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GE > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

Where the gastroesophageal junction together with teh stomach move above the diaphragm

A

Sliding hernia

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2
Q

Alpha cells pancreas

A

Secrete glucagon which increases glucose in the blood

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3
Q

When a peptic ulcer develops close to the pylorus, it may becomes stenotic due to development of ___ causing the pylorus to undergo ____

A

Fibrous tissue
Shrinkage and deformity

Pyloric stenosis

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4
Q

Differential diagnosis hiatal hernia

A

Ischemic heart disease (chest pain)
GERD (heartburn)
Lung diseases (shortness of breath)

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5
Q

Usually GERD happens because

A

The LES opens at the wrong time or does not close properly

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6
Q

In the stomach there is also absorption of

A

Alcohol
Medications
Water

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7
Q

The small intestine wall also contains 2 layers of smooth muscles, rhythmical contractions of which

A

Move products of digestion through the intestine (peristalsis)

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8
Q

When the symptoms of benign tumors are present, their severity and clinical outcomes depend on

A

The tumor size
Location
Complications (bleeding, ulceration)

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9
Q

Signs and symptoms of GERD

A 
Heartburn
Regurgitation
Dysphagia
Increased salivation
Nausea
Chest pain (radiating to arms and neck)
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10
Q

When a neoplasma has extended below the submucosa into the muscular wall

A

Advanced gastric carcinoma

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11
Q

The head of the pancreas lies

A

In the C loop of duodenum

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12
Q

Early clinical manifestations of malignant tumors

A

Heartburn
Loss of appetite, especially for meat
Abdominal discomfort or irritability
Darkness of the skin, frequently locating in axilla and groin
Tripe palms
Sudden eruption of multiple seborrheic keratosis

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13
Q

Adenocarcinoma has direct correlation with

A

GERD
Barrett esophagus
Scleroderma
Zollinger-Ellison syndrome

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14
Q

The first of the 3 parts of the small intestine and is directly attached to the pylorus of the stomach

A

Duodenum

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15
Q

Signs and symptoms of chronic gastritis depend on

A

The form

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16
Q

Treatment malignant tumors esophagus

A

Surgery
Chemotherapy
Radiotherapy

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17
Q

5-10% of upper gastrointestinal bleeding episodes

A

Mallory-weiss syndrome

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18
Q

Starving pain 6-7 hours after meal is characteristic for

A

Duodenal peptic ulcer

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19
Q

Neutralization of acidic gastric content due to function of

A

Brunner’s glands

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20
Q

Saliva contains

A 
98% water
Mucus
Salivary amylase
Electrolytes
Proteins
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21
Q

Other stomach benign tumors

A

Cystic

Inflammatory pseudotumors

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22
Q

Etiology of barrett esophagus

A

GERD
Central obesity
Smoking - most common

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23
Q

Bilirubin + albumin =

A

Unconjugated (indirect, non-H2O soluble) - blood - liver - albumin and bilirubin+glucuronic acid = conjugated direct H2O soluble - to gallbladder

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24
Q

Acquired pyloric stenosis

A

Scarring of stomach peptic ulcer or duodenal bulb

Tumors (stomach, pancreatic, etc)

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25
Q

Behind the sternum, with radiation to neck or arms can be extremely painful, gest worse after eating

A

Chest pain with achalasia

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26
Q

Pain in midback on the level of T5-7 around right scapula sometimes mimics gallbladder disease

A

Postbulbar area peptic ulcer

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27
Q

Benign tumors of the stomach

A

Epithelial
Mesenchymal
Other

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28
Q

Esophagus ends at

A

Cardia of the stomach - T11

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29
Q

The stomach consists of four major regions

A 
Stomach
Fundus
Cardia
Stomach body
Pylorus
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30
Q

Signs and symptoms of perforation complication of peptic ulcer

A

Stabbing upper abdominal pain 10/10
Extreme tenderness of the abdomen
Pain by radiate to the right shoulder and back
Sudden weakness, dizziness, breathes shallowly
Chills, tachycardia

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31
Q

GI tract

A

Food - G-cells - gastrin - HCl - pepsinogen (non-active enzyme) - pepsin (active enzyme) - digestion of proteins

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32
Q

There is absorption of glucose, water, some medications

A

Oral cavity

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33
Q

The prognosis of malignant tumors of esophagus is generally

A

Poor

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34
Q

Indigestion is characterized by

A

Severe pain or bruning feeling in the right upper abdomen

May be also accompanied by nausea, abdominal bloating, belching, vomiting

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35
Q

This route is generally typical for carcniomas

A

Lymphatic system

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36
Q

Risk factors benign tumors

A

Chronic h. Pylori infection of the stomach
Autoimmune gastritis
Radiation gastritis
Genetic abnormalities
Long term medication use antacids - proton pump inhibitors (PPIs)

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37
Q

Has only parasympathetic fibers and provides secretor innervation to the mucosa nearest the lumen of the gut - production of normal mucoas

A

Meissner’s plexus

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38
Q

Is an exophytic (projectile) tumor

A

Intestinal-type adenocarcinoma

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39
Q

Signs and symptoms chronic gastritis all forms

A

Cramping
Nausea, vomiting
Weakness
Intolerance of spicy food

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40
Q

The ascending part of duodenum runs

A

Cranially along the left side of the vertebral column

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41
Q

Complications peptic ulcer

A 
Bleeding or hemorrhages
Perforation
Penetration
Pyloric stenosis
Malignancy of stomach ulcer
Stomach deformity
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42
Q

Bird’s beak or rat’s tail sign

A

Achalasia

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43
Q

Suppress production of prostaglandins which inhibit secretion of gastrin

Etiology peptic ulcer

A

Corticosteroid hormones and nonsteroidal antiinflammatory drugs

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44
Q

A chronic syndrome resulting in mucosal damage caused by stomach acid coming up from the stomach into the esophagus

A

GERD - gastroesophagel reflux disease

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45
Q

On some types of food like meat and bread

A

Dysphagia - benign tumors of esophagus

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46
Q

Final digestion of proteins takes place

A

Small intestine

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47
Q

A breach in the mucosa of the alimentary tract that extends into the submucosa and deeper

A

Ulcers of alimentary tract

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48
Q

The esophagus is surrounded at the top and bottom by two muscular rings

A

The upper esophageal sphincter

The lower esophageal sphincter

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49
Q

Most common benign tumors of esophagus

A

Leiomyomas

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50
Q

This complication develops as a result of peptic ulcer healing, with development of scar tissue - so called hourglass stomach

A

Stomach deformity

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51
Q

Protein digestion in small intestine enzymes from the pancreas = _____

A

Chymotrypsin
Trypsin
Carboxypeptidase
Elastase

Break down short-chain peptides to AA

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52
Q

Gastric carcinoma is generally ____ until late in its course

A

Asymptomatic

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53
Q

The body’s cells in stomach secretes

A

Pepsinogen

HCl

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54
Q

Diagnosis of achalasia

A

X-ray

Upper endoscopy

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55
Q

Narrowing (stenosis) of the pylorus due to hypertrophy of the sphincter muscle, or scarring of the tissue surrounding the opening from the stomach to duodenum

A

Pyloric stenosis

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56
Q

The submucosa secretes mucus from ___ which aids the passage of food down the esophagus

A

Mucous glands

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57
Q

Diagnosis benign tumors

A

Upper endoscopy with multiple biopsy
CT-scan
Endoscopic ultrasonography for submucosal tumors

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58
Q

Treatment malignant tumors of stomach

A

Surgery
Chemotherapy
Radiation therapy

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59
Q

Recommendation by chiropractor acute gastritis

A

Avoid alochol, caffeine, tobacco
Hydration
Check for subluxation in neck and dorsal spine

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60
Q

Fat digestion in small interstine

A

Bile from liver and gallbladder emulsifies fats then lipase from the pancreas breaks down fat to fatty acids and glycerol

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61
Q

Diagnosis chronic gastritis

A

Clinical manifestations

Upper endoscopy with biopsy

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62
Q

Live size depends on

A

Age, sex, body size

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63
Q

During development, the liver size increases with increasing age, averaging

A

5cm span at 5 years and attaining adult size by age 15

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64
Q

Although an ulcer can be found anywhere in GI tract, the peptic ulcers develop only in

A

Organs which have exposure to the stomach pepsin and stomach acidity

Stomach
Duodenum
Esophagus

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65
Q

In the large intestine there is absorption of

A

Water
Electrolytes

Eliminates drier residues as feces

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66
Q

Exocrine enzymes produced by pancreas

A 
Chymotrypsin
Trypsin
Carboxypeptidase
Elastase
Amylase
Lipase
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67
Q

Peritonitis could also develop in

A

Peptic ulcer

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68
Q

Nausea, vomiting, regurgitation of food esophageal cancer due to

A

Disruption of normal peristalsis

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69
Q

Has known predisposing factors

A

Intestinal-type adenocarcinoma

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70
Q

Benign tumors of esophagus typically occur in the age between ____ abnd have ___ gender predominance

A

20-50 yo

No

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71
Q

Late clinical manifestations malignant tumors

A 
Upper abdominal pain
Weight loss
Nausea and vomiting
Diarrhea or constipation
Bleeding (hematemesis, melena)
Signs of anemia
Dysphagia
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72
Q

Common signs and symptoms of benign tumors

A

Abdominal pain
Nausea
Weight loss
Acute or chronic bleeding

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73
Q

The descending part and rest of duodenum lies

A

Retroperitoneally

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74
Q

Neurogenic

A

Neurinoma aka schwannoma aka neurilemmoma

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75
Q

H. Pylori
Bile reflux
In chronic gastritis affect the ___ part of teh stomach

A

Antral part

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76
Q

Malignant tumors can also send metastases to the

A

Pancreas and lungs

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77
Q

Squamous cell carcinoma has direct correlation with

A

Celiac disease
Hot tea with increased concentration of tannins
Tylosis (palmar/plantar hyperkeratosis)

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78
Q

Digestion in liver due to production of

A

Bile

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79
Q

Whereby the shallow or deeply erosive crater is present in the wall of the stomach

A

Excavated

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80
Q

Enteroendocrine cells (G-cells) secrete

A

Hormone gastrin

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81
Q

Leiomyomas originate from

A

The smooth muscle cells

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82
Q

Unusual hoarseness, coughing for cancer of esophagus due to

A

Involving of the recurrent laryngeal nerve

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83
Q

Signs and symptoms of zenker’s diverticulum

A

Food regurgitation in the absence of dysphagia, can be complicated by aspiration pneumonia

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84
Q

Exophytic

A

With protrusion of tumor into the lumen

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85
Q

Small intestine enzymes for carb digestion

A

Maltase
Sucrase
Lactase

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86
Q

Signs and symptoms penetration peptic ulcer

A

Pain from upper abdomen radiates to the back
Pain gets worse in teh night
Pain could be relieved by intake of antacids

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87
Q

Similar to intestinal lymphomas

A

Gastric lymphomas

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88
Q

About 25-35 cm long (12 fingers’ length)
C-shaped
Located in upper abdomen

A

Duodenum

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89
Q

Forms of acute gastritis

A

Based on degree of mucosal damage
Erosive
Nonerosive

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90
Q

The potentials for malignancy of benign tumors of esophagusl are

A

Extremely low

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91
Q

Carbohydrate digestion in small intestine

A

Pancreatic amylase finishes the breaking down of carbohydrates to simple sugars

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92
Q

Pancreas length

A

15 cm (6 in)

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93
Q

Neck of the pancreas lies

A

Between the body and head, anterior to the superior mesenteric artery and vein

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94
Q

Treatment esophageal diverticuli

A

Surgery

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95
Q

Treatment esophageal varicies

A

Life-threatening situation requires immediate hospitalization - NEVER ADJUST THIS PATIENT

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96
Q

It is associated with predominate venous blood flow from GI tract organs to

Maliganant tumor

A

Portal vein

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97
Q

Diagnosis esophageal diverticuli

A

X-ray with contrast fluid

Upper endoscopy

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98
Q

Zenker’s diverticulum aka

A

Pharyngoesophagel diverticulum

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99
Q

20% of peptic ulcer develops in the

A

Stomach

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100
Q

Esophageal varices appear in ___ of patients with liver cirrhosis

A

65%

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101
Q

Forms of achalasia

A

Primary achalasia

Secondary achalasia

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102
Q

In over 40% of patients, __ are the first sign of an undiagnosed cancer

A

Tripe palms

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103
Q

Midesophageal diverticulum aka

A

Traction diverticulum

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104
Q

Pathogenesis peptic ulcer

A

Aggressive forces - weaken mucous barrier (Defensive forces) - peptic ulcers

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105
Q

Diagnosis hiatal hernia

A

X-ray with liquid barium salt

Upper endoscopy

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106
Q

Tratment pyloric stenosis

A

Surgery

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107
Q

Signs and symptoms acute gastritis

A 
Constant or sporadic pain in epigastric area (achy, burning, sharp, dull)
Nausea
Vomiting
Fever, chills 
Belching, bloating
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108
Q

The duodenum may be subdivided into 4 sections

A

Superior part
Descending part
Horizontal part
Ascending part

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109
Q

Liver storage function

A

Vitamins A, D, B12, K, E
Glycogen
Iron
Copper

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110
Q

Mallory may develop

A

Metabolic acidosis

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111
Q

Gastrin - ____ - inc production of HCl

A

Parietal cells

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112
Q

Etiology benign tumors

A

Unkown

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113
Q

Sodium, potassium, chloride, phosphate, bicarbonate ions

A

Electrolytes in salivary glands

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114
Q

Cholecystokinin

A

Bile from liver and gallbladder and pancreatic enzymes

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115
Q

Lower GI tract

A

Mid-transverse colon to anus

Hindgut

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116
Q

Reduces rate at which food is absorbed from teh content of the intestines
Regulates/sotps alpha and beta cell functions

A

Somatostatin

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117
Q

Etiological factors of chronic gastritis cause ____ damages of the stomach mucosa

A

Multiple focal

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118
Q

Sucrase

A

Breaks down sucrose to glucose and fructose

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119
Q

Polyps are usually composed of

A

A combincation of fibrous, vascular or adipose tissue, covered by an intact mucosa

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120
Q

Signs and symptoms mallory-weiss syndrome

A

Episodes of vomiting with bright blood

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121
Q

Achalasia is characterized by

A

Incomplete relaxation of LES
Its increased tone
Lack of peristalsis of esophagus

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122
Q

Esophagus enters the diaphragm at

A

T10

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123
Q

Tail of pancreas ends

A

Abutting teh spleen

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124
Q

Etiology peptic ulcer

A 
H. Pylori
Corticosteroid hormones and nonsteroidal antiinflammatory drugs
Cigarette smoking
Zollinger-Ellison syndrome
Stressful lifestyle
Genetic predisposition
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125
Q

Immediately above the lower esophageal sphincter diverticulum

A

Epiphrenic diverticulum

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126
Q

Pain in left upper quadrant and retrosternal area - mimics heart problem like hiatal hernia or esophagitis

A

Area of cardia peptic ulcer

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127
Q

The pancreatic duct and common bile duct enter the descending duodenum, through the ____

A

Major duodenal papilla - hepatopancreatic ampulla

= ampulla of Vater

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128
Q

2 ducts of pancreas

A

The main pancreatic duct

The accessory pancreatic duct

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129
Q

Middle GI tract

A

Duodenal papilla to mid-transverse colon

Midgut

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130
Q

Usually occurs in the distal third of esophagus or gastro-esophageal junction

A

Adenocarcinoma

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131
Q

Hiccups tumors of esophagus

A

Phrenic nerve involvement

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132
Q

In peptic ulcer there is a strong casual association with ___ infection

A

H. Pylori

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133
Q

Chief (zymogen) cells secrete

A

Pepsinogen

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134
Q

Most commonly locates in distal 2/3 of the esophagus, usually they are multiple

A

Leiomyomas - benign tumors

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135
Q

The epithelial surface of plicae is further folded to form

A

Villi

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136
Q

Immunity function of liver

A

Contains Kupffer cells - a type of fixed macrophages

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137
Q

Majority of nutrients are absorbed in the

A

Jejunum

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138
Q

Immediately above the upper esophageal sphincter

False diverticulum

A

Zenker’s diverticulum/pharyngoesophageal diverticulum

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139
Q

In the small intestine there is also absorption of

A 
Iron
Vitamins A and B1
Calcium
Glycerol
Fatty acids, monoglycerides
AA
Monosaccharides and disacchariddes are absorbed in the duodenum
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140
Q

Forms chronic gastritis

A 
Hypertrophic
Hyperplastic
Erosive
Antral
Atrophic
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141
Q

Head of pancreas rests within

A

The concavity of the duodenum

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142
Q

Is found behind the stomach, with the head surrounded by duodenum

A

Pancrea

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143
Q

The esophagus passes close to the ___ and the ___ side of the heart

A

Trachea

Left

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144
Q

Represents 50-80% of esophageal cancer in USA

A

Adenocarcinoma

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145
Q

More complex arterial arcades
Shorter vasa recta
Less plicae circulares, thinner less folded
Fat present in mesentery

A

Ileum

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146
Q

Backflow of undigested food

A

Regurgitation

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147
Q

In which there is no obvious tumor mass within the mucosa

A

Flat or depressed

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148
Q

Benign tumors of esophagus

A 
Leiomyomas
Polyps
Fibromas
Lipomas
Hemangiomas
Neurofibromas
Squamous papillomas
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149
Q

An outpouching of the alimentary trat organ wall that contains all visceral layers

A

Diverticulum

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150
Q

The tissue of adjacent organ undergoes digestion, which is potentially also very dangerous and may result in death

A

Penetration peptic ulcer

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151
Q

The wall of the small intestine is lined with a ____ with certain modifications for each section of the intestine

A

An absorptive type of mucosa

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152
Q

The 1st place where digestion and absorption start

A

Oral cavity

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153
Q

Signs and symptoms epiphrenic diverticulum

A

Gives rise to nocturnal regurgitation

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154
Q

Treatment peptic ulcer

A

Physical and emotional rest
Anti-helicobacter therapy
Antacids
Diet modification

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155
Q

Erosive acute gastritis

A

Mucosal damage
Superficial
Deep
Hemorrhagic

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156
Q

Aspirationo f food or liquid - possible development fo aspiration pneumonia

A

Achalasia

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157
Q

Metastases malignant tumors of esophagus

A

Regional lymph nodes
Aorta
Liver and lungs
Mediastinum

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158
Q

Etiology of GERD

A

Failure of the lower esophageal sphincter
Sliding hernia
Obesity
H. Pylori infection
Some visceral diseases (SLE, asthma, gallbladder stones, laryngitis)

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159
Q

Here the salivary amylase starts to digest carbs

A

Oral cavity

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160
Q

Bleeding from longitudinal tears in the mucosa (not muscular layer) at the esophagogastric juinction

A

Mallory-weiss syndrome (lacerations)

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161
Q

Differential diagnosis peptic ulcer

A 
Acute or chronic gastritis
Esophagitis
Pancreatitis
Cholecystitis
Angina pectoris/heart attack
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162
Q

Diagnosis barrett esophagus

A

Upper endoscopy with biopsy

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163
Q

Diagnosis esophageal varicies

A

Upper endoscopy

CT scan

164
Q

Peyer’s patches provide

A

Local immunological protection

165
Q

Most common area of stomach with cancer

A

Lesser curvature

166
Q

Less complex arterial arcades
Longer vasa recta
More plicae circulares, thicker, more highly folded
No fat in mesentery

A

Jejunum

167
Q

In the case of heart attack it is very important to remember that indigestion is ___ to eating

A

Unrelated

168
Q

Gamma cells pancreas - endocrine role

A

Secrete pancreatic polypeptide

169
Q

Complications benign tumors

A

Malignancy
Bleeding
Ulcerations
Pyloric canal obstruction

170
Q

Microscopically the gastric carcinomas are classified to

A

Early gastric carcinoma

Advanced gastric carcinoma

171
Q

Pain in epigastric area, without radiation

A

Lesser curvature peptic ulcer

172
Q

Clinical manifestations for both cancers of esophagus are

A 
Dysphagia
Weight loss/dec appetite
Pain
Unusual hoarseness, coughing
Hiccups
Nausea, vomiting
Bleeding, hematemesis
173
Q

Esophagus starts

A

Around level of C6 behind cricoid cartilage

174
Q

When the stomach or duodenal wall is perforated, the stomach content spreads into teh peritoneal cavity, resulting in

A

Peritonitis

175
Q

Chest pain in heart attack

A

Lasts for more than a few minutes
Increases in intensity
Is not relieved by rest or by taking nitroglycerin

176
Q

Squamous cell carcinoma arises from

A

The squamous epithelium

177
Q

The stomach wall contains

A

Parietal cells
Chief cells
G-cells

178
Q

Benign tumors of esophagus bleeding or hematemesis result from

A

Ulceration or necrosis of benign tumors.

These manifestations are extremely rare.

179
Q

Parietal cells secrete

A

HCl and

Intrinsic factor

180
Q

Stomach carcinomas give metastases predominantly through ___ primarily to regional lymphatic nodes

A

Lymphatic system

181
Q

Diagnosis acute gastritis

A

CBC
Upper endoscopy
Stool sample for presence of blood
Pregnancy test

182
Q

Less common is pain while swalloing - usually is retrosternal

A

Benign tumors of esophagus

183
Q

Has a seasonal characteristic usually in spring or fall for

A

Stomach, dudodenum peptic ulcer

184
Q

This complication develops only in the stomach, and usually when peptic ulcer locates on greater curvature

A

Malignancy of stomach ulcer

185
Q

Diagnosis GERD

A

X-ray with liquid Barium salt

Upper endoscopy - the best

186
Q

Lactase

A

Breaks down lactose to glucose, and galactose

187
Q

Young children, sometimes congenital

A

Primary achalasia

188
Q

From gallbladder - in intestine

A

Direct bilirubin - stercobilinigen - stercobilin - excretion with feces

Direct bilirubin - reabsorption to blood (urobilinogen) - liver and kidneys - urobilin - excretion with urine

189
Q

Midesophageal diverticulum usually results from

A

Mediastinal lymphadenitis (as from tuberculosis)

190
Q

Provides motor innervation to both layers of the muscular layer, having both parasympathetic and sympathetic input

A

Auerbach’s plexus (myenteric plexus)

191
Q

Most common complication of peptic ulcer, manifested by

A 
Hematemesis and/or 
Melena (tarry feces)
Weakness
Orthostasis
Syncope
Thirst
Sweating caused by blood loss

May result in anemia

192
Q

Hollow muscular tube that transports saliva, liquids, and foods from the mouth to the stomach

A

Esophagus

193
Q

3 pairs of salivary glands secrete up to 1 L of saliva a day

A

Parotid glands
Submandibular glands
Sublingual glands

194
Q

Close association with chronic gastiritis due to intestinal metaplasia and H. Pylori infection

A

Intestinal-type adenocarcinoma

195
Q

Somatostatin also secreted by

A

Hypothalamuc and the intestine

196
Q

An endocrine organ that lies in the specifically upper left abdomen

A

Pancreas

197
Q

In barrett esophagus, The squamous epithelial cells of the esophageal mucosa are replaced by

A

Columnar epithelial cells with goblet mucus-producing cells

198
Q

Forms of esophageral diverticuli

A

Zenker’s diverticulum
Midesophageal diverticulum
Epiphrenic diverticulum

199
Q

This disease is also known as gastrinoma with overproduction of gastrin

A

Zollinger-Ellison syndrome

200
Q

No association with chronic gastritis and H. Pylori infection

A

Diffuse gastric carcinoma

201
Q

Most common area for blood

A

Duodenal bulb

202
Q

Treatment benign tumors of stomach

A

Laparoscopic or endoscopic surgery

203
Q

Signs and symptoms depend on degree of

A

Tumor progression

204
Q

Hepatic (intrahepatic) portal hypertension assocaited with

A

Liver cirrhosis - most common
Liver tumors
Amyloidosis

205
Q

Difficulty in swallowing of solid and liquid food

A

Dysphagia

206
Q

Achalasia aka

A

Cardiospasm

207
Q

Pancrease external digestive role - exocrine

A

Secretes pancreatic fluid that contains digestive enzymes which help to further break-down the carbohydrates, proteins and lipids in the chyme

208
Q

Leser-trelat sign

A

Sudden eruption of multiple seborrheic keratosis

209
Q

Second largest organ in the human body

A

Liver

210
Q

J-shaped organ with two openings

A

Stomach

211
Q

When a lesion confined to the mucosa and submucosa carcinoma

A

Early gastric carcinoma

212
Q

Etiology pyloric stenosis

A

Congenital

Acquired

213
Q

The superior part of duodenum lies

A

Intraperitoneally and is enlarged proximally (duodenal bulb)

214
Q

Proteins in salivary glands

A

Mucin
Lysozyme
IgA

215
Q

Pain in epigastric area and right upper quadrant

A

Pylorus and duodenum peptic ulcer

216
Q

The horizontal duodenum runs ___ and is located ____

A

From right to left

Retroperitoneally

217
Q

Delta cells pancreas endocrine role

A

Secrete somatostatin (regulates functioin of alpha and beta cells)

218
Q

Most patients benign tumors are

A

Asymptomatic for long period of time

219
Q

Causes portal hypertension

A

Posthepatic (suprahepatic)
Hepatic
Prehepatic (infrahepatic)

220
Q

Same as perforation, but because the involved wall is bound to an adjacent organ (liver, pancreas, greater omentum) the stomach content does not enter the peritoneal cavity

A

Penetration

221
Q

X-ray diagnosis of achlasia

A

Contrast liquid swallowing shows the narrowing of the distal part of the esophagus (bird’s beak or rat’s tail sign) and its dilatation above

222
Q

Most cases of does not cause any symptoms or specific symptoms

A

Hiatal hernia

223
Q

Diet modification peptic ulcer

A

Avoid:

Alcohol, coffee, sour food, spicy food, bubble water, broccoli, orange juice, hot food

224
Q

Stomach cancer arises from any part of the stomach, but a favored location is the

A

Lesser curvature of the antrum-pyloric region

225
Q

Kupffer cells

A

Clean the large volumes of blood very fast

226
Q

All complications of peptic ulcer are considered as

A

Emergency medical situations

227
Q

Pain of peptic ulcer can be

A

Diffuse, achy, acute or dull and is associated with mealtime

228
Q

Prehepatic (infrahepatic) portal hypertension associated with

A

Portal vein thrombosis
Portal vein sclerosis
Portal vein congenital stenosis or atresia

229
Q

They are suually asymptomatic, silent, and undetected

More than 5 cm in diameter can come to clinical attention

A

Benign tumors of the esophagus

230
Q

Etiology esophageal varicies

A

Portal hypertension

231
Q

This last part (ascending duodenum) joins it with the ___. And is located ___

A

Jejunum

Retroperitoneally

232
Q

Carcinomas occur when the DNA of a cell is ____ or ____ and the cell begins to grow uncontrollably and become malignant

A

Damaged

Altered

233
Q

Late peptic ulcer

A

1.5-2 hours after the meal

Typical for duodenal peptic ulcer

234
Q

The pancreas is a secretory structure with

A

Internal hormonal role (endocrine)

External digestive role (exocrine)

235
Q

Forms of hiatal hernia

A

Sliding hernia

Rolling or paraesophageal hernia

236
Q

In hypertrophic pyloric stenosis in babies

A

First symptoms appear in the first 2-6 weeks of the life

There is progressive vomiting with partially digested food after each or few feedings

237
Q

For esophageal motility studies

A

X-ray with barium liquid

238
Q

The most common malignant esophageal tumors are

A

Squamous cell carcinoma

Adenocarcinoma

239
Q

Great mimic disease

A

Hiatal hernia

240
Q

Acts principally on the liver where it stimulates conversion of glycogen to glucose and fat and protein to glucose

A

Glucagon

241
Q

Usually makes the pyloric canal such a narrow that the bolus cannot move from the stomach to duodenum

A

Pyloric stenosis

242
Q

Insulin ___ glucose in the blood

A

Decreases

243
Q

Site where the most of the chemical and mechanical digestion is carried out and where virtually all of the absorption of useful materials is carried out as well

A

Small intestine

244
Q

Most common form of hiatal hernia

A

Sliding hernia

245
Q

Duodenal mucosal cells produce and release

A

Secretin

Cholecystokinin

246
Q

On embryologic ground, teh GI tract should be divided into

A

Upper
Middle
Lower

247
Q

The esophagus has a ____ lining which protects the esophagus from ___

A

Nonkeratinized stratifies squamous epithelial lining

Trauma

248
Q

Muscles in middle portion of esophagus

A

Smooth

249
Q

Most important for evaluation of inflammation

A

Upper endoscopy (gastroscopy)

250
Q

Stomach polyps could undergo malignancy in ___ of cases

A

4-30%

Hyperplastic polyps and adenomas

251
Q

Complications barrett esophagus

A

Bleeding
Stricture due to healing or improper healing
Frank esophageal adenocarcinoma - goblet cells

252
Q

Risk factors are undefined

A

Diffuse gastric carcinoma

253
Q

Composed of neoplastic intestinal glands

A

Intestinal-type adenocarcinoma

254
Q

GERD recommendations by chriopractor

A

Life style modifications:
Eating not later than 3-4 hours before sleep
Avoid coffee, alcohol, chocolate, sour and spicy food
Increaesed fluid intake
Ginger tea

255
Q

The large intestine contains areas of lymphoid tissue called

A

Peyer’s patches - also found at distal part of ileum

256
Q

Normal bilirubin pathway

A

RBC - spleen lysis - globulin and heme - heme into iron and porphyrin ring - biliverdin - bilirubin

257
Q

Chronic mucosal inflammatory changes in the stomach wall that eventually result in mucosal atrophy and mucosal (intestinal) metaplasia

A

Chronic gastritis

258
Q

The mucosa of jejunum and ileum is highly folded (folds are called plicae) which dramatically increases

A

The surface area available for absorption

259
Q

In females the stomach carcinoma could sometimes metastasize thorugh the abdominal cavity, giving rise to development of secondary ovarian cancer called

A

Krukenberg tumors

260
Q

Has short latent period

A

Diffuse gastric carcinoma

261
Q

Vitamin B12 and bile salts are absorbed in the

A

Terminal ileum

262
Q

Detoxification liver function

A

Converts ammonium to urea
Breaks down insulin adn other hormones
Breaks down toxic substances

263
Q

Etiology of hiatal hernia

A

Kyphoscoliosis
Increased pressure within the abdominal cavity
Congenital diaphragmatic weakness
Obesity, trauma

264
Q

In the liver there is production of

A 
Bile
Albumins
Lipoproteins
Clotting factors
Angiotensinogen
265
Q

There are 3 main sections of the small intestine

A

Duodenum
Jejunum
Ileum

266
Q

Most common carcinoma of the stomach

A

Intestinal-type adenocarcinoma

Diffuse stomach carcinoma

267
Q

Treatment barrett esophagus

A

ONLY medical treatment

268
Q

Upper GI tract

A

Mouth to major papilla in duodenum

Foregut

269
Q

Usually occurs in the proximal 2/3 of esophagus

A

Squamous cell carcinoma

270
Q

The manifestations of chronic gastritis are ____ and do not push a patient to attend a phsyician

A

Vague, not severe, non-specific

271
Q

The second part of the duodenum also can contain the ___, the entrance for the accessory pancreatic duct

A

Minor duodenal papilla

=paillia of santorini

272
Q

Hyperproduction of ____ leads to vasoconstriction of the stomach wall arteries. It affects ___ thus weakens ___

A

Catecholamines
Stomach mucosal blood flow
Mucous barrier

273
Q

Cigarette smoking leads to impairment of ____ thus weakening the ____

Etiology peptic ulcer

A

Stomach mucosal blood flow

Mucous barrier

274
Q

Flat advanced gastric carcinoma is also known as

A

Linitis plastica

275
Q

Treatment benign tumors of esophagus

A

Removal of polyps thorugh endoscopy

Surgery

276
Q

Two openings of the stomach

A

Esophageal

Duodenal

277
Q

The lumen of the esophagus is surrounded by layers of muscle

A

Voluntary in top 1/3 - striated
Involuntary in the bottom 1/3 - smooth
Mixture of voluntary and involuntary in the middle 1/3

278
Q

Leiomyoma occupies 2nd position in frequency after

A

Polyps

279
Q

Etiology acute gastritis

A 
Food poisoning/food infection
Severe alcohol consumption
Heavy smoking
NSAIDs, especially aspirin
Extreme stress (severe trauma, burns, surgery, etc)
280
Q

Is a flat tumor

A

Diffuse gastric carcinoma

281
Q

Heart attack could be manifested by GI symptoms called ___ which also known as upset stomach or dyspepsia

A

Indigestion

282
Q

posthepatic (suprahepatic) portal hypertension assocaited with

A

Chronic right-sided cardiac failure

Budd-chiari syndrome

283
Q

The ___ within the stomach mucosa accounts for secretions of various active substances

A

Glandular tissue

284
Q

Muscles in upper portion of esophagus

A

Skeletal striated muscles

285
Q

Problem with auerbach’s plexus

A

Achalasia

286
Q

The pylorus is responsible for

A

Production of mucus, hormone gastrin, and pepsinogen secretion

287
Q

Stomach carcinomas also give metastases to a lymphatic node in the left supraclavicular fossa

A

Virchow’s node

288
Q

Endophelbitis of the liver veins or obstruction ofhte hepatic vein

A

Budd-Chiari syndrome

289
Q

In 50% of peptic ulcer patients

A

Constipation

290
Q

Diagnosis benign tumors of esophagus

A

Upper endoscopy with biopsy
Ultrasound endoscopy
CT scan
X-ray with barium liquid

291
Q

Signs and symptoms pyloric stenosis

A 
Severe worsening vomiting
Weight loss
Dehydration
Constant hunger
Visible or palpable peristaltic waves
292
Q

Early peptic ulcer

A

30 min to 1 hour after the meal - typical for stomach peptic ulcer

293
Q

Heartburn (in 30-80%) may be the only peptic ulcer symptom
Nausea
Vomiting (relieves the pain)
Belching with sour taste

A

Dyspepsia

294
Q

Near the midpoint of the esophagus diverticuli

A

Midesophageal aka traction diverticulum

295
Q

Recommendations by chiropractor hiatal hernia

A

To restrict activities that raise the intra-abdominal pressure
Avoid eating near bed-time
Diet modification - small frequent bland meal

296
Q

Has relatively long latent period

A

Intestinal-type adenocarcinom

297
Q

Diagnosis mallory-weiss syndrome

A

Upper endoscopy

298
Q

Maltase

A

Breaks down maltose to 2 glucose

299
Q

Diagnosis malignant tumors of esophagus

A

Endoscopy with biopsies
Ultrasound endoscopy
CT-scan of chest, abdomen and pelvis (esp for metastasis)
PET
X-ray with barium liquid for esophageal motility studies

300
Q

Begins the chemical digestion of carbs in the mouth

A

Salivary amylase

301
Q

Complications mallory-weiss syndrome

A 
Severe bleeding
Esophageal rupture (known as Boerhaave syndrome)
302
Q

Most common benign tumors of the stomach

A

Polyps

303
Q

H. Pylori is found in ___ of duodenal peptic ulcer and ____ of stomach peptic ulcer

A

100%

70%

304
Q

The junction between jejunum and ileum is

A

Not well-defined

305
Q

In late stages of carcinoma prognosis is often

A

Poor

306
Q

Diagnosis peptic ulcer

A 
X-ray with liquid barium (ulcer crater aka nicha)
Upper endoscopy with biopsy tests for H. Pylori
Ultrasound
CBC, UA, liver tests
Urea breath test for H. Pylori
Stool culture for H. Pylori antigen
PCR blood tests for H. Pylori DNA
CBC, UA, liver tests
Fecal occult blood test (FOBT)
CT
307
Q

Recommendations of chiropractor for achalasia

A

To eat slowly
Avoid eating near bed-time (3-4 hours)
Avoid ketchup, citrus, chocolate, caffeine
Physician’s consultation

308
Q

Congenital pyloric stenosis

A

Hypertrophic pyloric stenosis
Male:female = 4:1
Prevalence 2-4 per 1,000 newborns

309
Q

Macroscopic growth patterns of gastric carcinomas

A

Exophytic
Flat or depressed
Excavated

310
Q

Complications hiatal hernia

A

Ulcer in the esophagus

Stricture of the esophagus with possible achalasia

311
Q

By percussion the liver size is

A

6 cm for women

12 cm for men

312
Q

Diffuse stomach carcinoma is a typical example of ____ cancer

A

Scirrhous aka scirr

313
Q

Greatly coiled parts of the small intestine, and together are about 4-6 meters long

A

Jejunum and ileum

314
Q

5 major functions of the stomach

A

Preliminary digestion of protein with pepsin
Temporary food storage
Control of the rate at which food enters the duodenum
Acid secretion and antibacterial action
Fluidisation of stomach content

315
Q

Beta cells pancreas endocrine role

A

Secrete insulin - decreases glucose in the blood

316
Q

Atrophic form chronic gastritis signs and symptoms

A

Heaviness in epigastrium and left upper abdominal area
Fullness in the stomach after small amount of meal
Diarrhea
Signs of pernicious anemia

317
Q

Signs and symptoms of achalasia

A 
Dysphagia
Regurgitation
Chest pain
Coughing
Aspiration of food or liquid
318
Q

Fundus does what

A

Collects digestive gases

319
Q

Etiology chronic gastritis

A

NSAIDs
Autoimmune diseases (autoimmune chronic gastritis, SLE)
Allergic response

320
Q

Are found in the duodenum ONLY, located in its submucosa, secrete an alkaline mucus which neutralizes the chyme and protects the surface of the duodenum

A

Brunner’s glands

321
Q

Mesenchymal

A

Leiomyoma
Lipoma
Neurogenic
Vascular

322
Q

Benign tumors of esophagus are mostly ____ in origin and usually lie within the ____

A

Mesenchymal

Esophageal wall

323
Q

Major digestion of carbs take place

A

Small intestine

324
Q

Ulcer near the junction between stomach and esophagus

A

Reflux esophagitis necrosis

325
Q

Signs and symptoms of benign tumors of esophagus

A

Dysphagia
Pain while swallowing
Food regurgitation
Bleeding or hematemesis

326
Q

Darkness of skin frequently locating in axilla and groin known as

A

Acanthosis nigricans

327
Q

Body of pancreas lies

A

Behind the base of the stomach

328
Q

Usually more late syptom, the pain located behind sternum or epigastrium could be severe and is worsened by swallowing of any food

A

Tumors of esophagus

329
Q

Complications GERD

A 
Reflus esophagitis necrosis
Esophageal stricture
Barrett esophagus
Aspiration pneumonia
Esophageal cancer
330
Q

Amylin actions

A

Inhibits secretion of glucagon
Slows emptying of the stomach
Sends a satiety signal to the brain

331
Q

Squamous cell carcinoma represents ___ of esophageal cancer worldwide

A

90-95%

332
Q

Acanthosis palmaris
Skin condition in which teh skin of the palm becomes thick and velvety hyperpigmentation with pronounced folds in the lines of the hand

A

Tripe palms

333
Q

Malignant tumors of the stomach

A

Carcinomas (90-95% of all stomach malignant tumors)
Lymphomas
Carcinoids
Sarcoma

334
Q

The horizontal part of duodenum passes

A

In front of the inferior vena cava, abdominal aorta and the vertebral column,

335
Q

Genetic predisposition - more common in children

Etiology peptic ulcer

A

Type O blood (30% risk of duodenal ulcer)
Hypersecretion of HCl, pepsinogen
Familial tendencies

336
Q

Etiology of GERD - failure of the LES due to

A

CNS depressants
Hypothyroidism
Pregnancy
Alcohol or tobacco exposure

337
Q

Risk factors for both cancers of esophagus are

A

Tobacco smoking and chewing
Alcohol overconsumption
Age after 60-65 yo
Male:female = 4-5:1

338
Q

A liver span 2-3 cm larger or smaller than normal is considered to be

A

Abnormal

339
Q

Etiology mallory-weiss syndrome

A

Alocholism, after frequent severe retching and vomiting (most common cause)
Hiatal hernia
Overdose of NSAIDs
Severe vomiting in pregnancy

340
Q

Leather bottle stomach aka ____ aka _____

A

Linitis plastica

Diffuse stomach carcinoma

341
Q

For estimation of stage, metastases of the cancer

A

PET - positron emission tomography

342
Q

Four main cells exist in the islets of pancreas for internal hormonal role - endocrine role

A

Alpha
Beta
Delta
Gamma

343
Q

Bile is a mixture of

A

Water
Bile salts
Cholesterol
Pigment bilirubin

344
Q

Diagnosis pyloric stenosis

A

Ultrasound examination
Upper endoscopy
X-ray (string sign) or railroad track sign

345
Q

Indigestion in heart attack could be accompanied by

A

Shortness of breath
Sweating
Pain radiating to the left jaw, left part of the neck, or left arm
Chest pain
Experience severe abdominal pressure that feels like an elephant sitting on stomach

346
Q

Creates a bell-shaped dilation

A

Sliding hernia

347
Q

80% of peptic ulcer develops in the

A

Duodenum

348
Q

An abnormal change (metaplasia) in the cells of the lower portion of the esophagus

A

Barrett esophagus

349
Q

The stomach wall contains 3 layers of involuntary smooth muscles which aid digestion by physically breaking up the food particles

A

Inner oblique layer
Circular layer
Outer longitudinal layer

350
Q

Etiology chronic gastritis

A

H. Pylori (in 90%)

Bile reflux

351
Q

Complications of achlasia

A

Aspiration pneumonia or airway obstruction
Lower esophageal diverticulum
Esophageal cancer - in 5% of patients

352
Q

Vascular

A

Glomus tumors

353
Q

Nonerosive

A

Focal

Pangastritis (diffuse)

354
Q

The pancreas also produces hormones

A

Insulin, amylin - beta cells
Glucagon - alpha cells
Somatostatin - delta cells
Pancreatic polypeptide - gamma cells

355
Q

Hypertrophic erosive and antral forms chronic gastritis signs and symptoms

A

Acute pain in epigastrium and left upper abdominal area
Local pain without radiation
Usually pain develops in 30-60 min after meal
Heartburn
Belching
Constipation

356
Q

Sudden inflammation of the lining of the stomach

A

Acute gastritis

357
Q

Signs and symptoms peptic ulcer

A

PAIN
Dyspepsia
Constipation
Emotional instability

358
Q

Carcinomas are a type of cancer that develops from

A

Epithelial cells

359
Q

Duodenum main functions are

A

Neutralization of the acidic gastric content
Further digestion
Absorption of nutrients
Regulation of the rate of gastric emptying

360
Q

Coughing when lying in horizontal position especially at night

A

Achlasia

361
Q

For assessing a patient with acute abdominal pain, and in some settings may be able to identify the site of bleeding or perforation prior to endoscopy

A

CT

362
Q

Chronic atrophic gastritis may often be

A

Asymptomatic

363
Q

Anatomically the pancreas is divided into

A

Head
Body
Tail
Neck

364
Q

Extremely dilated submucosal veins in low third of the esophagus

A

Esophageal varices

365
Q

Signs and symptoms barrett esophagus

A

Heartburn
Hematemesis
Painful eating
Dysphagia (in case of complication by stricture)

366
Q

Pathogenesis mallory-weiss syndrome

A

Inadequate relaxation of the musculature of the lower esophageal spincter during vomiting, with stretching and tearing of the esophageal junction during propulsive expulsion of gastric contents

367
Q

Glucagon ___ glucose in the blood

A

Increases

368
Q

Rolling hernia can be complicated by development of

A

Venous infarction due to it’s possible strangulation by the diaphragm - this is EMERGENCY situation

369
Q

Characterized by failure of distal esophageal inhibitory neurons - the auerbach’s plexus (myenteric plexus)

A

Primary achalasia

370
Q

Typanosoma cruzi causes

A

Destruction of the myenteric plexus of the esophagus with its dilation

371
Q

Problems with the esophagus, such as eating something too hot, can sometimes feel like a pain

A

Close to or in the heart or throat

372
Q

Varicies produce no symptom until

A

They rupture, and the hemorrhage develops (hematemesis)

373
Q

Diagnosis malignant tumors tumor markers

A

CEA elevated in 45-50% of cases
CA 19-9 elevated in 20% of cases
CBC

374
Q

Parotid glands lie

A

Just below and in front of the ear near the jaw

375
Q

First digestion of fat takes place

A

Small intestine

376
Q

Achalasia most common etiological factor

A

Incomplete relaxation of LES

377
Q

An esophageal motility disorder involving the smooth muscle layer of the esophagus, and the lower esophageal sphincter (LES)

A

Achalasia (cardiospasm

378
Q

Gastric lymphomas represent ___ of all gastric malignancies

A

5%

379
Q

Signs and symptoms of hiatal hernia

A

Dull pain in the chest
Shortness of breath
Heartburn (typical for sliding hernia)
Heart palpitation (tachycardia)

380
Q

Both submandibular and sublingual glands lie

A

On the floor of the mouth

381
Q

The also are able to send metastases to the ___ via blood

Malignant tumors

A

Liver

382
Q

Differential diagnosis GERD

A 
Heart diseases (chest pain)
Hiatal hernia
383
Q

The liver consists of 4 distinct lobes

A

Left
Right
Caudate
Quadrate

384
Q

Secretin

A

Pancreatic juice

385
Q

Most of the liver’s mass is located

A

On teh right side of the body where it descends inferiorly toward the right kidney

386
Q

Diagnosis malignant tumors

A

Tumor markers
Endoscopic ultrasonography with biopsy
PET, CT, or MRI of chest, abdomen, and pelvis

387
Q

More advanced clinical manifestations malignant tumors

A

Weakness and fatigue

Bloating of the stomach, usually after meal

388
Q

Composed of gastric-type mucous cells

A

Diffuse gastric carcinoma

389
Q

Each villus has its own

A

Blood supply

390
Q

The surface of each villus is covered by

A

Small microvilli to maximize surface area and thus area available for absorption

391
Q

The mucosa of the large intestine consists of two types of epithelial cells

A

Cells specialized for water absorption

Mucus-producing goblet cells - also located in small intestine

392
Q

Kupffer cells play an important role by ____ and ___ bacteria, fungi, parasites, worn-out blood cells, and cellular debris

A

Capturing and digesting

393
Q

Villi further increase

A

The surface area of the small intestine

394
Q

Very important predisposing factor for development of one of the most common stomach cancers - intestinal-type adenocarcinoma

A

Intestinal (mucosal) metaplasia

395
Q

Most common cancer

A

Adenocarcinoma

396
Q

Obesity as adult
Trauma as a child
Marfan’s sydrome - congenital diaphragmatic weakness

A

Hiatal hernia

397
Q

Action in chiro office mallory-weiss syndreom

A

Call 911

398
Q

Traction diverticulum signs and symptoms

A

Usually asymptomatic

399
Q

Achalasia caused by trypanosoma cruzi is known as

A

Chagas’ disease

400
Q

When a separate portion of the stomach, usually along the greater curvature, enters the thorax through the widening foramen

A

Rolling or paraesophageal hernia

401
Q

Protrusion of the upper part of the stomach into thorax through the space between the muscular crura of the diaphragm (the hiatus)

A

Hiatal hernia

402
Q

Arises from metaplastic columnar epithelium

A

Adenocarcinoma

403
Q

Night pain at 4-5am is characteristic for

A

Duodenal peptic ulcer

404
Q

Chiropractic spinal manipulation may benefit some people with ____ gastric or duodenal ulcer

A

Uncomplicated

405
Q

Secondary achlasia could result from

A

Cancer of esophagus or upper stomach

Infeciton with a protozoa Trypanosoma cruzi - Chagas disease

406
Q

Pancreatic polypeptide

A

Reduces appetite

407
Q

Functions of liver

A 
Production
Digestion
Storage
Detoxification
Immunity

GE (5 decks)

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