Gastrointestinal · GI block — biliary tract and pancreatic disease module
By completing this question set, you will be able to distinguish cholesterol, black pigment, and brown pigment gallstones by pathogenesis and associated clinical context. You will differentiate biliary colic from acute calculous cholecystitis from acalculous cholecystitis using the specific clinical, laboratory, and imaging features that define each. You will recognize the life-threatening complications of cholecystitis — gallstone ileus with Rigler's triad and Bouveret syndrome — and explain their pathogenesis through cholecystoenteric fistula formation. You will apply Charcot's triad and Reynolds' pentad to escalating cholangitis presentations and sequence the emergency management correctly. You will identify gallbladder carcinoma and cholangiocarcinoma by anatomic subtype, risk factor profile, and diagnostic approach, and select the appropriate targeted therapy for FGFR2-rearranged and IDH1-mutant intrahepatic cholangiocarcinoma. You will apply Courvoisier's law to distinguish malignant biliary obstruction from choledocholithiasis at the bedside. You will diagnose acute pancreatitis, stage its severity using Ranson's criteria and BISAP, and distinguish the local fluid collection subtypes (APFC, ANC, pseudocyst, WON) by timing and composition — correctly applying drainage strategy to each. You will explain why saponification — not PTH failure or hypoalbuminemia — causes hypocalcemia in acute pancreatitis, and why Lactated Ringer's is preferred over normal saline for resuscitation. You will recognize autoimmune pancreatitis Types 1 and 2 and explain why AIP is the most dangerous diagnostic mimic of pancreatic adenocarcinoma. You will apply the double duct sign and Courvoisier's law to localize and characterize pancreatic head malignancy, interpret KRAS mutational biology as an early event, and apply the resectability framework to CT findings. You will identify each functional pancreatic neuroendocrine tumor syndrome — insulinoma (Whipple's triad + C-peptide interpretation), glucagonoma (necrolytic migratory erythema + 4 D's), VIPoma (WDHA syndrome), and somatostatinoma (inhibitory triad) — and apply octreotide as both a diagnostic and therapeutic agent.