Title: Big Ol' Bonewizardry Deck / Hex Clues / GI
Tags: hex-clues hex-clues::gi

Q: What is Osmotic diarrhea?
A: stops fasting 🍽️
osmotic gap ↑ 🚽 💧

Q: What adds color to stool?
A: Stercobilin 💩
bilirubin breakdown 🟤
gives poop its glory 🎨

Q: What color is a lower GI bleed?
A: Hematochezia 🔴
distal to Treitz 🚽
fresh red blood 🩸

Q: What defines Diarrhea?
A: >200g stool/day 🚽
official threshold 📊 📏

Q: How does Diverticulitis present?
A: LLQ pain + fever + WBC 🥦
left-sided appendicitis ⬅️ 🔥

Q: What color is an upper GI bleed?
A: Melena ⬛
proximal to Treitz 🚽
oxidized hemoglobin 🖤

Q: How does Diverticulosis present?
A: painless hematochezia in elderly 🥦
MCC acute lower GI bleed 👴 🩸

Q: What is Secretory diarrhea?
A: persists w/ fasting 🚽
cholera + VIPoma 🦠 🌊

Q: How do External Hemorrhoids present?
A: painful 🍩
somatic innervation below dentate 🔥 😖

Q: What is Inflammatory diarrhea?
A: blood + mucus + WBC 🚽
Shigella, EHEC, C. diff, IBD 🦠 🔥

Q: What is Tropical sprue?
A: post-infectious, hits ileum 🍕
antibiotics + folate 💊 🌴

Q: What defines Constipation?
A: 🚽
official threshold 🪨 📅

Q: What makes Scleroderma unique?
A: ↓LES pressure + dysmotility 🍕
GERD + strictures 🔥 🤐

Q: How do Internal Hemorrhoids present?
A: painless bleeding 🍩
visceral innervation above dentate 🩸 🩸

Q: What disease has an apple core x-ray?
A: Colorectal adenocarcinoma 🍎
annular constricting 🩻
napkin-ring lesion 🎀

Q: What produces Currant Jelly sputum?
A: Klebsiella pneumonia 🫁
alcoholics, diabetics, aspiration 🍇
Currant jelly sputum 🟣

Q: What disease has a bird's beak x-ray?
A: Achalasia 🦅
bird’s beak on barium 🍕
LES won’t relax 🚫

Q: What is the default color of urine?
A: conjugated bilirubin in urine 🍵
obstructive jaundice 🟫 🟡

Q: What is the default color of stool?
A: no stercobilin 💩
biliary obstruction 🪨 ⚪

Q: What is Type 1 Hyperlipidemia?
A: LPL deficiency 🧈
↑chylomicrons + pancreatitis + eruptive xanthomas 🌋 🩸

Q: What does high triglycerides cause?
A: Pancreatitis 🧈
TG >1000 🔥
autodigestion 💥

Q: What makes Esophageal spasms unique?
A: ↑peristalsis, corkscrew 🍕
chest pain mimics MI 💔 🌀

Q: What does high cholesterol cause?
A: Atherosclerosis 🧈
CAD + stroke + PVD 🩸
plaque buildup 🚧

Q: What disease has an abrupt cutoff x-ray?
A: Sigmoid volvulus ☕
coffee bean sign in elderly 🌀
twisted bowel 🌀

Q: What produces Currant Jelly stool?
A: Intussusception 🚽
kids 🍇
telescoping ileocolic 🔭

Q: What disease has a RUQ olive mass?
A: Pyloric stenosis 🫒
firstborn male, 3-4 wk 👶
projectile non-bilious vomit 🚀

Q: What is Type 3 Hyperlipidemia?
A: ApoE defect 🖐️
palmar xanthomas + premature CAD 💔 🩸

Q: What is Conjugated bilirubin?
A: water-soluble 🟡
excreted in urine 🚽 💧

Q: What disease has a corkscrew x-ray?
A: Diffuse esophageal spasm 🌀
corkscrew barium 🍕
uncoordinated contractions 💪

Q: What disease has a RLQ sausage mass?
A: Intussusception 🌭
RLQ sausage 👶
telescoped bowel 🔭

Q: What disease has a thumbprint x-ray?
A: Ischemic colitis 👍
thumbprinting 🩻
mucosal edema/hemorrhage 🟣

Q: What disease has a string sign x-ray?
A: Pyloric stenosis 🧵
UGI string sign 🩻
also Crohn’s TI stricture 🩻

Q: What is Unconjugated bilirubin?
A: fat-soluble + albumin-bound 🟡
hemolysis = ↑ 🩸 🧈

Q: What is Barrett's Esophagus?
A: squamous → columnar metaplasia 🍕
chronic GERD → adenocarcinoma 🎯 🔄

Q: How does IBS present?
A: alternating + relieved by BM 🚽
Rome criteria, no alarms 🇮🇹 😤

Q: What is a Xanthelasma?
A: cholesterol on eyelids 👁️
hyperlipidemia or PBC 🧈 🟡

Q: What disease has a stacked coin x-ray?
A: Intussusception 🪙
stacked coin contrast enema 👶
coiled spring 🌀

Q: What disease has a barium clumping x-ray?
A: Celiac sprue 🍕
barium flocculation 🥖
fat malabsorption 🧈

Q: What is Mallory-Weiss?
A: GE junction tear from retching 🍺
hematemesis after vomiting 🤮 🩸

Q: What is Carcinoid syndrome?
A: flush + diarrhea + wheeze 🌶️
5-HIAA in urine 🟡 🌊

Q: How does Choanal atresia present?
A: cyanosis w/ feed, pink w/ cry 👶
CHARGE association 💙 👃

Q: What is Type 4 Hyperlipidemia?
A: ↑VLDL hepatic overproduction 🍺
DM + alcohol + obesity → pancreatitis 🧈 🩸

Q: What is Choledocholithiasis?
A: CBD stone 🪨
obstructive jaundice + ↑alk phos + GGT 🚧 🟡

Q: How does Spastic Colon present?
A: cramps relieved by BM 🚽
intermittent dysmotility 💩 🌀

Q: What causes Rebound or Rigidity?
A: Peritonitis 🤰
rigid abdomen + rebound 🚨
perforation = surgical emergency 🔪

Q: What is Mesenteric ischemia?
A: pain out of proportion 🍔
post-prandial + ↑lactate 📈 💔

Q: What is a Xanthoma?
A: cholesterol histiocytes 🦵
tendons in FH 💛 🟡

Q: What is Gardner syndrome?
A: FAP + osteomas + soft-tissue tumors 🌳
supernumerary teeth 🦷 🦴

Q: What are Schatzki rings?
A: lower esophageal ring 💍
intermittent solid dysphagia 🥩 🍕

Q: What makes Achalasia unique?
A: ↓peristalsis + ↑LES tone 🍕
lost myenteric plexus ❌ 🚫

Q: What is Cholelithiasis?
A: 4 Fs: Female, Fat, 40, Fertile 💎
RUQ colic post-fat 🍔 🫃

Q: What is Dubin-Johnson?
A: black liver 🟡
defective conjugated excretion 🚫 🖤

Q: What is Turcot's syndrome?
A: colon polyps + brain tumors 🧠
FAP+medullo or HNPCC+GBM 🎯 🥦

Q: What is Ascending Cholangitis?
A: Charcot: fever, jaundice, RUQ 🟡
ERCP emergency 🚨 🔥

Q: What type of gallstones can be seen on x-ray?
A: Pigment stones 💎
Ca-bilirubinate, radiopaque 🩻
hemolysis-associated 🔴

Q: What is Rotor's?
A: defective storage 🟡
NO black liver ❌ 🔄

Q: What are Esophageal Varices?
A: portal HTN dilation 🍺
massive hematemesis in cirrhotic 🩸 💥

Q: What is Crigler-Najjar?
A: UGT deficiency 👶
Type I fatal, Type II → phenobarb 💊 🟡

Q: What is a Bezoar?
A: trichobezoar (hair), phytobezoar (veg) 🧶
antrum obstruction 🚫 🫃

Q: What is Type 2b Hyperlipidemia?
A: ↓LDL+VLDL receptors 🩸
↑LDL + ↑VLDL → premature CAD 📈 💔

Q: What is Hirschsprung's?
A: aganglionic colon, no Auerbach 👶
failure to pass meconium, Down assoc 🧬 🚫

Q: What is Turner's sign?
A: flank ecchymosis 🤰
hemorrhagic pancreatitis retroperitoneal bleed 🩸 🟣

Q: What is Type 5 Hyperlipidemia?
A: ApoC-II deficiency 🧈
↑chylo + ↑VLDL → pancreatitis 🌋 🩸

Q: What is Cholecystitis?
A: Murphy sign + RUQ + fever 🫃
cystic duct stone 💎 🔥

Q: What is Menetrier's disease?
A: hyperplastic foveolar rugae 🫃
protein-losing gastropathy 🫗 📈

Q: What is Cullen's sign?
A: periumbilical ecchymosis 🤰
hemorrhagic pancreatitis 🩸 🟣

Q: What does Ranson's criteria tell you?
A: ≥3 = severe pancreatitis 📊
mortality predictor 💀 🔥

Q: What is Pyloric stenosis?
A: firstborn male, 3-4 wk 🫒
projectile non-bilious + hypoK hypoCl met alk 🧂 👶

Q: What is the most common type of gallstone?
A: Cholesterol stones 💎
80%, radiolucent 🧈
4 Fs 🌸

Q: What is Duodenal atresia?
A: bilious vomit + double bubble 👶
Down syndrome assoc 🧬 🫧

Q: How is the Tetralogy of Fallot presentation different?
A: Tet spells 👶
cyanosis w/ exertion 💙
squat to relieve 🤸

Q: What is a Traction diverticulum?
A: true, all 3 layers 🍕
TB or mediastinal nodes pulling 🦠 🪢

Q: What is Boerhaave's?
A: full-thickness rupture 🍕
Hamman crunch + L pneumothorax 🫁 💥

Q: What is Cholangitis?
A: Charcot triad 🟡
Reynold pentad adds shock + AMS 🚨 🔥

Q: What is Type 2a Hyperlipidemia?
A: Familial hypercholesterolemia 🩸
defective LDL receptor 💔
tendon xanthomas + premature MI 🦵

Q: What is an Esophageal atresia w/ TE fistula?
A: EA + TEF 👶
MC = proximal atresia + distal fistula 🫧
choking + gastric air 🫧

Q: What is Cholestasis?
A: pruritus + jaundice 🟡
↑alk phos + GGT + conj bili 📈 🚧

Q: What is Whipple's disease?
A: Tropheryma whipplei 🦠
PAS+ foamy macrophages 🌊 🍕

Q: What is Peutz-Jegher syndrome?
A: mucocutaneous spots on lips 👄
hamartomatous polyps + ↑cancer risk 💋 ⚫

Q: What is Familial polyposis?
A: FAP 🥦
APC mutation 🧬
100% colon CA by 40 → prophylactic colectomy 🔪

Q: What is Gilbert's syndrome?
A: mild jaundice w/ stress/fast 😰
mild UGT def, benign 😊 🟡

Q: What is Hepatorenal Syndrome?
A: cirrhosis + renal failure 🍺
splanchnic vasodilation → renal vasoconstriction 🔀 🫘

Q: What is a Rolling hiatal hernia?
A: fundus rolls up next to esophagus 🍕
strangulation risk 🚨 🌀

Q: What is a Sliding hiatal hernia?
A: 95% of hernias 🍕
GE jxn slides up → GERD 🔥 ⬆️

Q: What is Achalasia?
A: bird’s beak + lost Auerbach 🦅
Chagas assoc + ↑SCC 🪲 🍕

Q: What causes hyperactive bowel sounds?
A: Mechanical obstruction 🚽
high-pitched tinkles 📈
fighting an obstacle 🔔

Q: What is Pseudomembranous Colitis?
A: post-antibiotic 💩
vanc or fidaxomicin 💊 🦠

Q: What causes Decreased or no bowel sounds?
A: Ileus 🚽
MCC hypokalemia 🔇
post-op + opioids 😴