Brainscape's Knowledge GenomeTM

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


See full index

USMLE Step 1 Quick Notes > Gastroenterology > Flashcards

Gastroenterology Flashcards

You may prefer our related Brainscape-certified flashcards:
USMLE® Step 1 flashcards
1
Q

Why do you see fat accumulation in alcoholic hepatic steatosis?

A

Decreased fatty acid oxidation since alcohol provides NADH from metabolism by alcohol and aldehyde DH

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

What is the histology of carcinoid tumors?

A

Nests/sheets of cells with round/oval nuclei and eosinophilic cytoplasm; very uniform looking

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

Increased gastric acid causes an ulcer where?

A

Duodenum!!!

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

When do you get gastric ulcer?

A

When H. pylori destroys the epithelial lining of stomach from ammonia production

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

What looks like a velvety cauliflower mass?

A

Villous adenomas

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

What is a polyp symptom specific for villous adenoma?

A

Secretory diarrhea (due to large amounts of mucus production)

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

Person ingests 13C labeled urea and then breath out 13C labeled CO2. What does this mean?

A

They have an H. Pylori infection. It is urease positive so it breaks down urea and the CO2 crosses into the blood and breathed out.

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

Why do you get fistulas and strictures in Crohn’s?

A

Transmural inflammation

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

What does Boerhaave present with?

A

Pleural effusion, retrosternal chest pain, left pneumothorax

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

What does Mallory Weiss present with?

A

Hematemesis after vomiting lots

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

What does stomach adenocarcinoma present with?

A

Virchow node (enlarged left supraclavicular node)

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

What is the embryonic tissue origin of the spleen?

A

Mesodermal

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

What is the pertechnetate scan for?

A

Meckel’s diverticulum

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

What is Trousseau Syndrome?

A

Redness and palpable purpura on extremities (migratory thrombophlebitis)

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

In what setting do you see Trosseau syndrome?

A

Pancreatic adenocarcinoma

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

What is courvoisier sign?

A

Obstructive jaundice with palpable nontender gallbladder? Seen in pancreatic adenocarcinoma

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

What do exclusively beast fed infants require?

A

Vitamin D supplementation

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

What is the function of Niacin?

A

Inhibits VLDL synthesis and lipolysis

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

What acid-base thing do you see with vomiting?

A

Metabolic alkalosis

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

What would you get if on parenteral nutrition?

A

Gallstones due to lack of enteral stimulation secondary to decreased CCK

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

What is the pathology of PBC?

A

Granulomatous bile duct destruction and lymphocyte portal duct infiltrate

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

What does the pathology of PBC look similar to?

A

Graft vs Host Disease (GVHD)

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

Why do you get gallstones in Crohn’s?

A

Impaired bile acid absorption which causes impaired fatty acid absorption. Calcium binds to it forming soap complexes and gets excreted in feces.

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

Why do you get kidney stones in Crohn’s?

A

Less calcium in gut lumen to bind to oxalate since it is binding unabsorbed lipids instead

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

Which stomach artery is most susceptible to ischemia?

A

Short gastric because of lack of anastamoses

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

A jejunal ulcer is most likely due to what?

A

Gastrinoma

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

In what setting do you see mallory bodies?

A

Alcoholic Hepatitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What are you at risk for if exposed to vinyl chloride and arsenic?

A

Liver angiosarcoma

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

Where is phosphatidylcholine found?

A

In bile acids

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

Which organ in the abdomen is least likely to get infarct?

A

Liver (due to dual blood supply; also has accessory supply from inferior phrenic, intercostals)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

In what situation would you see a liver infarct?

A

Liver transplant since anastamoses are cut

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

What is a major effect of fibrates?

A

Decrease triglycerides

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

Posterior duodenal ulcers are most likely to cause bleeding from what?

A

Gastroduodenal artery

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

Anterior vs posterior duodenal ulcers are more prone to?

A

Anterior: perforation
Posterior: hemorrhage

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

Where is the duodenal bulb?

A

Right after the pylorus

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

How far to gastric erosions extend?

A

Into the muscularis externa but not all the way through (destroys gastric pits and glands)

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

Where are gastric pits?

A

In the mucosa

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

Where are gastric glands?

A

In the lamina propria

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

How far to gastric ulcers extend?

A

Submucosa

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

What causes acute mesenteric ischemia?

A

Atherosclerosis of mesenteric arteries (similar to angina)

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

What does acute mesenteric ischemia present with?

A

Epigastric post prandial pain

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

How do you differentiate acute mesenteric ischemia and peptic ulcer disease?

A

Peptic ulcer disease resolves w/ antacids and is not aw/ atherosclerosis

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

Cystic Fibrosis patient with acute pancreatitis is likely to be infected with what?

A

Pseudomonas

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

What does acute hepatitis present with?

A

Fever, nausea, anorexia, RUQ pain, bilirubinuria

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

What does acute hepatitis histology look like?

A

Ballooning, infiltrate, councilman bodies (eosinophilic globule in liver due to apoptosis)

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

Can conjugated bilirubin be excreted into the urine?

A

Yes because it is water soluble and doesn’t need to bind to albumin

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

What would yo see on a radionuclide biliary scan during cholecystitis?

A

Nothing (failed visualization)

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

What do you see in the liver for sarcoidosis?

A

Scattered granulomas with Schauman and Asteroid bodies

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

What is a common complication of UC and how do you diagnose it?

A

Toxic megacolon. Diagnose by X-ray (colonoscopy and barium enema are contraindicated)

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

What causes autodigestion of pancreas?

A

Trypsin

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

How do right sided colon cancers present?

A

Fatigue, weight loss, iron deficiency anemia from bleeding

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

What is acalculous cholecystitis?

A

Inflammation of gallbladder without presence of stones. From ischemia

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

What is ectopy?

A

Structure/organ not in its usual place (Ex: Meckel’s Diverticulum)

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

What enzyme is colonic adenocarcinoma linked to and what can you use to block it?

A

COX2 (use aspirin)

55
Q

Where do anal tears occur?

A

Distal midline posterior to dentate line

56
Q

Where do you see dermatitis herpetiformis?

A

On the butt’s and extensor surfaces of adults?

57
Q

Where do you see eczema (atopic dermatitis)

A

Rash on trunk aw/ food (differentiate from dermatitis herpetiformis which is on butt and extensor surfaces)

58
Q

How does PBC commonly present?

A

Caucasian female with history of extreme pruritus now getting xanthelesma and pale stool

59
Q

How is copper normally excreted?

A

In bile (absorbed in the GI tract then carried by albumin to liver then bound to ceruplasmin and excreted through bile)

60
Q

What does alpha amanitin do?

A

It is from mushrooms and it inhibits RNA Pol II preventing mRNA synthesis. Toxic to hepatocytes, GI tract, PCT cells.

61
Q

What causes mallory weiss tears?

A

Increased intraabdominal pressure that causes retching?

62
Q

What causes esophagitis in HIV patients?

A

CMV, HSV, candida

63
Q

If you undergo gastric resection, what specific nutrient do you need?

A

Vitamin B12

64
Q

How do you diagnose Hirschsprung’s Disease?

A

Sample the submucosa of the narrowed part

65
Q

Lynch/HNPCC and sporadic colon adenocarcinoma are where?

A

Lynch/HNPCC: right

Sporadic: left

66
Q

What is a major toxicity of Omeprazole?

A

Hip fracture from decreased Ca absorption

67
Q

What is colitis associated carcinoma?

A

Progresses from fat and non-polypoid dysplasia; has mucinous nad signet rings; affects younger patients

68
Q

What mutation is colitis associated carcinoma associated with?

A

Early: p53
Late: APC

69
Q

Where do you see colitis associated carcinoma?

A

Proximal colon but can be multifocal

70
Q

How do you diagnose malabsorption?

A

Stool test to look for fat

71
Q

When do you see thin curvilinear lines of lucency (pneumatosis intestinalis)?

A

Necrotizing enterocolitis (bacterial invasion and ischemic necrosis o bowel wall see in premies and when enteral feeding began)

72
Q

What is gallstone ileus?

A

Fistula between gallbladder and small intestine leading to gallstone passing through small intestine and getting stuck at ileocecal valve?

73
Q

What causes air int he gallbladder and biliary tree?

A

Gallstone ileus (fistula between GB and SI)

74
Q

How does HBV cause hepatocellular carcinoma?

A

HBV integration into host genome

75
Q

What is acarbose/miglitol?

A

Glucosidase inhibitor that prevents hydrolysis of disaccharides into monosaccharides so they can’t be absorbed

76
Q

Side effects of Acarbose/Miglitol

A

Flatulence, bloating

77
Q

Ulcer in the distal duodenum is due to what?

A

Gastrinoma (Zollinger - Ellison)

78
Q

What should you neonatal hepatitis make you suspicous for?

A

A1AT Deficiency

79
Q

What does newborn with projectile nonbilious vomiting have?

A

Pyloric stenosis

80
Q

What does newborn with projectile bilious vomiting have?

A

Volvulus

81
Q

What happens if caudal fold fails to close?

A

Bladder exstrophy

82
Q

What is an H-type TEF?

A

Pure TEF where there is a fistula alone

83
Q

What does the splenorenal ligament contain?

A

Splenic artery and vein, tail of pancreas

84
Q

Where are plicae circulares not located?

A

Duodenum

85
Q

Where do peyers patches begin?

A

Ileum

86
Q

Where does inferior epigastric come off?

A

External iliac

87
Q

Where does superior epigastric come off?

A

Internal thoracic/mammary

88
Q

What does the femoral sheath not contain?

A

Femoral nerve

89
Q

Which hernia most likely to be incarcerated?

A

Femoral

90
Q

Phenylalanine and tryptophan are potent stimulators of what?

A

Gastrin

91
Q

What is a motilin receptor agonist?

A

Erythromycin

92
Q

What does VIP do?

A

Increases intestinal water and electrolyte secretion, relaxes smooth muscle and sphincters

93
Q

What neurotransmitter is used to stimulate G cells?

A

GRP

94
Q

What test do you to distinguish GI mucosal damage from other causes of malabsorption?

A

D-Xylose test

95
Q

What type of cancer does alcohol cause in the esophagus?

A

Squamous cell

96
Q

What causes a cushing’s ulcer?

A

Increased vagal stimulation leading to increased acid production

97
Q

What causes a curling ulcer?

A

Decreased plasma volume causing gastric sloughing

98
Q

If gastric ulcer perforates what artery bleeds?

A

Left gastric

99
Q

What does abetalipoproteinemia present with?

A

Night blindness, acanthocytes, ataxia, steatorrhea, FTT

100
Q

When do you see air in the bladder?

A

When diverticula perforate and cause colovesical fistula

101
Q

Where do zenker’s diverticulum occur?

A

At kilian triangle between thrypharyngeal and cricopharyngeal parts of inferior pharyngeal constrictor

102
Q

What is angiodysplasia?

A

Tortuous dilation of vessels in cecum, terminal ileum, ascending colon, Can cause hematochezia

103
Q

Why does aspirin cause reye’s?

A

Decreases beta oxidatoin by reversible inhibition of mitochondrial enzyme

104
Q

Can you biopsy a cavernous hemangioma?

A

No because it has a risk of hemorrhaging

105
Q

What is hepatic adenoma?

A

Benign liver tumor related to oral contraceptive or anabolic steroid use. May regress sponataneously or rupture

106
Q

What can you use to treat crigler-najjar?

A

Phenobarbital (increases liver enzyme synthesis)

107
Q

What do you see on histology for pancreatic adenocarcinoma?

A

Disorganized glandular structure with cellular infiltration

108
Q

What are the risk factors for pancreatic adenocarcinoma?

A

Tobacco, DM, Age >50, Jewish, African-American males, chronic pancreatitis

109
Q

What are the side effects of cimetidine?

A

CYP inhibitor, antiadrogenic effects (impotence, gynecomastia, prolactin release etc), can cross BBB (headaches, confusion)

110
Q

What are the side effects of PPI?

A

Pneumonia, osteoporosis, decreased Mg, increase risk for c. diff

111
Q

What does ApoE do?

A

Remnant uptake

112
Q

What does ApoC do?

A

LPL cofactor

113
Q

Peptic ulcer where is least associated with malignancy?

A

Duodenum (gastric ones can progress to adenocarcinoma or MALToma)

114
Q

What happens with the HFE gene is mutated?

A

Decreased hepicidin synthesis (less iron taken up from blood) and increased DMT1 (more iron uptake from GI lumen)

115
Q

What will decrease in lactose challenge in someone with lactase deficiency?

A

Stool pH (bacteria ferment lactose to make fatty acids)

116
Q

What is the D-xylose test for?

A

To check for malabsorption

117
Q

How do you test for lactase deficiency?

A

Lactose is given and then seen if patient’s blood glucose goes up and if they experience GI symptoms (bloating, diarrhea etc)

118
Q

Gastric and pancreatic tissue in Meckel’s is a type of: dysplasia, metaplasia, ecotpy?

A

Ectopy (tissue present in unusual locations because of embryonic maldevo)

119
Q

What is the problem with abetalipoproteinemia?

A

MTP gene mutation (MTP ensures proper ApoB folding) so can’t make chylomicrons, VLDL and absent cholesterol and triglycerides. Poor lipid absorption.

120
Q

Diagnosis: weight loss, anorexia, jaundice, dark urine, pale stools, gallbladder enlarged but nontender?

A

Pancreatic adenocarcinoma. The gallbladder thing is Courvoisier’s sign. That and obstructive jaundice indicate pancreas cancer.

121
Q

What does the ventral pancreatic bud make?

A

Part of the head, main pancreatic duct, uncinate process

122
Q

What causes bilious vomiting, absence of large segment of bowel, distal ileum winding around vascular stalk?

A

Vascular occlusion leading to intestinal atresia distal duodenum. If SMA obstructed, apple peel atresia –> blind proximal jejunum with absence of long length of small bowel due to ischemia and terminal ileum winding around ileocolic vessel.

123
Q

What would you see hyperpigmented mouth lips, hands + abdominal discomfort?

A

Peutz-Jeghers

124
Q

What is metaclopramide?

A

D2 antagonist, inc resting tone/contractility

Contraindicated in parkinson and small bowel obstruction
Interacts with digoxin and diabetic agents
Drowsiness, fatigue, restlessness, depression, nausea, diarrhea

125
Q

Where are the GI stem cells ?

A

Crypts of Lieberkuhn

126
Q

What drug can you use for weight loss in obese people?

A

Orlistat

127
Q

If mass in rectum that has metastases to liver and abdominal nodes, what was the venous route?

A

Inferior mesenteric vein (that drains into portal vein into liver explaining the liver metastases; also upper rectum drains into internal iliac nodes)

Inferior rectal vein would drain into systemic circulation and cause lung metastases

128
Q

What is a truncated form of ApoB100 and where is it produced?

A

ApoB48 produced in intestinal cells

ApoB100 in hepatocytes

129
Q

What looks like edematous friable and granular mucosa with neutrophils in crypt lumina?

A

UC

Crypt abscesses = neutrophils in crypt lumina

130
Q

What does Kaposi show on endoscopy?

A

Hemorrhagic nodules

131
Q

What do you suspect if bilateral pitting lower extremity edema without cause (ie CHF, cirrhosis etc)?

A

IVC obstruction (also see abdominal wall collateral venous circulation - aka epigastric veins)

132
Q

What is caput medusa from?

A

Anastamoses between paraumbilical and small epigastric veins

133
Q

Where does copper deposit in the eye in Wilson’s?

A

Descemet’s membrane of CORNEA

134
Q

Which type is associated with H. pylori? Intestinal or diffuse?

A

Intestinal

USMLE Step 1 Quick Notes (17 decks)

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