We have incorporated some gamification into your curriculum. You should all have received the email projected on the screen from Michelle Thomas that has a link to a knowledge challenge that is interactive. There's 15 questions. You have about 40 seconds to answer each question. There are multiple choice or multiple choices to each question. We're going to give you about 15 minutes for those of you that haven't completed it. It is covering topics that we covered in the morning lectures. Nothing about EOE on there yet because some of you haven't been introduced to that topic. So we'll leave it quiet and let you guys have about 15 minutes and then we'll review the answers. Esophagus, A moves food from the mouth to the stomach, B begins digesting proteins and fats in the food before arriving in the stomach, C is normally lined by squamous, excuse me, is normally lined by the same columnar mucosa similar to the rest of the GI tract, and D is A, B, and C are all true. Which one? A. Excellent. All right. Question number two is, the esophagus is where Barrett's mucosa occurs, is lined by squamous mucosa that can be damaged by acid exposure, C has an inner circular and an outer longitudinal muscle layers responsible for propelling food through peristalsis, and D is A, B, and C. I hear a lot of Ds. That's correct, D. Okay, the stomach is the main location of fluid and electrolyte absorption, B is the main location of nutrient absorption, C is where food is ground down into small pieces to increase digestive and absorptive surface area, and D is where gluten causes inflammation in patients with celiac disease. C. C, that's absolutely correct. Remember, gluten is causing injury in the duodenum and small bowel, and essentially a lot of these other A and B are also occurring in the small bowel, and the first A is primarily in the colon. Okay, stomach. Which of the following is a cause of bleeding peptic ulcers? Is it A, helicobacter pylori, B, acetaminophen, C, celiac disease, and D, protons? A, you guys are good. Okay. Next question. Crohn's disease is associated with inflammation limited to the colon, B, deep ulcerations and fistula formation anywhere in the GI tract, C, a normal appearing colonoscopy but inflammation is seen under the microscope, and D, improvement on a gluten-free diet. B as in boy, that is correct. Remember, a gluten-free diet is for celiac disease. Normal appearing colonoscopy but inflammation is under the microscope is what? Microscopic colitis. IBS, remember, has no inflammation. By the way, I think Tassif has a great mnemonic, but IBS, I always remember is S is symptoms but no damage, and IBD means there's damage to the digestive tract. And inflammation limited to the colon is what disease? Ulcerative colitis. Very good. Okay. All right. Next question. What is important for all of the following except, is it A, storage of vitamins, B, metabolism of drugs, C, production of clotting factors, D, clearing toxins from the body, and E, production of insulin? E. Where is insulin produced? In the liver. All right. Good. So insulin is produced by the toxins that occur within hepatocytes or the liver. Okay. Upper GI endoscopes and colonoscopes generally have the same dials to control the scope tip deflection. True or false? True. Excellent. Okay. In most GI endoscopes, optical fibers and electrical signals from digital chips, depending on the scopes, are used to carry both light to the scope tip and images to the imaging processor and monitor for visualization. A is true and B is false. True. It's true. Excellent. Okay. Esophageal disorders can result in A, maldigestion, B, difficulty swallowing, C, chest pain, or D, B, and C. D. D as in dog? Yes. Correct. Okay. Maldigestion is primarily going to be a problem with the small intestine because that's where most digestion and or absorption occurs. Okay. The initial treatment of bleeding peptic ulcer includes all of the following except proton pump inhibitors, a gastrectomy or surgical removal of the stomach, upper GI endoscopy, and IV fluids. And this is the initial treatment. B. B. We don't go hacking people's stomach out unless we really need to. By the way, I don't know, it just doesn't happen very often with peptic ulcers anymore at all. When I was in training, it happened all the time, but not anymore because of the therapies we have. Okay. What type of endoscope can be used to view at least part of the small intestine? Is it A, an EGD scope, an upper GI scope, which is an esophageal gastroduodenoscopy scope, an enteroscope, a colonoscope, or all of the above? Oh, we can't trick you guys. All of the above is right. Remember the EGD scope, the duodenum is part of the small intestine, and with a colonoscope, we can actually look in the very end of the small intestine, or the terminal ilium, which is frequently done, specifically and importantly done for anybody with inflammatory bowel disease because that terminal ilium is where Crohn's disease is often lurking. Okay, diverticulosis is associated with an increased risk of A, lower GI bleeding, B, colon cancer, C, ulcerative colitis, or D, appendicitis. Which one of those is associated with diverticulosis? A is correct. The other conditions are not associated, or diverticulosis is certainly not associated with them. Okay. Gastroenterologists, this is on the practice of gastroenterology, gastroenterologists commonly perform all of the following services except appendectomy, B, colonoscopy, C, prescribing biologic medications for inflammatory bowel disease, D, upper GI endoscopy, and E, esophageal motility testing. A. A, that's correct. We do obviously do a lot of colonoscopy. There are IBD colleagues that really focus, or a lot of general gastroenterologists in community practices prescribe biologic medications. In academic centers, it typically is more specialized IBD docs versus docs that do other things that they're subspecialized to treat. And now more and more in community practices, there are some docs that are becoming more focused on the inflammatory bowel disease and the use of biologic medications. And then obviously, upper endoscopy and motility testing is important. Okay, Crohn's disease can cause ulcers or fistulas in A, the colon, B, the small intestine, C, the colon and small intestine, or D, the colon, small intestine, and perianal area. D. D, that's correct. Okay, remember, Crohn's disease can affect anywhere, essentially from the mouth to the anus, and fistulas and deep ulcerations are often classic findings in that disorder. Okay, next question. IBS, irritable bowel syndrome, can cause ulcers in the colon. B can cause abdominal pain. C can cause ulcers in the small intestine, or D, all of the above. B. B as in boy? That's correct. Remember, it causes symptoms but not damage to the lining. IBD means damage. That's it. All right. Okay, we have some winners. Okay, we're going to count them down from fifth place to first place. Our fifth place winner and recipient of our extravagant gift prizes, which by the way is priceless ASGE swag. Our fifth place winner is Christine Gomez. Come on up, Christine. Is Christine here? Congratulations. Thank you. All right, our fourth place winner, April Yost. Congratulations. Our third place winner, Didi Dominguez. Congratulations. Our second place winner, Lisa Moss. I don't know, guys. The women are really kicking butt here. Congratulations. Our first place winner and recipient of the grand prize for today. We'll have another contest tomorrow. Tomorrow, we got to step up in the swag, right? There's going to be a step up in the swag tomorrow. First place winner goes to Lance Leder. He's not here? Lance is in the bathroom. Congratulations to Lance. We'll recognize him. Okay, I want to thank you. Just a summary of what we've done today. We've introduced you to the general concepts of digestive diseases that gastroenterologists see, both from a normal anatomy and the diseases that we see. You've also had a chance to understand what the experience of being a gastroenterologist is like. Some of you are now experts in EOE, and some of you are now experts in gastrointestinal endoscopy and can start doing endoscopy, right? Tomorrow, you'll switch those roles. It's been a great learning day. Now is the time for us to break for a reception with the faculty. Before we go, just a reminder. If you have any more Post-its, post them, because we really love to hear what you think is high-yield learning experiences. Thanks to our faculty today, and thank you for your participation. Thank you.

knowledge challenge

curriculum

multiple-choice questions

digestive system

ASGE swag