Gastroenterology

Question 1

Blood supply of the posterior duodenum/ posterior wall?

Answer 1

gastroduodenal

Question 2

Secretin does?

Answer 2

increases Hco3 secretion, gastric acid secretion, bile secretion

Question 3

Menetrier disease is?

Answer 3

hyperplasia of the gastric mucosa leads to hypertrophied rugae causes WAVE

Question 4

Whipple disease is?

Answer 4

Indection of Tropheryma whipplei (int. gram pos.), PAS periodic acid schiff reactive vacoules in macrophages * foamy macrophages.

PAS the foamy Wipped cream in a can

CAN: Cardiac symptoms,, arthralgias, neurologic symptoms.

Question 5

What is gilbert disease?

Answer 5

benigne, mild form of dicrease udp-glucuronosyltransferase conjugation adn impaired bilirubin uptake

Question 6

Crigler- najjar syndrome, type1 is?

Answer 6

absend udp-glucuronosyltransferase

type 2 is less sever responds to phenobarbital which increases liver enzyme

Question 7

Dubin-Johnson syndrome in?

Answer 7

Conjugated hyperbilirubinemia due to defective liver excretion, grossly Dark liver

Question 8

Roter Syndrome is similar, but?

Answer 8

it presents with black Regular liver

Question 9

Squamous cell carcinoma affects?

Answer 9

Upper 2/3

Question 10

Adenocarcinoma of the esophagus affects?

Answer 10

Lower 1/3

Question 11

gastric cancer

Answer 11

main cause h.pylori, most common is the adenocarcinoma

lymphoid spreading:

virschow node- involvement of left supraventricular node by metastasis from the stomach

krugenberg tumor- bilateral metastases to the ovaries. Abundant mucin-secreting, signet ring cells

Sister Mary Joseph nodule-subcutenous periumbelical metastasis.

Blumer shelf- palpable mass on digital rectal exam suggestion metastasis to pouch of Douglas

Question 12

What is associated with the RET mutation?

Answer 12

Hirschsprungs disease, RET for Rectum

Question 13

Nutckracker

Answer 13

compresion of the left renal vaein b/n the sup. mesenteric artery and aorta

Question 14

indirect inguinal hernia

Answer 14

internal deep ring, lateral inferior epigastric

Question 15

direct inguinal hernia

Answer 15

Lateral inferior epigastric

Question 16

rapture of the lesser curvature will cause?

Answer 16

left gastric

Question 17

penumoperitenuem is

Answer 17

air under the diaphragm, with referred pain to the shoulder via irritation of the phrenic nerve

Question 18

adenomatous polyps

Answer 18

neoplastic, via chromosomal instability pathway with mutation in APC and KRAS. Tubular is less malignent than villus

Question 19

serrated polyps

Answer 19

neoplastic, characterized by CpG island methylator phenotype. Defect may silence MMR gene (DNA-mismatch repair)

Question 20

lynch syndrome

Answer 20

=nonpolyposis colorectal cancer (HNPC). Autosomal dominant mutation of DNA. autosomal dom. mutation of dna mismach repair genes with subsequent microsatellite instability.

Question 21

Colorectal cancer

Answer 21

CEA tumor marker……………………..

Question 22

Angiosarcoma

Answer 22

Malignant tumor of the endothelial origin, associated with arsenic, vinyl chloride

Question 23

Cavernous hemangioma

Answer 23

Most common benigne liver tumor, venous malformation—– biopsy contraindicated

Question 24

hepatic adenoma

Answer 24

rare benign liver tumor, often related to oral contraceptives and steriods

Question 25

Budd- Chiari syndrome

Answer 25

thrombosis or compression of hepatic veins with centrilobular congestion and necrosis

Question 26

alpha1-antitrypsin deficiency

Answer 26

misfolded gene product protein aggregates in hepatocellular ER—-> cirrhosis with PAS+ globules

Question 27

conjugated/ direct bili in increased?

Answer 27

gallstones/ opstruction

Question 28

unconjugated/ indirect bili will be increased in?

Answer 28

hemolytic, bilbert, crigler-najar, physiolo. in newborn

Question 29

Mixed (direct/indirect) bili

Answer 29

hepatitis/ cirrhosis