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Step 1 > Gastrointestinal > Flashcards

Gastrointestinal Flashcards

1
Q

What arises from the foregut?

A

pharynx –> duodenum

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2
Q

What arises from the midgut?

A

duodenum –> proximal 2/3 of transverse colon

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3
Q

What arises from the hindgut?

A

disal 1/3 of transverse colon –> anal canal above pectinate line

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4
Q

Duodenal atresia is due to what?

A

Failure to recanalize (trisomy 21)

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5
Q

Jejunal, ileal, colonic atresia is due to what?

A

Due to vascular accident (apple peel atresia)

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6
Q

What is gastroischisis?

A

Extrusion of abdominal contents through abdominal folds; not covered by peritoneum

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7
Q

What is omphalocele?

A

Persistence of herniation of abdominal contents into umbilical cord, sealed by peritoneum

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8
Q

What is an annular pancreas?

A

Ventral pancreatic bud abnormally encircles 2nd part of duodenum; forms a ring of pancreatic tissue that may cause duodenal narrowing

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9
Q

What is a pancreas divisum?

A

Ventral and dorsal parts fail to fuse at 8 weeks

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10
Q

What are the retroperitoneal structures?

A

“SAD PUCKER:” Suprarenal (adrenal) glands, Aorta and IVC, Duodenum (2nd-4th parts), Pancrease (except tail), Ureters, Colon (descending and ascending), Kidneys, Esophagus, Rectum

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11
Q

What kind of cells line the lumen of the esophagus?

A

Nonkeratinized stratified squamous epithelium

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12
Q

What kind of cells line the lumen of the stomach?

A

Gastric glands

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13
Q

What kind of cells line the lumen of the duodenum?

A

Villi and microvilli, Brunner glands (submucosa), and crypts of Lieberkuhn

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14
Q

What kind of cells line the lumen of the jejunum?

A

Plicae circulares and crypts of Lieberkuhn

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15
Q

What kind of cells line the lumen of the ileum?

A

Peyer patches, plicae circulares, and crypts of Lieberkuhn; largest number of goblet cells in small intestine

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16
Q

What kind of cells line the lumen of the colon?

A

Crypts of Lieberkuhn but no villi; numerous goblet cells

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17
Q

Which zone of the liver contains the portal vein and hepatic artery branches?

A

Zone I

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18
Q

Which zone of the liver contains the central vein?

A

Zone III

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19
Q

Which zone of the liver is first affected by viral hepatitis?

A

Zone I

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20
Q

Which zone of the liver is first affected by alcoholic hepatitis?

A

Zone III

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21
Q

Which zone of the liver contains cytochrome P450 system?

A

Zone III

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22
Q

Which zone of the liver is most affected by metabolic toxins?

A

Zone III

23
Q

Which zone of the liver is most affected by ingested toxins?

A

Zone I

24
Q

Which zone of the liver is first affected ischemia?

A

Zone III

25
Q

What does the femoral triangle contain?

A

Femoral nerve artery and vein

26
Q

What does the femoral sheath contain?

A

Femoral vein artery and canal (deep inguinal nodes)

27
Q

Hesselbach triangle is bordered by what?

A

Lateral border of rectus abdominus, inguinal ligament, and inferior epigastric vessels

28
Q

What is the source, action, and regulation of cholecystokinin?

A

Source: I cells (duodenum and jejunum)
Action: Increase pancreatic secretion and gallbladder contraction, decrease gastric emptying, and increase sphincter of Oddi relaxation
Regulation: Increased by fatty acids and amino acids

29
Q

What is the source, action, and regulation of gastrin?

A

Source: G cells (antrum of stomach)
Action: Increases gastric H+ secretion, growth of gastric mucosa, and gastric motility
Regulation: Increased by stomach distention/alkalinization, amino acids, peptides, vagal stimulation. Decreased by stomach pH

30
Q

What is the source, action, and regulation of glucose-dependent insulinotropic peptide?

A

Source: K cells (duodenum and jejunum)
Action: Decreases H+ secretion and increases insulin release
Regulation: Increased by fatty acids, amino acids, and oral glucose

31
Q

What is the source, action, and regulation of motilin?

A

Source: Small intestine
Action: Produces migrating motor complexes
Regulation: Increased in a fasting state
*erythromycin is a motilin R agonist

32
Q

What is the source, action, and regulation of secretin?

A

Source: S cells (duodenmum)
Action: Increased pacreatic bicarb secretion and bile secretion, decreased gastric acid secretion
Regulation: Increased by acid, fatty acids in lumen of duodenum

33
Q

What is the source, action, and regulation of somatostatin?

A

Source: D cells (pancreatic islets, GI mucosa)
Action: Decreases gastric acid and pepsinogen secretion, decreases pancreatic and small intestine fluid secretion, gallbladder contraction, and insulin and glucagon release
Regulation: Increased by acid, decreased by vagal stimulation

34
Q

What is the action of nitric oxide?

A

Action: Increases smooth muscle relaxation, including lower esophageal sphincter

35
Q

What is the source, action, and regulation of vasoactive intestinal polypeptide (VIP)?

A

Source: Parasympathetic ganglia in sphincters, gallbladder, and small intestine
Action: Increase intestinal water and electrolyte secretion, increase relaxation of intestinal smooth muscle and sphincters
Regulation: Increased by distention and vagal stimulation, decreased by adrenergic input

36
Q

What is the source and action of intrinsic factor?

A

Source: Parietal cells of stomach
Action: VitaminB12-binding protein - required for absorption of B12 in terminal ileum

37
Q

What is the source, action, and regulation of gastric acid?

A

Source: Parietal cells of stomach
Action: Acidify stomach
Regulation: Increased by histamine, ACh, gastrin. Decreased by somatostatin, GIP, PG, and secretin

38
Q

What is the source, action, and regulation of pepsin?

A

Source: Chief cells of stomach
Action: Protein digstion
Regulation: Increased by vagal stimulation and local acid

39
Q

What is the source, action, and regulation of bicarb?

A

Source: Mucosal cells of stomach, duodenum, salivary glands, and pancreas, and Brunner glands of duodenum
Action: Neutralizes acid
Regulation: Increased by pancreatic and biliary secretion with secretin

40
Q

Vagal stimulation of the gastric parietal cells works through which receptor?

A

ACh binds to M3 receptor - Gq

41
Q

Gastrin stimulation of the gastric parietal cells works through which receptor?

A

CCKb receptor - Gq

42
Q

Histamine stimulation of the gastric parietal cells works through which receptor?

A

H2 receptor - Gs

43
Q

Prostaglandin stimulation of the gastric parietal cells works through which receptor?

A

Gi

44
Q

Somatostatin stimulation of the gastric parietal cells works through which receptor?

A

Gi

45
Q

What are Brunner glands?

A

Located in duodenal submucosa. Secrete alkaline mucus. Hypertrophy seen in peptic ulcer disease.

46
Q

How is trypsinogen activated to trypsin?

A

By enterokinase/enteropeptidase, a brush-border enzyme of the duodenal and jejunal mucosa

47
Q

What is the D-xylose absorption test?

A

Distinguishes GI mucosal damage from other causes of malabsorption

48
Q

Bilirubin is conjugated in the liver with what?

A

Glucuronate

49
Q

What is sialadenitis?

A

Inflammation of the salivary gland, due to an obstructing stone usually unilateral s aureus

50
Q

What is a pleomorphic adenoma?

A

Benign mixed tumor of the parotid gland

51
Q

What is a Warthin tumor?

A

Aka papillary cystadenoma lymphomatosum - benign cystic tumor with germinal centers of parotid gland

52
Q

What is a mucoepidermoid carcinoma?

A

Mucin and squamous malignant tumor of parotid gland - can cause facial nerve palsy

53
Q

What is achalasia?

A

Failure of relaxation of LES due to loss of myenteric (Auerbach) plexus. High LES opening pressure and uncoordinated peristalsis –> progressive dysphagia to solids and liquids. Increased risk of squamous cell carcinoma.

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