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UWorld > GI 1 > Flashcards

GI 1 Flashcards

1
Q

___ is a condition due to dec/absent lactase

lactose enters ___ and fermented by bacteria

sx include D/F/B/C

A

lactose defic

LI

diarrhea, flatulence, bloating, cramping

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2
Q

Primary lactose deficit due to __ reduction in lactase
incidence inc w ___

Secondary due to __ like celiac dz
or ____ due to giardiasis in SI

both cause ___ to intestine

damage cells slough off, replaced w ___ cells

COMMON AFTER ____

A

genetic
age

inflammatory
infection

cell damage
low lactase

GIARDIA

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3
Q

conflicting input to the V/V/S systems leads to motion sickness

integration occurs in __ via M1 and H1 NT

thus, tx w antimuscarinic (like S___) or antihistamine like M/D/P

Promethazine also used for H

SE include B/D/U/C

A

vestibular, visual, somatosensory

vestibular nuclei

scopolamine
meclizine, dimenhydrinate/promethazine

hyperemesis gravidarum

blurry vision, ddry mouth, urinary retention, constipation

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4
Q

SE of dopamine receptor antags D

used for visceral aka D___ naseua

drugs include P/M

A

diarrhea

diabetic gastroparesis

prochlorperazine

metaclopramide

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5
Q

Chemo induced emesis tx

D

5HT3 antags O/G

NK1 receptor antags A/F

A

dopamine antags

odansetron, granisetron

aprepitant, fosaprepitant

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6
Q

Dx of hirschprung’s comes from ___

NCC normally develop into ___ of submucosal/M and myenteric A__ plexus

need to biopsy the __ portion for absence

ganglionic cells never enter the ___

dilated segments are ____

A

rectal biopsy

ganglion cells
Meissner, auerbach

submucosa

mucosa

undistinguishable

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7
Q

primary iron absorption occurs in D/J

gastrojejunostomies used to tx comps of __ such as perforation, GOO

removing gastric antrum dec ___ sec

bypass can result in ___

tx w ___

may have dec absorption of F/ VB12/F/Ca

A

duodenum/jejunum

PUD

gastrin

Fe deficient anemia

iron replacemnet

fat solubles, folate

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8
Q

VC absorbed in ___ via active transport

Pyridoxine absorbed in J__/I__ by passive diffusion

not affected w __

A

distal SI

Jejunum/Ileum

GJ ectomy

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9
Q

most cmmon trype of gallstone ___

mostly cholesterol __, __ salts, B/M

Bile acids/phopshpilipids solubilize __ to preent stone formation

dec __/__ allows gallstones

A

cholesterol

monophosphate, bile, bilirubin, mucin

cholesterol

BA/phosph

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10
Q

medical therapy for gallstones

hydrophulic bile acids like U__ reduces __ secretion and inc __ conc

promotes gallstone ___

A

ursodeoxycholic acid, cholesterol, bile acid

dissolution

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11
Q

bile acid sequestrants like C__ dec enterohepatic recirc of bile acids

inc ____

also convert cholesterol to ___ inc biliary motility

dec risk of ___

overall no effevt

A

cholestyramine

gallstones

BA

gallstones

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12
Q

Estrogen inc ___ and Progesterone reduces ___

fibrates inc __ in bile

dec calorie intake/rapid weight loss leads to ___

all inc risk of __

A

holesterol sec, BA sec

cholesterol

bile stasis

gallstones

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13
Q

femoral hernias protrude through __

lateral to P and __ ligament

medial to Femoral __/___

more common in __ and on __ side

more prone to __

if bowel present, can cause __ w N/V/pain/distenstion

reduced blood flow causes ___

A

femoral ring

pubic tubercle, lacunar

vein, artery

women, R

incarceration

obstruction

strangulation

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14
Q

Coopers ligament is part of ___ fascia, posterior to ___

posterior wall of inguinal canal is __

deep inguinal ring opens here, site of protrusion for ___ hernias

round ligament is woman equivalent of __ in men

leaves pelvis via __ through inguinal canal

A

pectineal, femoral canal

transversalis fascia

indirect, inquinal

spermatic cord

deep inguinal ring

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15
Q

perforated appendictis is commonly __ infection

Most likely, possible anaerobic, gram neg bacillus is __

other options include E/E/S

A

polymicrobial

b fragilis

E coli, enterococcus, streptococci

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16
Q

anaeorbic bacteria that forms abscesses in cervicofacial region/ab cavity ___

__ may be isolated from perforated bowel/ulcer

A

actinomyces

candida

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17
Q

Most cases of PUD due to __ infection or __ use

RF S/G/A

comps- H/P/G/P

gastric ulcers occur along __ of stomach, between body/antrum

Left/right ___ pefuse lesser curvature

A

H pylori, NSAID

soking, GC, age

hemorrhage, perf, GOO, peritonitis

lesser curvature

gasttric arteries

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18
Q

Glands in body of stomach contain ___ to produce ___ and __

mucosal glands in antrum contain __ to produce Gastrin

___ allows for __ growth

A

parietal cells, HCl, IF

G cells

transitional zone, H pylori

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19
Q

___ pefuses liver/GB/pyrlous/duodenum/pancreas

arises from ___

___ supplies pyrlous/duodenum

Ulcers in ___ erode GD artery

right __ arises from GD artery, perfusing __ of stomach (ulcer uncommon)

___ comes from celiac trunk to perfuse spleen

A

common hepatic artery

celiac trunk

GD artery

duodenal bulb

gastroepiploic artery, greater curvature

splenic artery

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20
Q

integrity of small intestine depends on neutralization of ___
bicarb secreted by

S___ releasing alkaline mucus to duodenum

ducts pass through M, terminating in Mucosal __

also from epithelial cels of pancreatic ductules- alkaline panc sec emty in to __

A

gastric acid

submucosal brunner glands

muscularis mucosa, crypts

duodenum

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21
Q

stimulation of duodenal mucosa and inc __ activity and __ in D/J cause release of S

produces __

excessive ___ secretion can cause overproduction of secretin, leading to __ of subuocsla glands

A

PNS, acid, secretin

bicarb release

GA, hyperplasia

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22
Q

antrum of stomach contains __ glands releasing mucus

GA released by B/F of stomach

mucosal crypts of jejunum contain __ cells for mucus and E for water/electrolytes

bicarb is secreted by epithelial cells in I/C to prevent acid released from __

released at __

A

pylric

body/fundus

goblet, enterocytes

ileum, colon, bacteria

villi

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23
Q

common location for intussception __ jxn

in older than 2, occurs from lead point IE M/F/T

look for N/V/__ stools

therapeutic/dx measure ___

may have __ in RLQ

A

ileocolic

MD, foreign body, tumor

currant jelly

barium enema

palpable mass

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24
Q

normal intestinal bacteria supress growth of __

RF for C diff growth is __

causes disease by releasing __ to damage mucosal lining

enterotoxin Toxin __ leads to diarrhea

cytotxin toxin B leads to ___ w __ formation

inc risk of CDI w ___ use

A

C diff

antibiotics

toxins

A

necrosis, pseudomembrane

PPI

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25
Q

hepatocyte injury causes release of __, inc __

biliary injury indicated w inc __/__

indicators of liver biosynthetic fxn __/___/___

may also see low ___

A

enzymes, transaminases

ALP, GGT

albumin, bilirubin, PT

fibrinogen

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26
Q

SAD PUCKER

retroperitoneal ab organs

more likely to present w ___

A 
suprarenal glands
aorta/IVC
lower duodenum
pancreas
ureter/bladder
colon (A and D)
kidney
esophagus
rectum

hemoperitoneum

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27
Q

freq cause of retroperitoneal hematoma is ___

assc w __/_ trauma

A

panc injury

blunt/penetrating

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28
Q

Hep B virus

DNA containing __ family

contains __ and outer __ w surface antigen

Pathway
DS DNA trxn to ___ used for __/__ into ssDNA and eventually ___

A

Hepadaviridae

nucleocapsid core, lipoprotin envelope

ss RNA, translation/RT, DS DNA

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29
Q

ss DNA to DS DNA to ssDNA progeny

ds DNA, to DS DNA temp, to DS DNA progeny

ss RNA + to RNA temp to ss RNA + progeny

ss RNA + to ds DA temp to ss RNA progeny

ss RNA - to RNA + to Ss RNA -

viruses

A

parvo B19

adeno/herpes/pox

polio

retroviruses ie HIV

influenza, measles, rabies

30
Q

portosystemic anastamosis in cirrhosis

abterior abdomen C

lower rectum A

inferior esophagus E

may tx w ___ bw portal/hepatic vein

A

caput medusa

anorectal

esophageal varices

TIPS

31
Q

___ separates posterior rectus sheat

above, RA surrounded by __/__ sheaths

below, only __ sheath

superior/inferior epigastric arteeies supply s/i portion of RA

below the arcuate line, no __ can result in significant hemorrhage

be concerned w __ and IEA

A

arcuate line

anterior/posterior

anterior

superior/inferior

posterior sheath

horizontal transection

32
Q

inguinal canal contents
Ilioinguinal ___, R/S

__ more susceptible to inguinal hernia

femoral sheath contents
Femoral A/V/N

A

nerve, round ligament/sperm cord

men

artery, vein, canal

33
Q

defect in __ can lead to formtion of ___

usually from __ abnroms or __

only pass through __ ring

only covered by __ fascia

IIH covered by all 3 __

A

transerslis fascia, direct inguinl

CT, chronic injury

superficial inguinal

external spermatic

fascial layers

34
Q

IIH due to filure of __ to close

protrude through __ ring

A

processus vaginalis

internal inguinal

35
Q

__ cleaves trypsinogen to trypsin

trypsin is necessary to activate other __

pathway occurs in ___, leading to inflammation/destruction

could result in ___, w high risk of bacterial infection

release of ___ causes fat necrosis

A

enterokinase

zymogens

acute pancreatitis

necrotizing pancreatitis

lipase

36
Q

PBC occurs in MA women w ___

patchy __ inflammation w destruction of __ bile ducts

G/bile __ of hepatocytes occur

GVHD
donor T cells enter host tissues, recognizing __ as foreing

S/L/GI tract most commonly affected

rise in __ w similar pathologic findings to PBC

A

autoimmune disorders

lymphocytic, intrahepatic

granulomas, staining

MHC

skin, liver

ALP

37
Q

acetominophen overdose leads to __ and liver failure

__ seen w hepatocellular swelling, necrosis, Mallory bodies, PMN and fibrosis

__ in hepatomegaly w purplish parenchyma, centrilobular congestion, necrosis

__ due to deposition of hemosiderin in liver, noninflammatory

__ w encephalopathy and lvier disease
seen w __ in __ illness
look for microvesicluar ___

A

centrilobular necrosis

alcoholic hepatitis

Bdd chiaria

hemochromatosis

reye sydnroe
aspirin, viral
steatosis

38
Q

EHEC does not ferment __ w overnight incubation

use ____ for isolation
O157H7 does not produce __

EHEC elaborates __ toxin, which is ___ encoded, enhanced by __def

inactivates ___ subunit, resulting in cel death

also results in __ w Thrombocytopenia, MHA, and renal insuf

EHEC does not invade __, unlike EIEC

unlike ETEC, does not produce __

A

sobitol

sorbitol containing Maconkey

glucurnidase

shiga like, phage, iron

60s ribosomal

HUS

intestinal mucosa

heat LT/ST

39
Q

toxins produced by B/ETEC __, C, V

inc ___ dec absorption and inc secretion of Na/Cl/water

A

bordetella pertussis, LT, campylobacter, vibrio cholera

cAMP

40
Q

ETEC __ and Y produce toxins to inc ___

leading to __ and __

A

ST, yersinia, cGMP

watery diarrhea, electrolyte loss

41
Q

__ produces toxin to disrupt cytoskeleton

this is toxin __

depolymerizes ___

A

c diff

b

actin

42
Q

__ is macrocylcic antibiotic to inhibit ___ of RNA polymerase

inhibits __ leading to __

thus, it is ___

minimal ___

CDI can be tx w M/V/F

A

sigma subunit

protein synth, cell death

bacteriocidal

systemic absorption

metro, vanc, fidaxomicin

43
Q

__ inhibits 30s ribosome for clostrium __

__ interact w DNA in anaerboes, causing ___

__ is an aminoglycose to inhibit 30s ribosomal subunit

__ inhibits cell wall synth, bacteriostatic against C diff

A

doxycycline

metronidazole, strand breakage

neomycin

vancomycin

44
Q

,majority of copper is absorbed in S/D and taken to ___

there, forms __

unabsorbed copper is then secreted into __ and excreted into ___

A

stomach, duodenum, liver

ceruloplasmin (majority)

bile, stool

45
Q

___ is abnormal spasm/dec relaxation of CP muscles during swallowing

dx is ___

sx include __/__/__

results in herniation of mucosa and formation of __ in the hypopharynx

present w __/__/___

A

Cricopharyngeal motor dysfxn

Zenker diverticulum

cough/chokng/obstruction

false diverticula

halitosis, regurg, aspiration

46
Q

mucosal tear in GE jxn due to inc intraluminal pressure dx

__ form due to trapped secretions following obstruction of glands duct

__ ie TB/fungi can cause scarring/traction of esophagus, resulting in formation of __

A

mallory weiss

retention cyst

mediastinal LAN, true diverticula

47
Q

distal duodenal ulcer, high/normal gastrin levels rise in response to secretin

dx is ___
usually located in __/__

presents w peptic ulcer, D, H

typically seen in ulcer beyond ___

A

ZES

SI, pancreas

diarrhea, heartburn

duodenal bulb

48
Q

__ released from duodenum in response to acid/fat in SI

inc panc __ sec, dec __ from G cells

paradoxically, secretin stimulates gastrin w __

A

secretin

bicarb, gastrin

gastrinoma

49
Q

__ involves body/funds w antral sparing
CD4 t cell mediated pareital destruxn impairs GA/IF sec

resulting in A/P

___ assc w antral gastritis, reducing __ producing delta cells
lack of somatostatin inc __ release
secretin thus __ gastrin in these pateitns

A

autoimmune gastritis

achlorhydria, pernicious anemia

H pylori
somatostatin
gastrin
dec

50
Q

non atrophic chronic gastritis is due to __

usually hits the __ and __

acute phase, inflam infiltrate commonly composed of __

chronic characterized by L___, lymphid follicles, __ cells

H pylori seen as __ shaped bacilli

A

H pylori

antrum body

PMN

lymphs, plasma

spiral

51
Q

H pylori inc local __ prodxn, and development of __ ulcers

in body/fundus, leads to loss of __ and dec GA prodxn

inc risk of gastric __, Fe ___, and M___

Chron disease likely does not affect __ alone

__ w autoimmune atrophic chronic gastritis
characteristically affects __

A

gastrin, duodenal

g cells

adenocarcinom, Fe deficient anemia, MALT

stomach

Pernicious anemia, body

52
Q

night blindness, hyperkeratosis suggestve of ___ deficiency

VA becessary for __ and __ differentiation

usually due to biliary __, panc ___, or __ resect

PBC can lead to malabsorption of F/F

__ is chronic hemolytic anemia leading to retinopathy at all times

A

VA

vision, keratinocyte

obstrructiob, insufficieny, SB

fat/FSV

SCD

53
Q

Chron diseae w inflam to __ dec BA resoprtion, and lost in __

risk of forming ___

bile acids produced by __ and excreted into __ to emulsify __ to form micelles

allow __ to hydrolize TG

bile acids reabsorbed in __

A

terminal ileum, stool

gallstones

liver, duodenum, fat droplets

panc lipase

TI

54
Q

pt w spinal cord injury/parenteral nutrtion can get gallstones w ___

__ reduce risk of gallstones

A

gallstone hypomobility

statins

55
Q

elefated __ suggestive of hepatobiliary dz

__ inc indvates inc bilirubin formation/dec conjugation

Gilbert dz is due to deficiency of ___

seen in pt w mild ___ otherwise asx’

__ pt presents w chronic conj hyperbilirubinemia not assc w hemolysis

A

conj bilirunbin

unconj bilirubin

UDP glucurnyl transferase

unconj bilirubin

dubin johnson

56
Q

Palpable, nontender gallbladder, WL, jaundice indicate ____ of pancreas head compressing the ___

RF A/S/D/C/G

low fiber diet assc w __

A

adenocarcioma, CBD

age, smoking, DM, chronic panc, genes

colon ca

57
Q

___ has affected bowel that appears hyperemic/edemaous on examination w __ appearance

also formation of ___ and __ inflammation

pathology is due to inc activity of ____
inc prodxn of __/__/__

A

Chron disease, cobblestone

noncaseating granulomas, tranmural

TH1 cells

IL2, IFNG, TNF

58
Q

___ acute inflam of gallblader caused by __ of cystic duct

RUQ pain, fever, leukocytosis, Murphy sign

preceded by ___

persistent obstruction promotes hydrolysis of luminal __ to disrupt mucus layer

epithelium exposed to __ resulting in inflamation, w inc pressure/distension leading to __

ultimately, __ enter, and cause infection

A

acute cholecystitis, obstruction

biliary colic

lecithins

bile salts, ischemia

bacteria

59
Q

Pancreatic pseudocyst has leakage of ___, w high enzyme content, inducing inflammatory rxn

__ forms a border, has no __ (unlike true cyst)

usually located in the ___, near the stomach/duodenum/transverse colon

A

panc enzymes

granulation tissue, epithelial lining

lesser peritoneal sac

60
Q

glycogen rich cuboidal epithelium seen in __ neoplasm

columnar mucinous epithelium seen in __ panc neoplasm

atypcial cells w papillary projections seen in __

A

serous panc

mucinous cystic

panc adenocarcinoma

61
Q

Reye syndrome

hepatic dysfxn w V/H
AST/ALT/bilirubin/PT/PTT all __

microscopy shows ___ w out __/__
dec number of __/__

encephalopathy occurs due to __ and ___ w cerebral edema

thus, do not administer __ to children

A

vomting, hepatomegaly
inc

microvesicular steatosis, necrosis/inflam
mtio/glycogen

hepatic dysfxn, hyperammonemia

aspirin

62
Q

apoptosis of hepatocytes, acina necrosis, periportal infallmation seen in ___

centrilobular liver congestion in pt w ___

A

viral hepatitis

right heart failure

63
Q

hematochezia/abnormal outpouchings diagnosis is __

__ diverticula w inc intraluminal pressure caused by straining

causes formation of __

commonly seen in __ colon
hematochezia due to disrupted ___

once inflamed, progresses to __

traction diverticula due to __/__ such as w mediatsinal LAN

A

diveticulosis

pulsion

false diverticula

sigmoid
arterioles

diverticulitis

inflam/scarring

64
Q

Causes of acute pancreatitis

G/A/E/D/I/H/A/S/H

high TG > ___ inc production of ___, leading to injury to panc ___ cells

cholesterol is assc w __/__

A

gallstone, alcohol, ERCP, drug, infection, hyperTG, anatomy, surgery, hyperCa

1000,free FA, acinar cells

athero, stroke

65
Q

sharp pain, red bleeding w defection suggests ___

caused by long tear distal to ___, usually at the __ of anal verge

related to __/___

A

anal fissure

dentate line, posterior midline

constipation/hard stools

66
Q

porcelein gallbladder presents w ___ or __

radiograph shows thickened __ and rim of ___

assc w ___, due to dystrophic deposition of ___

assc w inc risk of ____

A

RUQ pain, asx

gallbladder wall, calcification

chronic cholecystitis, calcium salt

adenocarcioma

67
Q

___ demonstreated flattened epithelial cells, w keratin nests/pearls and IC bridging

Rf include A/T, B/N (esp Asia)

A

SCC

alcohol, tobacco, Betel nuts/nitrosamines

68
Q

VB12 def, w preexisting autoimmune diseases suggests ___

progressive destruction of oxyntic mucosa leads to dec ___

lack of __
Achlorhydria results in elevated intraluminal __ and __ secretion

may have inc risk of ___ tumor

A

pernicious anemia

parietal cell mass

IF
pH, gastrin

carcinoid

69
Q

___ may cause rise in intraluminal pH, gastrin, hypertrophy of parietal cells

__ leadds to inc gastrin, parietal cell hypertrophy, low pH

A

PPI

Gastrinoma

70
Q

predisposing factor ofr mallory weiss syndrome

A

hiatal hernia/alcoholism

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