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USMLE/ Step ONE > GastroIntestinal > Flashcards

GastroIntestinal Flashcards

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USMLE® Step 1 flashcards
1
Q

What are the salivary gland tumors?

A

Pleomorphic adenoma
Warthin’s tumor
Mucoepidermoid carcinoma

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2
Q

Describe Pleomorphic adenoma’s

A

-benign mixed tumor

Sx: painless, mobile mass made of cartilage & epithelium

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3
Q

Describe Warthin’s tumor

A
  • Benign
  • cyctic tumor w/ germinal centers
    aka: Papillary cystadenoma lymphomatosum
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4
Q

What is a Mucoepidermoid carcinoma?

A

Malignant
Painful mass, hasa mucinous & squamous portions
involves facial nerves

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5
Q

Failure of relaxation of LES (neurological cause) called?

presentation on barium swallow?

A

Achalasia

Barium swallow: “bird’s beak”. Dilated esophagus w/ area of distal stenosis

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6
Q

Cause of Achalasia?

Effect on peristalsis and pressure changes

A

Loss of myenteric (Auerbach’s) plexus. Secondary disease due to Chagas

Unocordianted peristalsis and increased pressure to open LES

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7
Q

What can you eat and not eat during Achalasia?

A

Dysphagia of solids & liquids

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8
Q

What is associated w/ Achalasia?

A

Esophageal squamous cell carcinoma

Scleroderma (CREST). Low pressure proximal to LES

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9
Q

C/C: 46 yo male feels heartburn and feels like vomiting after lying down. Has trouble breathing, coughs at night, and feels like he may have asthma. What is it?

A

GERD

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10
Q

GERD affect on LES?

A

Decrease LES tone

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11
Q

Portal hypertension can have what affect on esophagus?

A

Esophageal varices-

Painless bleeding of dialted submucosal veins in lower 1/3 of esophagus

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12
Q

Non-infective causes of Esophagitis?

A 
Chemical ingestion
Acid Reflux (if not due to bug!)
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13
Q

Bugs associated with eophagitis? Presentation w/ each

A 
Candida = white pseudomembrane
HSV-1= punched-out ulcers
CMV= linear ulcers
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14
Q

Who presents w/ Mallory-Weiss syndrome?

A

Drunks and bulimics

severe vomiting

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15
Q

What can Mallory-Weiss lead to?

A

Hematemisis- throwing up blood!

Mucosal lacerations

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16
Q

Violent retching
Transmural esophageal rupture

What is it?

A

BoerHaave Syndrome

aka: “Been Heaving Syndrome”

17
Q

Esophageal strictures are associated with what? 2 things…

A

Lye ingestion- containing largely potassium carbonate or “potash”). In oven cleaners, drain openers

Acid reflux (GERD)

18
Q

triad of Plummer-Vinson syndrome

A

Dysphagia (due to esophgeal webs)
Glossitis
Iron deficiency anemia

19
Q

Metaplasia where nonkeratinized stratified squamous cells replaced w/ intestinal cells (noncillaited columnar) in distal esophagus

A

Barret’s esophagus

20
Q

What causes Barret’s esophagus?

A

GERD (acid reflux)

21
Q

Risk’s & association’s w/ Barret’s esophagus

A

Esophagitis
Esophageal Ulcers

increased risk of: esophageal ADENOCARCINOMA

22
Q

Types of cancer in esophagus. Sites affected, and demogprahics.

A

Squamous cell: upper 2/3, MC worldwide (outside US)

Adenocarcinoma: lower 1/3, MC in USA

23
Q

Presentation of esophageal cancer?

A

Dysphagia- first solids, then liquids

Weight loss

24
Q

Risk factors for Esophageal cancer

A

AABCDEFFGH

Achalasia
Alcohol- sqm
Barret's- adeno
Cigarettes-both
Diverticula (e.g. Zenkers)- sqm
Esophageal web- sqm
Familial
Fat/obestity- adeno
GERD-adeno
Hot liquids- sqm
25
Q

Key Sx of Malabsorption diseases?

A 
Diarrhea
Steathorrhea
Weight loss
Weakness
Vit & mineral deficiencies
26
Q

List malabsorbtion diseases?

A 
Tropical sprue
Whipple's disease
Celiac sprue
Disaccharidase deficiency
Abetalipoproteinemia
Pancreatic insufficiency

“These Will Cause Devastating Absorption Problems”

27
Q

Differentiate Tropical Sprue & Celiac Sprue

A

Both similar. Tropical cause unknown, and can effect entire small GI

28
Q

Histo & IF of Whipple’s disease

A

PAS+ foamy macrophages in intestinal lamina propria

Mesenteric nodes

29
Q

Sx of Whipple disease?

A

Cardiac
Arthalgia
Neurologic

“Foamy Whipped cream in a CAN”

30
Q

What is the MC disaccharidase deficiency?

Type of diarrhea present?

A

Lactase!

Osmotic diarrhea

31
Q

Lactase tolerance test is positive when…

A

Lactase administration–> Sx (bloating, osmotic diarrhea)

& glucose rises only <20mg/dL

32
Q

explain path of abetalipoproteinemia

A

↓apolipoprotein B made ->
cannot make chylomicrons->
↓ Cholesterol & VLDL secreted into blood->
fat builds up in enterocytes

33
Q

When does abetalipoproteinemia present?

A

early in childhood, w/ neurological Sx

34
Q

What can cause pancreatic insufficiency?

A

CF
obstructing cancer
chronic pancreatitis

35
Q

What cant you absorb with pancreatic insufficiency?

A

cant absorb fat-soluble vitamins

A, D, E, K –> neutral fat in stool

36
Q

HLA associations w/ celiac spru? Who gets it? What skin presentation associated?

A

HLA-DQ2 & HLA-DQ8

Northern Europeans

Dermatitis herpetiformis

37
Q

What Abs associated w/ celiac spru?

Which one is used to test?

A

Abti-endomysial

Anti-tissue transglutaminase<– screening test Anti-Gliadin

USMLE/ Step ONE (11 decks)

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