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VideoGIE Image Quiz

  1. Classification conundrum

    What classification system can be used to describe this pictured endoscopic finding?
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  2. Gallbladder polyps

    A 75-year-old woman presents with weight loss. Imaging reveals irregular thickening of the gallbladder wall and multiple broad-based polyps. Given the concern for malignancy, a biopsy is pursued. Which is the most common type of gallbladder polyp identified?
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  3. EUS examination

    A 45-year-old woman with decompensated cirrhosis and chronic pancreatitis presents with recurrent upper GI bleeding. Upper endoscopies reveal varices but no active bleeding. CT with angiography shows a splenic arterial pseudoaneurysm, which is treated with transcatheter arterial embolization and subsequently EUS-guided embolization because of persistent bleeding. What is the characteristic EUS finding of a pseudoaneurysm?
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  4. Boerhaave badness

    A 38-year-old patient presents with chest pain after self-induced vomiting while attempting to relieve food impaction. A chest CT scan shows a complex heterogenous air and fluid-filled mediastinal collection suggestive of esophageal rupture. The patient is hemodynamically stable and hence referred for endoscopic evaluation. A perforation is identified consistent with Boerhaave syndrome. Which of the following is true of this syndrome?
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  5. Postsurgical fluid collection

    A 54-year-old man develops leukocytosis 6 days after undergoing a Whipple procedure for ampullary adenocarcinoma. A CT scan reveals a 6-cm fluid collection in the retroperitoneum. This is successfully drained using a cautery-enhanced lumen-apposing metal stent (LAMS). Where is the LAMS placed for drainage of this postsurgical fluid collection?
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  6. Just a GIST?

    An outside EGD shows a 2.5-cm submucosal lesion in a 49-year-old man’s gastric fundus. EUS-FNA is performed, and a GI stromal tumor (GIST) is confirmed. The lesion is removed using endoscopic full-thickness resection. Which of the following tumor features denotes a better clinical prognosis?
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  7. Small-bowel bleed

    A 66-year-old man with cardiac comorbidities presents with melena and anemia. The bleeding site was eventually identified by small-bowel capsule as a Dieulafoy’s lesion in the mid-jejunum. Along with the water immersion technique, multiple endoscopic devices are applied to this actively bleeding lesion. Which of the following techniques is ultimately successful in achieving hemostasis?
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  8. Breaking up the band

    A 65-year-old woman who had vertical banded gastroplasty 30 years ago presents with poor oral intake resulting in recent weight loss. Upper endoscopy reveals severe gastric outlet obstruction because of the silastic band. She undergoes submucosal dissection, and the band is ruptured and removed. Which technique is used to close the mucosotomy site?
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  9. Appendiceal answers

    A novel double-balloon endoluminal interventional platform is used for resection of a subepithelial cecal lesion. During dissection, it is discovered that the lesion is located within the appendix. Multidirectional retraction with the platform allows for traction and resection of the appendix. Which of the following is true about the vermiform appendix?
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  10. Feeding failure

    A 17-year-old patient with severe neurological impairment and dystonic syndrome is referred for repeated percutaneous endoscopic gastrojejunostomy (PEGJ) tube dislodgment. Gastric feeding is not tolerated because of delayed gastric emptying. What alternative access is used to assist with feeding?
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