Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

PLE > Anatomy and Surgery Part 1 > Flashcards

Anatomy and Surgery Part 1 Flashcards

General Surgery Topics Stomach Small intestines Pancreas Liver Gallbladder Spleen Vertebrae

1
Q

Vertebral Level : Anatomic Structure

C3-4

A

Hyoid bone

Bifurcation of common carotid artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Vertebral Level : Anatomic Structure

C5

A

Thyroid cartilage

Carotid pulse palpated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Vertebral Level : Anatomic Structure

C6

A

Cricoid cartilage

Start of trachea

Start of esophagus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Vertebral Level : Anatomic Structure

T2

A

Sternal notch

Arch of the aorta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Vertebral Level : Anatomic Structure

T4

A

Sternal angle

Junction of superior and inferior mediastinum

Bifurcation of trachea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Vertebral Level : Anatomic Structure

T5-7

A

Pulmonary hilum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Vertebral Level : Anatomic Structure

T8

A

Inferior vena cava hiatus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Vertebral Level : Anatomic Structure

T9

A

Xiphisternal joint

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Vertebral Level : Anatomic Structure

T10

A

Esophageal hiatus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Vertebral Level : Anatomic Structure

T12

A

Aortic hiatus

Celiac artery

Upper pole of left kidney

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Vertebral Level : Anatomic Structure

T12-L1

A

Duodenum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Vertebral Level : Anatomic Structure

L1

A

Superior mesenteric artery

Upper pole of right kidney

End of spinal cord in adults (conus medullaris) and pia mater

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Vertebral Level : Anatomic Structure

L2

A

Renal artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Vertebral Level : Anatomic Structure

L3

A

End of spinal cord in newborn

Inferior mesenteric artery

Umbilicus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Vertebral Level : Anatomic Structure

L4

A

Iliac crest

Bifurcation of aorta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Vertebral Level : Anatomic Structure

S1

A

Sacral promontory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Vertebral Level : Anatomic Structure

S2

A

End of dural sac, dura, arachnoid, subarachnoid space, and cerebrospinal fluid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Vertebral Level : Anatomic Structure

S3

A

End of sigmoid colon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Positional changes of the spinal cord

Embryo

A

Entire length of vertebral canal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Positional changes of the spinal cord

6 months

A

S1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Positional changes of the spinal cord

Birth

A

L3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Positional changes of the spinal cord

Adult

A

L1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Spinal cord region: Cervical
Shape
White matter
Gray matter/lateral horn

A

Oval
Fasciculus cuneatus and gracilis present
Absent lateral horn

Cuneatus - upper body
Gracilis - lower body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Spinal cord region: Thoracic
Shape
White matter
Gray matter/lateral horn

A

Round
Fasciculus cuneatus (T1 and T6) and gracilis present
Present lateral horn

Cuneatus - upper body
Gracilis - lower body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Spinal cord region: Lumbar
Shape
White matter
Gray matter/lateral horn

A

Round to oval
Fasciculus cuneatus absent and gracilis present
Present lateral horn

Cuneatus - upper body
Gracilis - lower body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Spinal cord region: Sacral
Shape
White matter
Gray matter/lateral horn

A

Round
Fasciculus cuneatus absent and gracilis present
Absent lateral horn

Cuneatus - upper body
Gracilis - lower body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Functions of Dorsal/Posterior column (Ascending tract)

A 
Position sense
2-point discrimination
Stereognosis
Vibration sense
Fine, discriminitive
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Functions of spinothalamic tract, anterior

A

Touch, crude
Pressure

*Spinothalamic = Contralateral manifestation, everything else is ipsilateral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Functions of spinothalamic tract, lateral

A

Pain
Temperature

*Spinothalamic = Contralateral manifestation, everything else is ipsilateral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Function of column tracts:
Ascending
Descending

A 
Ascending = Sensory
Descending = Motor
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Spinal cord lesions

Central cord
Progressive cavitation around central canal
Loss of pain and temperature sensation on hands and forearms (common in cervical)

A

Syringomyelia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Spinal cord lesions

Attacks the anterior horn cells leading to LMNL

A

Poliomyelitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Spinal cord lesions

Caused by neurosyphilis
Dorsal root involvement with secondary degeneration of dorsal columns (loss of position and vibration sense)

A

Tabes dorsalis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Spinal cord lesions

Lou Gehrig’s disease
Pure motor neuron disease involving degeneration of anterior horn cells (LMNL) and corticospinal tract (UMNL)
No sensory loss

A

Amyotrophic lateral sclerosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Spinal cord lesions

Caused by vitamin B12 deficiency
Degeneration of posterior and lateral columns (loss of position and vibration sense in legs associated with UMNL)

A

Subacute combined degeneration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Spinal cord hemisection features

A

Brown-Sequard Syndrome

Contralateral loss of pain and temperature
Ipsilateral loss of proprioception
Ipsilateral manifestation of UMNL and LMNL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

UMN vs LMN

Function

A

UMN: inhibits muscle stretch reflex
LMN: motor component of muscle reflex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

UMN vs LMN

Type of paralysis

A

UMN: spastic
LMN: flaccid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

UMN vs LMN

DTRs

A

UMN: hyperreflexia
LMN: hyporreflexia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

UMN vs LMN

Muscle tone

A

UMN: hypertonic
- Decorticate rigidity: lesion above midbrain
- Decerebrate rigidity: lesion bellow midbrain
LMN: hypotonic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

UMN vs LMN

Muscle mass

A

UMN: disuse atrophy
LMN: wasting atrophy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

UMN vs LMN

Fasciculations

A

UMN: absent
LMN: present

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

UMN vs LMN

Babinski sign

A

UMN: positive
LMN: negative

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

UMN vs LMN

Other reflexes

A

UMN: abdominal and cremasteric lost
LMN: N/A

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

UMN vs LMN

Voluntary movement

A

UMN: decreased speed
LMN: lost

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

UMN vs LMN

Area of body involved

A

UMN: large
LMN: small

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Sign related to injury to lemniscal pathway

A

(+) Romberg sign

Astereognosis
Cannot recognize limb position
Loss of two point discrimination and vibration sense

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Brainstem lesions: What is affected?

Wallenberg syndrome

A

lateral medullary
PICA syndrome
alternating sensory loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Brainstem lesions: What is affected?

Millard Gubler

A

Pons

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Brainstem lesions: What is affected?

Claude

Weber

A

Midbrain (both)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Anterolateral System

Loss of pain and thermal sensations on the contralateral side at what level compared to level of lesion?

A

1-2 segments BELOW the level of the lesion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Bilateral cervical spinal cord damage C4-C6 manifests as

A

Quadriplegia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Unilateral spinal cord lesions in thoracic levels manifest as

A

Paralysis of ipsilateral lower extremity (Monoplegia)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Thoracic spinal cord lesion is bilateral

A

Paraplegia - both extremities may be paralyzed

up toL1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Layers traversed in lumbar puncture/spinal needle

A 
Skin
Subcutaneous tissue/Superficial fascia
Supraspinous ligament
Interspinous ligament
Ligamentum flavum
Epidural space
Dura mater
Arachnoid
Subarachnoid space - contains CSF
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Spinal tap landmark and entry

A

Iliac crest highest point

Above or below L4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Intervertebral disc herniations, cervical area

A

Between C5-C6 or C6-C7

C5 - biceps brachii - lateral arm
C6 - brachioradialis - lateral forearm
C7 - triceps brachii - digits 2, 3, 4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

Intervertebral disc herniations, lumbar area

A

Between L4-L5 or L5 to sacrum

L4 - patellar tendon - medial aspect of leg
S1 - achilles tendon - lateral aspect of foot

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

IVD herniation between 5th and 6th cervical vertebra compresses what nerve root?

A

Sixth cervical

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

Strong thigh flexors but weak hamstrings. Where is the lesion?

A

L5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

Spina bifida occulta most commonly affected vertebral levels

A

L5 and S1

No clinical manifestations, just dimple and tuft of hair

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

Severe type of spina bifida

A

SB cystica

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

Spina bifida + CSF + meninges

A

SB with meningocoele

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

Spina bifida + spina cord and/or nerve roots

A

SB with meningomyelocoele

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

Most severe spina bifida, spinal cord is open because of failure of neural fold fusion

A

SB with myeloschisis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

What incomplete spinal cord syndrome?

Bilateral paresis: upper > lower

A

Central cord syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

What incomplete spinal cord syndrome?

Bilateral motor paralysis, loss of pain and temperature sensation, autonomic dysfunction below the level of the lesion

A

Anterior cord syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

What incomplete spinal cord syndrome?

Ipsilateral loss of proprioception, vibration, and touch sensation below the level of the lesion

A

Posterior cord syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

What incomplete spinal cord syndrome?

Ipsilateral
Loss of proprioception, vibration, tactile discrimination below level of the lesion
Segmental flaccid paresis at the level of the lesion
Spastic paralysis below level of lesion
Ipsilateral Babinski sign
Contralateral loss of pain and temperature sensation one or two levels below lesion

A

Brown-Sequard/Hemisection syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

What incomplete spinal cord syndrome?

Flaccidity, areflexia and impairment of bladder and bowel function
Regeneration of peripheral nerves is possible (as long as endoneurium is intact, this is possible)

A

Cauda equina syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

Round ligament of the liver is also called

A

Ligamentum teres

Remnant of the (left) umbilical vein, between left and quadrate lobe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

Fetal structures = adult derivatives

Umbilical artery

A

Medial umbilical ligament

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

Fetal structures = adult derivatives

Ductus venosus

A

Ligamentum venosum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

Fetal structures = adult derivatives

Urachus

A

Median umbilical ligament

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

Fetal structures = adult derivatives

Foramen ovale

A

Fossa ovalis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

Fetal structures = adult derivatives

Ductus arteriosus

A

Ligamentum arteriosum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

Enumerate the liver segments

based on bile ducts and hepatic vessels

A 
Anatomy:
I - Medial superior
II - Lateral superior
III - Lateral inferior
IV - Medial inferior (landmark: Quadrate lobe, beside gallbladder)
V - Anterior inferior
VI - Posterior inferior
VII - Posterior superior
VIII - Anterior superior
Surgery:
I - Caudate
II and III - Lateral segment
IV - Left medial segment
V and VIII - Right anterior lobe
VI and VII - Right posterior lobe
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

Liver arrangement based on blood flow, a.k.a. Acinus of Rappaport

A

Liver acinus

Diamond-shaped
Central veins long axis, portal triads shorter axis
Zone 1 most perfused
Zone 3 most prone to ischemic injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

Liver arrangement with central vein at center, 6 portal triads at side

A

Hepatic lobule

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

Liver arrangement based on bile flow, triangular in shape, apices are central veins

A

Portal lobule

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

Contents of porta hepatis

A

Portal triad:

  1. Portal vein (a.k.a. hepatic vein)
  2. Hepatic artery
  3. Bile duct
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

30% (25% in surgery) of liver blood supply, from celiac artery

A

Hepatic artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

70% (75% in surgery) of liver blood supply, from superior mesenteric and splenic veins

A

Portal vein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

Pringle maneuver can control liver hemorrhage since the hepatoduodenal ligament at the epiploic foramen contains

A

Portail vein
Hepatic artery
Common bile duct

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

Where is the needle inserted to get a liver biopsy?

A

R 10th ICS at the MAL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

Right hepatic vein drains

A

Segment V and VIII (surgery)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

Middle hepatic vein drains

A

Segments IV, V, VIII (surgery)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

Left hepatic vein drains

A

Segments II, III (Surgery)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

IVC drains what segment?

A

Caudate lobe/ I (surgery)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

Trace bile drainage

A 
Bile canaliculi
Intrahepatic ducts
Common hepatic duct
(+ cystic duct)
Common bile duct
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

Cantlie/Rex-Cantlie line separates right and left lobes, it passes at the IVC and the

A

Gallbladder

(important for segmentectomy, separates right medial and left medial lobes, middle hepatic veins also falls in this area/line)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
92
Q

LFTs for hepatocellular injury

A

AST - SGOT

ALT - SGPT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
93
Q

LFTs for abnormal synthetic functions

A

Albumin

Clotting factors except for Factor VIII (also made in endothelium, useful for liver failure determination)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
94
Q

LFTs for cholestasis

A

B2 - conj. bili
total bilirubin
GGTP
alk phos

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
95
Q

Best test to measure liver’s synthetic function

A

Prothrombin time + INR

Decreased in Vit K deficiency since there will be nothing to carboxylate the factors used to measure PT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
96
Q

Increased in intrahepatic cholestasis, hemolytic disorders, conjugation or hepatic uptake defects of bilirubin

A

Indirect (unconjudated) bilis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
97
Q

Increased in extrahepatic cholestasis or obstructive cholestasis, problems of intrahepatic excretion of bilirubin

A

Direct (conjugated) bilis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
98
Q

Half life of 7 days, synthesized in liver and bone, increase is indicative of biliary obstruction

A

Alkaline phosphatase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
99
Q

Early marker, sensitive for biliary disease but also elevated in a lot of other conditions

A

GGTP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
100
Q

At what serum bilirubin is jaundice detectable?

A

> 2.5 to 3 mg/dl

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
101
Q

Intra-hepatic causes of jaundice

A

Crigler-Najar - glucoronyl transferase
Gilbert disease
Dubin-Johnson/Rotor syndrome
Hepatitis from whatever cause

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
102
Q

Causes of jaundice:
Prehepatic
Posthepatic

A

Prehepatic: Acquired or inherited hemolytic anemias, protein loss
Posthepatic: Obstruction of bile flow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
103
Q

When bile enters vasculature in the setting of abnormal fistulae (ex. Hep C patient)

A

Hemobilia

RUQ pain, jaundice, dec Hgb, FOBT positive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
104
Q

7 complications of liver cirrhosis

A
  1. Portal hypertension
  2. Malnutrition
  3. HCCA
  4. Progressive hyperbilirubinemia
  5. Hepatic encephalopathy
  6. Decreased synthetic function
  7. Spontaneous bacterial peritonitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
105
Q

DOC for acute esophageal variceal bleed

A

Octreotide

Splanchnic vasoconstriction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
106
Q

No need to biopsy to confirm malignancy in these organs, biopsy only if they seem unresectable on imaging

A
  1. Liver
  2. Pancreas
  3. Salivary glands
  4. Gonads
  5. Retroperitoneum
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
107
Q

Trace origin of cystic artery

A

Celiac artery –> Common hepatic –> Right hepatic –> Cystic artery

Celiac art.

  • Left gastric
  • Splenic
  • Common hepatic
  • -> Right hepatic
  • ——-> cystic artery
  • -> Left hepatic
  • -> Gastroduodenal
  • -> Right gastric
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
108
Q

Indications for cholecystectomy (asymptomatic)

A

Elderly with diabetes
Isolation from medical care for extended periods
Increased risk of GB cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
109
Q

Gall stone disease risk factors

A 
Female
Obese
Pregnant
Crohn disease
Gastric and terminal ileal surgery
Hemolytic disorders
Biliary stasis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
110
Q

Major organic solutes in gallstones

A

Cholesterol
Bile salts
Phospholipids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
111
Q

Prophylactic cholecystectomy indicated in patients with

A

Hemoglobinopathies (sickle cell disease)
Hereditary spherocytosis and thalassemia at the time of splenectomy
Transplant patients (cardiac and lung)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
112
Q

Acute cholecystitis DOC for analgesia

A

NSAIDs and Meperidine

Surgery: no evidence that morphine induces spasm of sphincter of Oddi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
113
Q

Radiologic sign in gallstone-induced pancreatitis

A

Smooth narrowing of distal common bile duct

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
114
Q

Normal INR range

A

In healthy people an INR of 1.1 or below is considered normal.

An INR range of 2.0 to 3.0 is generally an effective therapeutic range for people taking warfarin for disorders such as atrial fibrillation or a blood clot in the leg or lung.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
115
Q

Adenicarcinoma at bifurcation of hepatid ducts, also perihilar cholangiocarcinoma, a.k.a.

A

Klatskin tumor
(bile duct carcinoma)

Elevates: CA125, CEA, CA19-9

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
116
Q

Common bile duct diameter (normal)

A

The mean diameter of the normal common duct was 4.1 mm. A common duct greater than 7 mm in diameter can be seen in (a) nonjaundiced patients with gallstones and/or pancreatitis, or (b) jaundiced patients with common duct obstruction by stone or tumor.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
117
Q

Occupies area between diaphragm and stomach, corresponds to 9th, 10th and 11th left rib

A

Spleen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
118
Q

Ligament between the hilum and greater curvature of the stomach, carries short gastric and left gastroepiploic vessels

A

Gastrosplenic ligament/omentum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
119
Q

Ligament between spleen and left kidney, carries splenic vessels, a.k.a Lienorenal ligament

A

Splenicorenal ligament

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
120
Q

Remnants of the dorsal mesentery of the stomach

A

Splenicorenal/lienorenal and gastrosplenic ligaments

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
121
Q

Remnants of the ventral mesentery of the stomach

A

Lesser omentum and falciform ligament

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
122
Q

Strongest flexor of the thigh

A

Iliopsoas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
123
Q

Thick, fusiform muscle, muscle of the loin

A

psoas

124
Q

Large, triangular, lateral side of psoas major

A

iliacus

125
Q

Quadrilateral muscle

A

quadratus lumborum

126
Q

Within psoas major muscle, ventral rami of L1 to L4

A

Lumbar plexus

127
Q

Name and origin of nerve:

Supplies skin on lower part of anterior abdominal wall

A

Iliohypogastric

L1

128
Q

Name and origin of nerve:

Supplies skin on lower part of anterior abdominal wall, labia majora and scrotum

A

Ilioinguinal nerve

L1

129
Q

Name and origin of nerve:

Cremasteric reflex, branch of it supplies cremaster muscle, the other supplies skin on thigh

A

Genitofemoral nerve

L1 and L2

130
Q

Name and origin of nerve:

Supplies skin on lateral surface of thigh

A

Lateral femoral cutaneous

L2 and L3

131
Q

Name and origin of nerve:

Largest branch of lumbar plexus
Supplies muscles of anterior thigh and skin on antero-medial aspect

A

Femoral nerve

L2, L3 and L4

132
Q

Supplies medial thigh and muscles and skin on medial aspect of thigh

A

Obturator nerve

L2, L3 and L4

133
Q

Lies on posterior pelvic wall in front of piriformis, anterior rami of L4, L5 and S1 to S4

A

Lumbosacral plexus

134
Q

Branches of lumbosacral plexus that go to the lower limb through the greater sciatic foramen

A

Sciatic (L4, L5, S1, S2, S3)
Superior gluteal (L4, L5, S1) - gluteus medius and minimus
Inferior gluteal (L5, S1, S2) - gluteus maximus
Nerve to quadratus femoris
Nerve to obturator internus
Posterior cutaneous nerve of the thigh

135
Q

Branches of lumbosacral plexus to the pelvic muscles, viscera and perineum

A

Pudendal (S2, S3, S4) - perineum
Nerve to piriformis
Pelvic splanchnic nerves (S2, S3, S4)

136
Q

Branch of lumbosacral plexus that supplies skin on lower medial part of buttock

A

Perforating cutaneous nerve

137
Q

Forms most of head of pancreas, including uncinate process

A

Ventral pancreatic bud

138
Q

Dorsal pancreatic bud forms

A

Head, body and tail

139
Q

Pancreatic duct that extends through entire length of pancreasm joins bile duct to form hepatopancreatic ampulla, empties into second part of duodenum via ampulla of vater, ventral

A

Main pancreatic duct/ Duct of Wirsung

140
Q

Pancreatic duct that lies at the head of the pancreas, drains into the main duct, may be absent, opens into duodenum via minor duodenal papilla, dorsal

A

Accessory pancreatic duct, Duct of Santorini

141
Q

Blood supply of pancreas and origins

A

Superior pancreaticoduodenal artery from gastroduodenal branch of celiac trunk
Inferior pancreaticoduodenal artery from SMA
Pancreatic arteries from splenic artery (also from celiac)

142
Q

Venous drainage of pancreas from

A

SMV and splenic vein, most drain into splenic vein

143
Q

Accounts for most cases of obstructive jaundice (extrahepatic)

A

Pancreatic cancer

144
Q

Pancreatic cancer that may cause portal or IVC obstruction

A

Neck and body

145
Q

Structures removed in Whipple procedure

A

Pancreaticoduodenectomy

  1. Head of pancreas
  2. CBD
  3. GB
  4. Distal part of stomach
146
Q

Length and weight of pancreas

A

15-20 cm

Weighs 75 to 100 g in adult

147
Q

Narrowest portion of the pancreas

A

Neck

148
Q

Functional obstruction of the duct of Santorini, predisposes to acute and chronic panc, most common congenital anomaly of pancreas

A

Pancreas divisum

149
Q

Pancreatic veins drain into

A

portal vein

150
Q

Lymphatic drainage of pancreas

A

Celiac nodes

Superior mesenteric nodes

151
Q

Celiac plexus blocked in severe pain derived from

A

T12 (sympathetic and vagal)

152
Q

Duodenal atresia and annular pancreas in children is associated with

A

Down syndrome

153
Q

Etiology of acute pancreatitis

A

Miscellaneous
Alcohol
Gallstone

154
Q

Complications of severe pancreatic inflammation and necrosis, caused retroperitoneal hemorrhage

A

Large third spacing
Hypovolemia
Hypotension
Tachycardia

155
Q

Pancreatitis, flank ecchymosis

A

Grey turner sign

156
Q

Pancreatitis, periumbilical echhymosis

A

Cullen sign

157
Q

Pancreatitis, ecchymosis of inguinal ligament

A

Fox sign

158
Q

Pancreatitis, bluish discoloration of scrotum

A

Bryan sign

159
Q

More specific of the panreatic enzymes

A

Serum lipase, sustained for a much longer period, diagnostic if 3x elevated (like amylase)

160
Q

DDx of pancreatitis, findings of hyperamylasemia

A 
Acute cholecystitis
CBD stones with or without cholangitis
Perforated peptic ulcer
Strangulated small bowel
Acute alcoholism
Cancer of the pancreas
Mumps
161
Q

Prognosis criteria for pancreatitis

A

Ranson Signs

162
Q

Ranson sign for severe panc

A

3 or more

163
Q

Ranson sign for 50% mortality

A

> 7 signs

164
Q

Ranson sign at admission

A 
>55 years old
WBC > 16k
FBS > 200
LDH > 350
SGOT/AST > 250
165
Q

Ranson sign at initial 48 hours

A 
Hct fall >10
BUN elevation >5
Serum Ca < 8
PO2 < 60
Base deficit > 4
Fluid deficit > 6
166
Q

Capacity of stomach

A

1.5 L

167
Q

Cardiac orifice is at the level of

A

6th costal cartilage

T10 and T11 vertebra

168
Q

Pyloric antrum

A

L1 vertebra

169
Q

Pyloric canal

A

L4 vertebra

170
Q

Gastric disease associated with projectile vomiting

A

Hypertrophic pyloric stenosis

171
Q

Largest arterial supply of the stomach and the smallest branch of the celiac trunk

A

Left gastric a.

172
Q

Blood supply of lesser curvature of stomach

A

Right gastric a. from hepatic a.

Left gastric a. from celiac a.

173
Q

Blood supply of greater curvature of stomach

A

Right gastroepiploic from gastroduodenal branch of hepatic a.
Left gastroepiploic from splenic a.

174
Q

Blood supply of fundus of stomach

A

Short gastric from splenic a.

175
Q

Venous drainage of stomachand detination

A

R and L gastric veins to portal v.
L gastroepiploic and short gastric v. to splenic v. to portal v.
R gastroepiploic v. to SMV to portal v.

176
Q

Sympathetic nerve supply of stomach

A

T6 to T9

177
Q

Parasympathetic nerve supply of stomach

A

Ant. vagal trunk from L vagus n.

Post. vagal trunk from R vagus n.

178
Q

Most common site of peptic ulcer and adenocarcinoma in stomach

A

Lesser curvature at or near/above incisura angularis

179
Q

Most common stomach lesion found at the pylorus

A

Carcinomas of the stomach

180
Q

NGT insertion: length from nostril to cardiac orifice of stomach

A

17.2 inches or 44 cm

181
Q

NGT insertion: Sites of esophageal narrowing

A

1st - 18 cm
2nd - 28 cm
3rd - 44 cm

182
Q

Length of duodenum

A

25 cm

183
Q

Vertebral level of end of duodenum

A

L2

184
Q

Duodenal compression at the 3rd/horizontal part of the duodenum from superior mesenteric vessels manifests as

A

epigastric pain
nausea after meal
bilious vomiting

185
Q

Venous drainage of stomach

A

Superior pancreaticoduodenal v. –> Portal v.

Inferior pancreaticoduodenal v. –> superior mesenteric v.

186
Q

Perforation of the duodenum affects which structures?

A

More often anterior wall ulcers vs posterior wall

Erode gastroduodenal a. causing severe hemorrhage
May perforate into the pancreas

187
Q

Gastric vs. duodenal ulcers:

Origin of bleed

A

Gastric: L gastric a.
Duodenal: Gastroduodenal a.

188
Q

Gastric vs. duodenal ulcers:

SSx

A 
Gastric:
Burning epigastric pain soon after eating
Pain increases with food intake
Relieved by antacids
Incisura angularis
Duodenal:
Burning epigastric pain 1-3 hours after eating
Pain decreases with food intake
Relieved by antacids
Wakes at night because of pain
Ant. wall of first part of duodenum
189
Q

Hematemesis vs. Hematochezia

Boundary

A

Hematemesis - proximal to ligament of Treitz

Hematochezia - distal to ligament of Treitz

190
Q

Hematemesis vs. Hematochezia

Blood is seen where?

A

Hematemesis - vomitus

Hematochezia - stool

191
Q

Hematemesis vs. Hematochezia

Bleeds into where?

A

Hematemesis: lumen of esophagus, stomach, duodenum
Hematochezia: lumen of jejunum, ileum, colon, rectum

192
Q

Hematemesis vs. Hematochezia

Bleeding originates from

A

Hematemesis: Esophageal varices or gastric or duodenal ulcers
Hematochezia: May be from anywhere along GI tract

193
Q

Lies in LUQ, proximal 2/5 of the 6 meters after duodenum

A

Jejunum

Begins at duodenojejunal flexure

194
Q

Lies in RLQ and is distal 3/5 of the 6 meters after duodenum

A

Ileum

Ends at ileocecal junction

195
Q

Trace blood supply of jejunum and ileum

A

Abdominal aorta –> Level L1: SMA –> arterial arcades –> vasa recta

196
Q

Jejunum vs. Ileum

Color

A

Jejunum - Deeper red

Ileum - Paler pink

197
Q

Jejunum vs. Ileum

Caliber

A

Jejunum - 2-4 cm

Ileum - 2-3 cm

198
Q

Jejunum vs. Ileum

Wall

A

Jejunum - thick and heavy

Ileum - thin and light

199
Q

Jejunum vs. Ileum

Vascularity

A

Jejunum - greater

Ileum - less

200
Q

Jejunum vs. Ileum

Vasa recta

A

Jejunum - long

Ileum - short

201
Q

Jejunum vs. Ileum

Arcades

A

Jejunum - few, large

Ileum - many

202
Q

Jejunum vs. Ileum

Fat

A

Jejunum - less

Ileum - more

203
Q

Jejunum vs. Ileum

Plicae circularis

A

Jejunum - large, tall (absorption)

Ileum - low, sparse, absent in distal

204
Q

Jejunum vs. Ileum

Lymphoid nodules

A

Jejunum - Few

Ileum - Many (Peyer’s patches)

205
Q

Most common site of intussusception in children due to hyperplasia of lymphatic tissue in this area

A

Ileocecal (ileal lymphatic tissue hyperplasia, ileum is the intusscusceptum/entering)

206
Q

SSx of intussusception

A

Obstructed bowel, right-sided colicky pain, abdominal distention, hematochezia

207
Q

Another name for plicae circulares

A

Valvulae conniventes

Valves of Kerkring

208
Q

Duodenum is embryologically derived from

A

foregut

209
Q

Jejunum and ileum are embryologically derived from

A

midgut

210
Q

Peritoneal cavity and parietal and visceral peritoneum are derived from

A

mesoderm

211
Q

Small intestines are connected with the yolk sac to through the

A

vitelline duct

obliterates on 6th week

212
Q

What happens to the SI embryologically at the 5th week?

A

Extracoelomic herniation

213
Q

When does the bowel retract back into abdominal cavity and undergo 270 degree counterclockwise rotation around the SMA?

A

10th week AOG

214
Q

Water and electrolyte absorption and excretion in small bowel
Amount of fluid entering?
Absorbed?
How much enters colon?

A

Amount of fluid entering? 8-9 L
Absorbed? 80%
How much enters colon? 1.5 L

215
Q

Extrinsic causes of small bowel obstruction

A

Adhesions: congenital (Ladd or Meckel bands), postoperative (most common), postinflammatory (after PID)
Hernias
Volvulus
External mass effect

216
Q

Compression of 3rd portion of duodenum since angle between SMA and AA is narrow

A

SMA Syndrome
a.k.a.:
Wilkie syndrome- congenital, children
Cast syndrome- dieters, loss of mesenteric fat

217
Q

Intrinsic causes of small bowel obstruction

A

Congenital - Meckel diverticulum, atresia, stricture, stenosis
Inflammatory - Crohn, diverticulitis, radion enteritis or stricture, medication-induced (NSAIDs, KCl)
Neoplasms - primary (malignant vs benign), secondary (mets and carcinomatosis)
Trauma

218
Q

Intraluminal causes of small bowel obstruction

A 
Foreign body
Parasites
Feces, meconium in CF
Gallstones
Intussusception
Polyps and exophytic lesions
219
Q

Most common mechanical obstructions causes in chidren, adolescent and elderly

A

Children - intussusception
Adolescent - hernia
Elderly - neoplasm

220
Q

Cardinal signs of bowel obstruction (partial or completed)

A

Vomiting
Obstipation
Distention
Crampy/colicky abdominal pain

221
Q

Signs of strangulated small bowel obstruction

A

Disproportionate abdominal pain severity to physical findings
Acidosis
Hyperkalemia

Cardinal: Fever, Tachycardia or tachypnea, localized abd tenderness, Leucocytosis

222
Q

Triad of radiographic findings in SBO (70% sensitivity)

A

Dilated small bowel loops > 3 cm
Air-fluid levels
Paucity of air in colon

223
Q

Radiographic signs of strangulated small bowel obstruction

A

thickened small bowel loops
mucosal thumb printing
pneumatosis intestinalis
pneumoperitoneum
string-of-beads sign (air trapped in valvulae conniventes)
coffee bean sign/sentinel loop: closed-loop SBO, fluid and little gas

224
Q

Imaging gold standard for SBO (best for complete onstruction, can diff between closed loop and bowel strangulation)

A

CT scan with water-soluble contrast

225
Q

Imaging gold standard for SBO (partial)

A

small bowel series (enteroclysis)

226
Q

Ileus vs small bowel obstruction on UTZ

A

Ileus - generalized loss of peristalsis

SBO - proximal to site of obstruction, there is increased peristalsis initially

227
Q

Strangulated SBO management

A

Lap

228
Q

Contraindications for non-operative/conservative management of SBO

A 
suspected ischemia
large bowel obstruction
closed loop obstruction
strangulated herbia
perforation
229
Q

Causes of intestinal fistulas

A 
Congenital
Trauma
Infection
Perforation
Inflammation, irradiation or tumor
230
Q

Factors that inhibit spontaneous closure of intestinal fistulas

A

FRIENDS

Foreign body within the fistula tract
Radiation enteritis
Infection/inflammation at the fistula origin
Epithelialization of the fistula tract
Neoplasm at the fistula origin
Distal obstruction at the intestine
Short tract

Operate within 10 days of diagnosis or at 4 months

231
Q

Malignant small bowel tumors are more common in

A

Distal bowel

except for duodenum, site of adenocarcinoma

232
Q

Risk factors for small bowel neoplasms

A 
FAP
HNPCC
Gardner syndrome
Crohn disease
Peutz-Jeghers syndrome
Celiac disease
Neurofibromatosis
Immunosuppressio (IgA dificiency, AIDS)
Infection: EBV, H. pylori
History of other primary cancer
233
Q

5-year survival for small bowel neoplasms
Best
Worst

A

Best: Localized carcinoid (75-95%)
Worst: Jejunum/ileal adenocarcinoma (5-30%)

234
Q

Tx for unresectable or metastatic GIST

A

Imatinib (Gleevac)

235
Q

CHOP regimen for small bowel lymphoma

A

Cyclophosphamide
dOxorubicin
vHincristine
Prednisone

236
Q

Most prevalent congenital anomaly of GIT

A

Meckel diverticulum
Most common site: ileum
Persistence of vitelline/omphalomesenteric duct

237
Q

Rule of 2s of Meckel diverticulum

A

2% of population
2:1 male preponderance
2 feet proximal to ileoceccal valve
2 years old below comprise 50% of patients

children = bleeding
adults = intestinal obstruction
238
Q

Acute and chronic mesenteric ischemia more common in patients with

A

CVD

Atherosclerosis

239
Q

Non-operative management for acute mesenteric ischemis

A

Vasodilator (papaverine) infusion

240
Q

Small bowel disorder: Malrotation

Manifestation
Dx
Tx

A

Manifestation: intermittent vomiting, abdominal distention, tenderness, melena
Dx: Abdominal x-ray
Tx: Ladd procedure, appendectomy

241
Q

Small bowel disorder: Intussusception

Manifestation
Dx
Tx

A

Manifestation: intermittend colicky abdominal pain, vomiting, lethargy, currant-jelly stool, sausage-shaped mass, hyperactive bowel sounds, (+) dance sign - no bowel in RLQ
Dx: Abdominal UTZ - pseudokidney sign, donut/target sign, coiled ring sign on contrast enema
Tx: enema, lap, resection and anastomosis

242
Q

Small bowel disorder: Intestinal atresia

Manifestation
Dx
Tx

A

Manifestation: feeding intolerance, maternal polyhydramnios, bilious emesis, abdominal distantion, non-passage of meconium on first day of life
Dx: prenatal UTZ
Tx: resection and anastomosis, enterotomy

243
Q

Small bowel disorder: Meconium ileus

Manifestation
Dx
Tx

A

Manifestation: feeding intolerance, bilious emesis, cystic fibrosis family history, abdominal distention
Dx: abdominal x-ray - eggshell pattern, contrast enema - microcolon
Tx: ileostomy

244
Q

Double bubble sign usually seen in

A

Duodenal obstruction

  • duodenal atresia
  • duodenal web
  • annular pancreas
245
Q

Most common and lethal gastrointestinal disorder affecting preterm neonates

A

Necrotizing enterocolitis

(+) pneumoperitoneum - indication for surgery

246
Q

Short bowel syndrom

A

< 200 cm length
malabsorptive symptoms: diarrhea, dehydration, malnutrition
usually acquired > congenital
Small intestine resection not well tolerated if 50-80% is removed

247
Q

Vitamin B12 deficiency can occur after

A

gastrectomy - R protein from saliva hydrolyzed by pancreatic enzymes in the duodenum

gastric bypass - parietal cell-derived intrinsic factor

ileal resection - receptors for cobalamin absorption

248
Q

Stomach innervation is embedded in

A

lesser omentum

249
Q

Produce protective mucus layer in stomach that contains HCO3 and glycoprotein

A

surface mucous cells

250
Q

Produces less alkaline mucus layer that contains glycoprotein, pepsinogen

A

Mucous neck cells

251
Q

Produces hydrochloric acid and intrinsic factor

A

Parietal/oxyntic cells

252
Q

Produces pepsinogen, gastric lipased and leptin

A

Chief/zymogenic cells

253
Q

Produces serotonin in stomach

A

enterochromaffin cells

254
Q

Produces histamine in stomach

A

enterochromaffin-like cells

255
Q

Produces the lone inhibitor to HCl synthesis

A

D cells (somatostatin)

256
Q

Produces gastrin in stomach

A

S cells

257
Q

Compounds that induce stomach acid secretion

A

Acetylcholine
Histamine
Gastrin - most potent for HCl secretion

258
Q

Acid-base abnormality in stomach in gastric outlet obstruction, treat first before surgery

A

hypokalemic, hypochloremic, metabolic alkalosis

259
Q

Trauma –> hospital admission –> UGIB. Cause?

A

Erosive gastritis from mucosal ischemia

260
Q

Most serious complication of EGD

A

Esophageal perforation

requires 8 hour fasting as well

261
Q

Better than EGD in detecting diverticula, fistula , hernias

A

Double contrast upper GI series

262
Q

Gastric secretory analysis is usually evaluated in patients with these conditions:

A

Hypergastrinemia such as Zollinger-Ellison syndrome (gastrinoma, also associated with MEN I)
Refractory ulcer or GERD
Recurrent ulcer after operation

263
Q

Focal defects in the gastric or duodenal mucosa which extends into the submucosa or deeper

A

Peptic ulcer disease

if superficial only, erosion

264
Q

NSAID use more common cause of what kind of PUD?

A

Gastric

265
Q

Bicarbonate secretion decrease more common cause of what kind of PUD?

A

Duodenal

266
Q

Method to decrease production of gastric acid

A

Vagotomy

267
Q

PUD alarm symptoms

A 
weight loss
bleeding
recurrent vomiting
anemia
dysphagia
268
Q

PUD rebleeding risk categorization

A

Forrest Classification for Endoscopic Findings and Rebleeding Risks

Grade IA, IB and IIA - high rebleeding risk, surgical correction needed

269
Q

Initial Dx for pneumoperitoneum

A

upright chest x-ray

270
Q

H. pylori eradication: Bismuth triple therapy

10-14 days

A

Bismuth
Metronidazole
Tetracycline

271
Q

H. pylori eradication: Quadruple therapy

10-14 days

A

PPI
Bismuth
Metronidazole
Tetracycline

272
Q

H. pylori eradication: PPI triple therapy

10-14 days

A

PPI
Amoxicillin
Clarithromycin

273
Q

Surgical treatment of PUD for symptom of: Bleeding

A

Gastric: Oversew and biopsy
Duodenal: Oversew

274
Q

Surgical treatment of PUD for symptom of: Perforation

A

Gastric: Biopsy and patch
Duodenal: Patch

275
Q

Surgical treatment of PUD for symptom of: Obstruction

A

Gastric: HSV + GJ + biopsy
Duodenal: HSV + GJ

276
Q

Surgical treatment of PUD for symptom of: Non-healing ulcer

A

Gastric: HSV and wedge excision
Duodenal: HSV

277
Q

Gastric ulcer types

A 
Type I: antral lesser curvature - most common
Type II: Type I plus duodenal ulcer
Type III: pre-pyloric ulcer
Type IV: high in the lesser curvature
Type V: NSAID-induced
278
Q

Patch used for perforated PUD

A

omental patch

279
Q

Difference between Billroth I and II

A

I - gastroduodenostomy

II - gastrojejunostomy

280
Q

Pyloroplasty objective

A

widen pylorus to guarantee stomach emptying even without vagal stimulation

Types: Heineke-Mikulies, Finney, Jaboulay

281
Q

Post-gastrectomy problems

A 
dumping syndrome
diarrhea
gastric stasis
bile reflux gastritis
roux syndrome
gallstones
weight loss
anemia
bone disease
282
Q

Causes splanchnic vasoconstriction, helps in early dumping syndrome

A

octreotide

283
Q

Used in late dumping syndrome

A

alpha-glucosidase inhibitors

284
Q

Non-pharm or surg management for dumping syndrome

A

No liquids with meals

High fiber diet

285
Q

Surgical managment for dumping syndrome

A

Conversion of Billroth to Rous en Y anastomosis

286
Q

Bile or alkaline reflux gastritis is associated with

A

Billroth II (gastrojejunostomy)

287
Q

Risk factors for gastric adenoCA (95% of stomach neoplasms)

A 
Family history
Diet (preserved, salt)
Low Vit A and C diet
Familial polyposis and adenomas
HNPCC
H. pylori infection
Previous gastric surgery
Atrophic gastritis
Cigarette smoking
Adenomatous gastric polyps
Menetrier disease
Pernicious anemia
Type A blood
288
Q

Most common etiologies for gastric adenoCA

A

H. pylori

Autoimmune gastritis

289
Q

Most common manifestations of gastric adenoCA

A

weight loss
anorexia
early satiety

290
Q

PE findings that suggest gastric adenoCA

A 
Virchow node (left supraclavicular lymphadenopathy)
axillary lymphadenopathy
Krukenburg tumor
Sister Mary Joseph nodule
Blumer shelf
291
Q

With surgery for gastric adenoCA, leave R0 margin of

A

5 cm

292
Q

How many lymph node groups are present in the stomach?

A

18
odd number - lesser curvature
even number - greater curvature

293
Q

“Leather bottle stomach”

A

Linitis plastica
poor prognosis
Signet ring cells

294
Q

95% non-Hodgkin type, B-cell, MALT

A

Gastric lymphoma

295
Q

Gastric lymphoma risk factors

A 
H. pylori gastritis
Gene mutations
Transplant-related immunosuppression
IBD
HIV infection
296
Q

Management for low-grade gastric lymphoma

A

H. pylori eradication

297
Q

Management for high-grade gastric lymphoma

A

Chemoradiation

298
Q

Neoplasms from the interstitial cells of Cajal

A

GIST

Bleeding, early satiety, abdominal pain/fullness
Huge tumors
Donut sign (submucosal)
299
Q

Tumor markers for GIST

A

CD 34, c-KIT or CD 117

Tx: Imatinib (inhibits tyrosine kinase)

300
Q

Neoplasm that arises from gastric ECL-cells

A

Gastric carcinoids

Type I - inflammatory (most common)
Type II - gastrinoma (ZES, MEN 1)
Type III - Sporadic, worst prognosis

301
Q

Carcinoid syndrome clinical manifestations (gastric)

A 
secretory diarrhea
flushing
telangectasia
valvular heart disease
pellagra
cramping
edema
bronchial constriction
302
Q

Management for carcinoid syndrome

A 
debulking surgery
somatostatin analogue (octreotide)
303
Q

Middle-aged man with epigastric pain, weight loss, diarrhea, hypoproteinemia (protein losing enteropathy, hypochlorhydria)

A

Hypertrophic gastropathy (Menetrier disease)

304
Q

A.k.a. watermelon stomach

Elderly woman with chronic GI blood loss

A

Gastric antral vascular ectasia

305
Q

Congenital AVM

Men with intermittent UGIB

A

Dieulafoy lesion

submucosal vessel bleed

306
Q

What to do when patient is unable to swallow and expected to not improve/no intervention more than a month?

A

percutaneous endoscopic gastrostomy (PEG)

307
Q

Seen in children, regurgitation of feeding, projectile non-bilious vomitus, peristaltic gastric waves, olive-shaped mass in right upper epigastrium, hypokalemic, hypochloremic metabolic alkalosis

A

Pyloric stenosis

Tx: Correct acid-based abnormalities, Fredet-Ramstedt pyloromyotomy

PLE (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions