Board Pearls

Board Pearls
  • 4.7 (3)
  • Medicine
  • Series

Board Pearls is a gastroenterology board review built around clinical reasoning, not recall. Each episode takes one high-yield topic and works it the way you would on rounds: a case to anchor it, the framework that sorts the differential, and the specific decisions the exam rewards. The gastroenterology series covers the full blueprint across nine modules: esophagus, stomach and duodenum, small bowel, colon, pelvic floor, liver, pancreas and biliary, endoscopy, and the cross-cutting topics. Episodes are grouped by chapter and built from the primary guidelines and pivotal trials the boards draw from (ACG, AGA, AASLD, ASGE), not from textbook summaries. Use it as an audio companion to the written curriculum, MCQs, and AI tutor at boardpearls.com. Questions or feedback: hello@boardpearls.com.

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  1. Episode 6

    Chapter 15, Ep 1 of 2: CRC Screening Biology Treatment Polyps

    Episode one of two on the Colorectal Cancer, Polyps, and Diverticular Disease chapter, tracing the neoplastic pathway from average-risk screening through molecular subtyping to stage-based treatment and polyp surveillance. The organizing thread is mechanism: why screening starts at forty-five, why MLH1 loss reflexes to BRAF, and why histology sets the surveillance interval.   Topics covered Average-risk CRC screening at 45 Screening modalities and intervals Adenoma-carcinoma vs serrated pathways Universal mismatch-repair reflex testing TNM staging and workup Stage-based and molecular treatment Rectal cancer and total mesorectal excision Post-polypectomy surveillance intervals   Key decisions Average-risk screening starts at 45, runs to 75, shared decision 76 to 85; FDR with CRC or advanced adenoma starts at 40 or 10 years before youngest case with 5-year intervals. A positive stool DNA with a high-quality negative colonoscopy needs no further GI workup; any positive noninvasive test is an indication for diagnostic colonoscopy. MLH1 loss reflexes to BRAF or MLH1 methylation testing; MLH1 loss with positive BRAF is sporadic serrated disease with no germline implication, while MSH2, MSH6, or isolated PMS2 loss goes straight to germline testing. At least 12 lymph nodes must be examined for adequate node staging; there is no lower fallback minimum. MSI-high stage II tumors do not benefit from single-agent fluorouracil and are usually observed; stage III gets mandatory oxaliplatin-based adjuvant chemotherapy. Anti-EGFR therapy is used only in RAS-wild-type left-sided primaries; MSI-high metastatic disease gets first-line pembrolizumab; BRAF-mutant disease gets a BRAF inhibitor plus cetuximab. Advanced adenoma is 10 mm or larger, villous or tubulovillous histology, or high-grade dysplasia, any one sufficient, and gets a 3-year surveillance interval; any proximal hyperplastic polyp 10 mm or larger is managed as a sessile serrated lesion.   For the full chapter with MCQs, tables, and primary-guideline references, visit www.boardpearls.com. Questions or feedback: hello@boardpearls.com. (00:00) - Introduction (01:06) - Screening ages and risk tiers (02:01) - Screening modalities and intervals (04:30) - Molecular pathways and subtypes (05:48) - Reflex MMR and Lynch testing (08:34) - Staging and treatment by stage (09:57) - Stage four molecular therapy (12:57) - Polyps and surveillance intervals

  2. Episode 7

    Chapter 15, Ep 2 of 2: Diverticular Disease

    Diverticular disease as its own entity, following a management algorithm that shifted meaningfully in the last decade while the boards catch up. Uncomplicated diverticulitis is now an inflammatory process treated with selective rather than reflex antibiotics, and prophylactic resection by episode count is dead. Complicated disease grades on Hinchey and splits at the four-centimeter abscess threshold.   Topics covered Diverticulosis anatomy and false diverticula Acute diverticulitis and CT grading Hinchey classification of complicated disease Selective antibiotics in uncomplicated disease Complicated disease and abscess thresholds Recurrence and elective surgery indications Segmental colitis (SCAD) as IBD mimic Modifiable risk factors and post-episode workup   Key decisions Well-appearing immunocompetent outpatient with uncomplicated left-sided diverticulitis gets supportive care with selective, not reflex, antibiotics; ciprofloxacin plus metronidazole is the wrong move. Antibiotics remain standard for the immunocompromised, frail, septic, admitted, or any complicated CT feature, because these hosts cannot mount the response that drives spontaneous resolution. Pericolic abscess under four centimeters resolves with antibiotics alone; four centimeters or larger gets percutaneous drainage plus IV antibiotics, not urgent sigmoidectomy. Elective resection is reserved for debilitating recurrences, prior complicated attacks, or immunocompromise, never a fixed episode count in immunocompetent patients. Colonoscopy six to eight weeks after a first episode is mandatory to exclude a perforating sigmoid cancer masquerading on CT. Segmental colitis spares the rectum and proximal colon, rests on segmental distribution not histology, and responds to mesalamine, not an IBD diagnosis.   For the full chapter with MCQs, tables, and primary-guideline references, visit www.boardpearls.com. Questions or feedback: hello@boardpearls.com. (00:00) - Why the algorithm shifted (00:54) - Anatomy of diverticulosis (02:00) - Acute diverticulitis and CT grading (03:05) - Selective antibiotics in uncomplicated disease (05:06) - Complicated disease and abscess thresholds (06:48) - Recurrence and elective surgery (09:13) - Segmental colitis, the IBD mimic

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Ratings & Reviews

4.7
out of 5
3 Ratings

About

Board Pearls is a gastroenterology board review built around clinical reasoning, not recall. Each episode takes one high-yield topic and works it the way you would on rounds: a case to anchor it, the framework that sorts the differential, and the specific decisions the exam rewards. The gastroenterology series covers the full blueprint across nine modules: esophagus, stomach and duodenum, small bowel, colon, pelvic floor, liver, pancreas and biliary, endoscopy, and the cross-cutting topics. Episodes are grouped by chapter and built from the primary guidelines and pivotal trials the boards draw from (ACG, AGA, AASLD, ASGE), not from textbook summaries. Use it as an audio companion to the written curriculum, MCQs, and AI tutor at boardpearls.com. Questions or feedback: hello@boardpearls.com.

Information

  • Creator
    Board Pearls
  • Episodes
    35
  • Seasons
    15
  • Rating
    Clean
  • Copyright
    © 2025
  • Show Website
    Board Pearls