MedRidle - How to Play

MedRidle™
In this game, you will see a 4x4 grid filled with terms and phrases related to diseases. These terms cover various categories such as:

Epidemiology
Pathophysiology
Risk Factors
Symptoms
Clinical Findings
Diagnostic Criteria
Treatments
Complications

Objective: Rearrange the tiles so that all terms related to a specific disease are grouped together in the same row or column.

Here is an example puzzle

Hyperparathyroidism

Reduced Expression of Calcium-sensing Receptors (CaSRs)

Alcoholic Liver Disease

Jaundice

Acute Glomerulonephritis

Low C3, Normal C4

Alcoholic Liver Disease

Liver Transplant

Bipolar Disorder

Valproic Acid

Hyperparathyroidism

Urine Calcium-to-creatinine Ratio

Acute Glomerulonephritis

Immune Complex Deposition in the Glomeruli

Acute Glomerulonephritis

Younger Age

Alcoholic Liver Disease

Hepatocyte Damage Induced by Excessive Alcohol Use

Bipolar Disorder

Euphoria

Alcoholic Liver Disease

Right Upper Quadrant Pain

Acute Glomerulonephritis

AKI

Hyperparathyroidism

Elevated PTH Levels

Bipolar Disorder

DIGFAST

Hyperparathyroidism

Nausea

Bipolar Disorder

Two Types

3 disease tiles in the same row or column the tiles turn blue
4 disease tiles in the same row or column, the tiles turn a different color
Move the tiles around to see if you can solve a row.

Acute Glomerulonephritis

AKI

Alcoholic Liver Disease

Jaundice

Acute Glomerulonephritis

Low C3, Normal C4

Alcoholic Liver Disease

Liver Transplant

Bipolar Disorder

Valproic Acid

Hyperparathyroidism

Urine Calcium-to-creatinine Ratio

Acute Glomerulonephritis

Immune Complex Deposition in the Glomeruli

Acute Glomerulonephritis

Younger Age

There are a total of 5 diseases layed out on the grid.
The last diseases is made of 4 tiles that overlap between all the diseases.
Look out for the tile border to clue you in when 3 tiles containing the overlapping disease are in the same row or column.

Alcoholic Liver Disease

Jaundice

Bipolar Disorder

Euphoria

Alcoholic Liver Disease

Hepatocyte Damage Induced by Excessive Alcohol Use

Alcoholic Liver Disease

Right Upper Quadrant Pain

Acute Glomerulonephritis

AKI

Bipolar Disorder

DIGFAST

Hyperparathyroidism

Reduced Expression of Calcium-sensing Receptors (CaSRs)

Acute Glomerulonephritis

Younger Age

Bipolar Disorder

Valproic Acid

Alcoholic Liver Disease

Liver Transplant

Acute Glomerulonephritis

Low C3, Normal C4

Bipolar Disorder

Two Types

Hyperparathyroidism

Nausea

Acute Glomerulonephritis

Immune Complex Deposition in the Glomeruli

Hyperparathyroidism

Urine Calcium-to-creatinine Ratio

Bipolar Disorder

Two Types

This is the final solution to this puzzle

Alcoholic Liver Disease

Jaundice

Alcoholic Liver Disease

Liver Transplant

Alcoholic Liver Disease

Hepatocyte Damage Induced by Excessive Alcohol Use

Alcoholic Liver Disease

Right Upper Quadrant Pain

Acute Glomerulonephritis

AKI

Acute Glomerulonephritis

Low C3, Normal C4

Acute Glomerulonephritis

Immune Complex Deposition in the Glomeruli

Acute Glomerulonephritis

Younger Age

Bipolar Disorder

Valproic Acid

Bipolar Disorder

Euphoria

Bipolar Disorder

DIGFAST

Bipolar Disorder

Two Types

Hyperparathyroidism

Nausea

Hyperparathyroidism

Reduced Expression of Calcium-sensing Receptors (CaSRs)

Hyperparathyroidism

Urine Calcium-to-creatinine Ratio

Bipolar Disorder

Two Types

These are the diseases that were in your puzzle. They appear anytime you place 4 tiles of belonging to a single disease in the same row or column. Click the banner to refresh your memory about that specific pathology

Hyperparathyroidism

Category	Details
Brief Description	Dysregulated overgrowth of parathyroid glands, leading to hypercalcemia and other symptoms.
Epidemiology	Postmenopausal status, family history, chronic renal disease, and vitamin D deficiency are risk factors.
Pathophysiology	Reduced expression of calcium-sensing receptors (CaSRs) and increased bone resorption, intestinal calcium hyperabsorption, and increased renal calcium excretion.
Risk Factors	Postmenopausal status, family history, chronic renal disease, and vitamin D deficiency.
Symptoms	Bone pain and fractures Kidney stones Muscle weakness Fatigue Depression Gastrointestinal symptoms like nausea and vomiting Polyuria and polydipsia
Clinical Findings	Hypercalcemia (elevated serum calcium) Elevated PTH levels Low serum phosphate Elevated alkaline phosphatase
Diagnostic Criteria	Persistent hypercalcemia with elevated PTH levels Urine calcium-to-creatinine ratio to differentiate from familial hypocalciuric hypercalcemia (FHH) Imaging (SPECT/CT, ultrasound, or 99mTc-MIBI scintigraphy) to localize adenomas or hyperplastic glands.
Treatment	Parathyroidectomy Bisphosphonates (e.g., alendronate, risedronate) Calcimimetics (e.g., cinacalcet) Radiofrequency Ablation (RFA)
Complications	Osteoporosis and fractures, nephrolithiasis, hypertension, arrhythmias, depression, cognitive impairment, hypocalcemia following surgery.
Sources	Endocrine Society's Clinical Practice Guideline on Primary Hyperparathyroidism, Journal of Clinical Endocrinology and Metabolism, and UpToDate.

Alcoholic Liver Disease

Category	Details
Brief Description	Alcoholic liver disease is a condition characterized by liver damage caused by excessive alcohol consumption.
Epidemiology	Alcoholic liver disease is a common condition, affecting approximately 10-20% of heavy drinkers. It is more common in men than women and is often associated with other health problems, such as obesity and diabetes.
Pathophysiology	Alcoholic liver disease is caused by the toxic effects of ethanol on liver cells, leading to hepatocyte damage, fibrosis, and regeneration nodules. The damage is often progressive and can lead to cirrhosis and liver failure.
Risk Factors	History of significant alcohol intake, family history of alcoholism, and genetic predisposition are all risk factors for developing alcoholic liver disease.
Symptoms	Fatigue Right upper quadrant pain Jaudice (in advanced stages) Hepatomegaly Spider angiomas Palmar erythema
Clinical Findings	AST / ALT > 2 Increased mean corpuscular volume (MCV) Elevated gamma-glutamyltranspeptidase (GGT) Increased IgA to IgG ratio
Diagnostic Criteria	Imaging studies (ultrasound, CT, or MRI) showing fatty liver or cirrhosis Liver biopsy (in unclear cases or for staging)
Treatment	Lifestyle modifications (e.g., reducing alcohol intake, improving nutrition) Nutritional support (e.g., vitamin supplements, enteral nutrition) Pharmacological treatment (e.g., steroids, pentoxifylline) Liver transplant (in severe cases)
Complications	Alcoholic hepatitis Cirrhosis Portal hypertension Esophageal varices Hepatic encephalopathy Hepatorenal syndrome Peritonitis Hepatocellular carcinoma
Sources	National Institute on Alcohol Abuse and Alcoholism (NIAAA) World Health Organization (WHO) Journal of Hepatology Alcoholism: Clinical and Experimental Research

Acute Glomerulonephritis

Category	Details
Brief Description	Acute Glomerulonephritis (AGN) is a rare kidney disorder characterized by immune-mediated inflammation and injury to the glomeruli.
Epidemiology	Prevalence is higher in developing countries, with a peak incidence in children and young adults.
Pathophysiology	Immune complex deposition in the glomeruli, complement activation, inflammation, and subsequent glomerular damage.
Risk Factors	Recent streptococcal infections Increased age Younger age Diabetes mellitus Cancer Alcohol use disorder
Symptoms	Periorbital edema Peripheral edema Hematuria Proteinuria Hypertension
Clinical Findings	Oliguria Azotemia Urinalysis: hematuria, proteinuria, and casts
Diagnostic Criteria	Positive streptomyces test Low C3, normal C4 Urinalysis: hematuria, proteinuria, and casts
Treatment	Antihypertensives (e.g., lisinopril, hydrochlorothiazide) Diuretics (e.g., furosemide, spironolactone) Antibiotics (e.g., penicillin, erythromycin) Steroids (e.g., prednisone, methylprednisolone) Dialysis (e.g., hemodialysis, peritoneal dialysis)
Complications	Acute Kidney Injury (AKI) Chronic Kidney Disease (CKD) Hypertensive encephalopathy Heart failure Pulmonary edema Nephrotic syndrome
Sources	National Kidney Foundation (2020) Mayo Clinic (2020) Merck Manual (2020)

Bipolar Disorder

Bipolar disorder

Category	Details
Brief Description	Bipolar disorder is a mental health condition characterized by extreme mood swings, including episodes of mania and depression.
Epidemiology	Bipolar disorder affects approximately 2.8% of adults in the United States, with a higher prevalence in women than men.
Pathophysiology	The exact cause of bipolar disorder is unknown, but it is believed to be related to an imbalance of neurotransmitters, such as dopamine and serotonin, in the brain.
Risk Factors	Family history Substance use disorder Sleep disturbances
Symptoms	Depressed mood Manic episodes Euphoria Irritability Depression Risk-taking behaviors Social withdrawal Distractibility Racing thoughts
Clinical Findings	At least one manic episode for Bipolar I At least one hypomanic episode and one major depressive episode for Bipolar II
Diagnostic Criteria	Manic episodes lasting at least 1 week Hypomanic episodes lasting at least 4 days, depressive episodes lasting at least 2 weeks
Treatment	Lithium Valproic acid Lamotrigine Quetiapine Olanzapine Risperidone CBT Important note: Avoid monotherapy with antidepressants, as it may increase the risk of suicide.
Complications	Increased risk of suicide
Sources	American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Washington, DC: Author. National Institute of Mental Health. (2020). Bipolar disorder. World Health Organization. (2020). Mental health: Bipolar disorder.

Acute Pancreatitis

Category	Details
Brief Description	Acute Pancreatitis is a sudden inflammation of the pancreas, characterized by autodigestion of pancreatic tissue.
Epidemiology	Acute Pancreatitis is a relatively rare condition, with an estimated incidence of 5-10 cases per 100,000 people per year. It is more common in males and in individuals with a history of alcohol use disorder, gallstones, or hypertriglyceridemia.
Pathophysiology	Acute Pancreatitis is caused by the premature activation of pancreatic enzymes, leading to autodigestion of pancreatic tissue. This can occur due to a variety of factors, including alcohol use, gallstones, and hypertriglyceridemia.
Risk Factors	Alcohol use disorder Gallstones Hypertriglyceridemia Smoking Seat belt injury Pancreas divisum Steroids Mumps Scorpion sting Hypercalcemia ERCP Azathioprine Valproic acid
Symptoms	Epigastric abdominal pain Pain radiates to back Nausea Vomiting Fever Tachycardia
Clinical Findings	Jaundice Rebound tenderness Guarding Elevated serum amylase and lipase levels
Diagnostic Criteria	Atlanta classification APACHE II Score Elevated serum amylase and lipase levels
Treatment	IV fluids Pain management Early enteral feeding Antibiotics for suspected infection Supportive care for complications such as pancreatic necrosis, pseudocysts, and abscess formation
Complications	Pancreatic necrosis Pseudocysts Abscess formation Acute respiratory distress syndrome (ARDS) Acute kidney injury (AKI) Shock liver Diabetes mellitus
Sources	Merck Manual UpToDate Mayo Clinic

The overlapping disease is tricky, but before you can finish the puzzle you have to choose from one of three tiles that you think best fits the overlapping disease.