tests to predict survival. It is also used to prioritize allocation of organs for liver transplantation. Go to the United Network of Organ Sharing web site to learn more about MELD and to use a calculator to determine the MELD score.

Drug Therapy - View a table of drugs commonly used to manage cirrhosis.

Inflammatory Bowel Disease (Chapter 23)

Diagnostic Evaluation - Review the standard diagnostic evaluation for suspected inflammatory bowel disease.

Clostridium difficile Colitis - Colonoscopic view of C. difficile colitis.

Ischemic Colitis - Colonoscopic view of ischemic colitis.

Anal Fistula - View an anal fistula associated with Crohn's disease.