Gastroenterology

Question 1

Secreted by G cells (antrum), stimulates parietal cells in fundus

Answer 1

Gastrin

Question 2

Secreted by I cells (duodenum), contracts gallbladder & prolongs gastric emptying time

Answer 2

Cholecystokinin (CCK)

Question 3

Secreted by S cells (duodenum), inhibits acid secretion

Answer 3

Secretin

Question 4

Secreted by K cells (duodenum), stimulates insulin secretion

Answer 4

Glucose-dependent insulinotropic Peptide (GIP)

Question 5

Stimulate gastric acid secretion ( synergistic effects)

Answer 5

Gastrin
Histamine
Acetylcholine

Question 6

Stimulates mucus in the stomach

Answer 6

Mucus neck cells

Question 7

Stimulates motility during fasting

Answer 7

Motilin

Question 8

Secrete HCl and intrinsic factor (IF) in the stomach

HCl = parietal

Answer 8

Parietal cells

Question 9

Secretes pepsinogen in the stomach

Answer 9

Chief cells

Question 10

Secretes serotonin in the stomach

Answer 10

Enterochromaffin cells

Question 11

Secretes histamine in the stomach

Answer 11

Enterochromaffin-like cells

Question 12

Pacemaker cells of the GI tract (generate slow waves)

Answer 12

Interstitial cells of Cajal

Question 13

Preferred functional unit of liver

Answer 13

Liver Acinus Model (Zones 1-3)

Question 14

Store vitamin A in the liver

Answer 14

Ito cells

Question 15

Intestinal enzyme that triggers conversion of pancreatic trypsinogen to trypsin

Answer 15

Enterokinase

Question 16

Main mechanism for bile salt reabsorption

Answer 16

Enterohepatic circulation

Question 17

Triglyceride absorption

Answer 17

Lumen -> Interstitial cells as micelles

Intestinal cells -> lymph vessels (lacteals) as Chylomicrons

Question 18

Start of digestion

Answer 18

Carbohydrates: mouth (salivary glands)
Fats: Stomach (lingual lipase)
Proteins: Stomach (pepsin and denaturation by Hcl)

Question 19

Absorption of nutrients

Answer 19

Duodenum: Iron, vitamin C
Jejunum: Carbohydrates, fats, proteins, water
Ileum: Vit B12, bile salts, Vitamins ADEK

Question 20

Rules of 2’s in Meckel’s Diverticulum

Answer 20

• 2% of the population
• 2 y/o
• 2:1 male:female ratio
• 2 types of tissue involved
• 2 inches long
• 2 feet from ileocecal valve

Question 21

Diagnostic criteria for IBS

Answer 21

Recurrent abdominal pain or discomfort at least 3 days per month in the last 3 months assoc w/ 2 or more of the ff:

• Improvement w/ defecation
• onset assoc w/ a change in frequency of stool
• onset assoc w/ a change in appearance of stool

Question 22

Charcot’s triad for Ascending Cholangitis

Answer 22

• Fever
• abdominal pain
• jaundice

> FPJ

Question 23

Charcot’s Neurologic trias for multiple sclerosis

Answer 23

• scannning speech
• intention tremor
• nystagmus

> SIN

Question 24

Reynold’s Pentad

Answer 24

• Charcot’s Chonagitis triad ( fever, abd pain, jaundice)
• shock
• confusion

Question 25

Triad for Hepatopulmonary Syndrome

Answer 25

- Liver disease - Hypoxemia - Pulmonary arteriovenous shunting

Question 26

Triad of Acute Cholecyctitis

Answer 26

- sudden RUQ tenderness - fever - leukocytosis

Question 27

Triad of Choledochal Cyst

Answer 27

- abd pain - jaundice - abd mass

Question 28

Triad of Hemobilia

Answer 28

- biliary pain - obstructive jaundice - melena

Question 29

Diagnosis of Acute Pancreatitis

Answer 29

- typical abdominal pain - 3x or greater elevation in serum amylase and or lipase levels - confirmatory findings on cross sectional abdominal imaging

Question 30

Triad of Hemorrhage from Pancreatic Pseudocyst

Answer 30

- Increase in the size of the mass - a localized bruit over the mass - sudden decrease in Hgb and Hct w/o obvious external blood loss

Question 31

Classic symptoms of GERD

Answer 31

water brash and substernal heartburn

Question 32

Most common cause of espohageal chest pain

Answer 32

GERD

Question 33

Most sensitive test for the diagnosis of GERD

Answer 33

24 hr ambulatory pH monitoring

Question 34

Perception of a lump or fullness in the throat that is felt irrespective of swallowing

Answer 34

Globus hystericus

Question 35

Characteristic symptom of Infectious esophagitis

Answer 35

odynophagia

Question 36

Common cause of Steakhouse syndrome

Answer 36

Schatzki ring in the lower esophagus ( meat usually instigates intermittent food impaction)

Question 37

Radiographic sign in Achalasia

Answer 37

Bird's beak appearance

Question 38

Seen radiographically in diffuse esophageal spasm (DES) or spastic achalasia

Answer 38

Corkscrew or rosary bead esophagus