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1 GI T Flashcards

1
Q

What is 99mmTc-Pertechnetate used for?

A

detecting gastric mucosa - often in Meckels, HCL production leading to bleeding

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2
Q

What is secreted from D cells

A

somatostatin

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3
Q

What does anicteric infection mean?

A

a subclinical or silent infection

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4
Q

Three types of groin hernias and locations?

A

femoral - below inguinal ligament (women, right side)

Direct/Indirect - above inguinal ligament

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5
Q

What is diphenoxylate?

A

opioid (mu) to inhibit GI motility

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6
Q

What are the MC and LC causes of acute pancreatitis?

A

MC - alcohol/gallstones

LC - hypertriglyceridemia (1000+), hypercalcemia, recent ERCP procedure

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7
Q

What are apple-peel and Christmas-tree signs seen with?

A

intestinal atresia due to vascular obstruction in utero

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8
Q

What is toxic megacolon and how do you find it?

A

abdominal distension, fever, and signs of sepsis; often due to UC or Chron’s Dx; abdominal Xray as invasive procedure could perforate

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9
Q

How do lactase deficiency and celiac sprue differ histologically?

A

lactase - normal histology

celiac sprue - flattened villi

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10
Q

Describe CMV esophagitis

A

linear shallow ulcers with enlarged cells and intranuclear inclusions. presenting with dysphagia and odynophagia

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11
Q

How does GI bleeds induce encephalopathy?

A

Increased aa breakdown in the gut leading to increased ammonia absorption

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12
Q

What is F1P turned into?

A

DHAP or glyceraldehyde via Aldo B

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13
Q

Botulism toxin has what type of effects?

A

DESCENDING paralysis (vs Guinne Barre [ASCENDING])

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14
Q

What vitamins should be supplemented to a breastfed infant

A

Vit K/D

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15
Q

Causes of true diverticulum formation in the esophagus

A

Mediastinal lymphadenitis (TB/fungi) leading to scarring/traction of the mid esophagus

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16
Q

When will gastroenteritis not show fecal leukocytes

A

toxin mediated diarrhea

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17
Q

What are the three phases of digestion and what occurs in each?

A

Cephalic - vegal stimulation at sight/though
Gastric - gastrin mediated
Intestinal - YY peptide to down regulate HCl secretion via ECLs

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18
Q

What does Reye’s syndrome hepatic histology look like?

A

microvesicular steatosis (Remember give aspirin in Kawasaki’s)

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19
Q

What are two types of gastric CA and their morphology

A

intestinal - projects into lumen (H. Pylori)

Diffuse - invades stomach wall (signet) linitis plastica

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20
Q

What gene mutations are associated with Crohn’s Dx

A

NOD2 - codes intracellular receptor that recognizes LPS and activates Nf-kB

21
Q

What are some associated findings with systemic mastocytosis?

A

itching, hypotension, rash, hyper secretion of gastric acid

22
Q

What are imporferate anuses associated with?

A

urorectal, urovaginal, urovesicular fistulas

23
Q

COX2 inhibitors can prevent what type of CA?

24
Q

Where are bile salts and lipids absorbed

A

Ileum and Jejunum respectively

25
Cardiovascular induced dysphagia is due to what?
LA enlargement
26
What type of E coli doesn't ferment sorbitol or produce glucuronidase
EHEC
27
HIV esophagitis is caused by...
Candida (yeast), CMV (linear ulcers w/ intranuclear and intracytoplasmic inclusion), HSV (Cowdry Type A)
28
CF patients need what Tx to help prevent failure to thrive
pancreatic lipase
29
What is the relationship between Crohn's and gallstones?
terminal ileum commonly affected and can't absorb bile salts leading to cholesterol precipitation
30
What is the relationship between Crohn's and kidney stones?
Excess oxalate absorption leading to oxaluria and stone formation: terminal ileum is diseased, impaired bile salt absorption, impaired fat absorption, fat binds to Ca2+, no Ca2+ left to bind oxalate, increased oxalate absorption
31
Where does HBV undergo RT?
inside the viron once RNA is packaged prior to release
32
What is the difference between the right and left colon cancers?
Right side project into the lumen and cause bleeding and iron deficiency, left side encircle the gut wall and cause napkin ringing and obstruction
33
How to differentiate primary biliary cirrhosis and cholestasis?
both have elevated direct bilirubin (liver okay) and alkaline phosphatase (bile duct lining damage) but primary biliary cirrhosis has antimitochondrial antibodies and is associated with Sjorgren, Raynaud, Celiac Dx
34
Histology of acute vs chronic hepatitis
acute will have ballooning degeneration/hepatocyte swelling and chronic will have cirrhosis with regenerative nodules
35
Where can Karposki's occur and what is it's histology?
Mainly skin but GI and lungs are possible. It will show as spindle cells with blood vessel proliferation
36
What is fibrates effects on cholesterol stones?
inhibits cholesterol 7a hydroxyls which is rate limiting step in bile acid synthesis so it increases risk. Also it increases LPL to decrease hypertriglyceridemia
37
What is the bodies best defense against Giardia
Not eosinophils but IgA to prevent adherance
38
Gallbladder fistulas with intestine lead to
cholesterol stone ileus AND air in gallbladder (pneumobilia)
39
Differences between colitis associated cancers and sporadic cancers
early p53 and late APC mutations; multifocal; signet ring morphology. Depends on extent and duration of colitis
40
Explain hereditary hemochromatosis
HFE gene mutations lead to inability of transferrin-Fe complex to endocytose and the body thinks there is low iron leading to increased ferroportin activity and DMT1 expression on the luminal surface
41
What is the pringle maneuver?
Compress the hepatoduodenal ligament (common bile/portal vein/hepatic artery) to determine if bleeding is in IVC or hepatic vein
42
What is WDHA syndrome and what causes it
watery diarrhea, hypokalemia, achlorhydria
43
What is the stippling in lead poisioning
ribosomal aggregation
44
What is the diff bw gastroschiesis and omphalocele
gastroschiesis is not covered by peritoneum and omphalocele is
45
What causes Chagas and what does it cause
Trypanosoma cruzi; megacolon/ureter achalasia dilated CM
46
What cell type is common in adenocarcinoma of esophagus?
Goblet cells
47
MC location of anal fissures and why
posterior midline due to poorer blood supply
48
Submucosal and myenteric plexi are called
Messiness' and Auerbach's
49
What test can you use in ulcer patients when gastrin is high?
Secretin to see if gastrin rises more. Indicates ZE

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