GI 1 test

Question 1

What is Zollinger-Ellsion syndrome and what neoplasia is it related to?

Answer 1

Gastrin secreting tumor–Gastrinoma within endocrine pancreas causing increased Gastrin secretion that is not under negative feedback–creating ulcers

Related to MEN1-Pituitary, Pancreatic and parathyroid

Question 2

What syndrome is associated with autoimmune dz in which there is excessive production and deposition of collagen?

Answer 2

Scleroderma–CREST syndrome

Question 3

What does CREST syndrome stand for?

Answer 3

C- Calcinosis
R- Raynaud phenomenon 
E- Esophageal Dysmotility
S- Sclerodactyly
T- Telangiectasia

Question 4

What organism is involved in a liver fluke infection that is a risk factor for development of pigmented gallstones?

Answer 4

Clonorchis Sinensis

Question 5

Failure of what feels to migrate to the distal colon cause Hirschsprung dz?

Answer 5

Neural crest cells–which are responsible for forming PNS and non-neural structures nearby

Question 6

Hirschsprung dz is failure to form ________ in sigmoid colon and rectum?

Answer 6

Myenteric plexus–presents in newborn with bilious emesis, abd distention and failure to pass meconium

Question 7

Condition involving abdominal distress and GI bleeding in a 1 wk old baby who is premature/low birth weight and is formula fed?

Answer 7

Necrotizing enterocolitis

Question 8

If a patient is on Warfarin and has GERD, what drug should be avoided when treating the GERD?

Answer 8

Cimetidine–H2- receptor antagonist

Question 9

Disease seen in the elderly that involves enlarged rugal folds with increased mucus-secreting cells–increased mucous production and decreased protein absorption?

Answer 9

Menetrier Dz–Protein losing gastropathy

Seen in the elderly—have edema due to hypoalbuminemia and decreased vascular oncotic pressure

Question 10

Rupture of esophagus after episodes of retching with evidence of air in inappropriate locations in the chest?

Answer 10

Boerhaave syndrome

Question 11

Carcinoid syndrome has the potential to cause Carcinid heart dz, what occurs with this disease?

Answer 11

R-sided endocardial fibrosis with tricuspid damage

Question 12

Ulcerative colitis predisposes pts to what type of carcinoma?

Answer 12

Colorectal Adenocarcinoma of the colon

Inflammatory bowel diseases increased risk–Crohns and UC, but UC more so

Question 13

Oral lesions that show leukoplakia are associate with _______ and have an increase risk of what?

Answer 13

Hyperkeratosis—increased risk of containing carcinoma in situ or overt carcinoma

Question 14

What is the tx for the symptoms of Carcinoid syndrome–flushing and diarrhea and what is MOA?

Answer 14

Octreotide–synthetic somatostatin analog–bonds to receptors on carcinoid tumors and inhibits synthesis and release of hormones

Question 15

What is the most likely cause of cholesterol stones (Yellow, monohydrate crystal)?

Answer 15

Obesity–Female, fat, forty, fertile

Question 16

Why is the stomach very unlikely to infarct with the loss of a vessel feeding it?

Answer 16

The stomach is full of anastomotic vasculature –low probability of infarction

Question 17

What is seen on microscopy of a pt with cirrhosis?

Answer 17

Diffuse bridging fibrosis and regenerative nodules

Question 18

How is Campylobacter jejuni differentiated from other enteric organisms?

Answer 18

Grows at 42C

Question 19

Charcot Triad indicating cholangitis–Infection of biliary tree proximal to an obstruction?

Answer 19

Fever
Jaundice
RUQ pain

Question 20

3 wk old baby with non bilious projectile vomiting with olive shaped mass present on Abd exam?

Answer 20

Congenital pyloric stenosis

Question 21

What is the triad of Plummer-Vinson syndrome and what are these pts at increased risk of developing?

Answer 21

Dysphagia, Iron deficiency anemia and esophageal webs

Increased risk of SCC–> Upper 2/3

Question 22

Punched out ulcers within the esophagus of immunocompromised pt?

Answer 22

HSV causing esophagitis

Question 23

Released during a fasting state and causes migrating motor complexes (MMCs)?

Answer 23

Motilin

Question 24

What stimulates gastric secretion from the parietal cells in the stomach?

Answer 24

Histamine
Gastrin
Vagal stimulation (ACH)

Question 25

Where are chylomicrons broken down and what enzyme is responsible for the breakdown?

Answer 25

At vascular endothelium –by Lipoprotein Lipase (LPL)–into FFA and Chylomicron remnants

Question 26

Newborn has bilious vomiting after first feeding and a “double bubble” is found on X-ray. What is the cause of this disorder?

Answer 26

Failure in recanalization of the duodenums lumen–Duodenal atresia

Question 27

Triple therapy for H. pylori duodenal ulcer?

Answer 27

PPI + Clarithromycin and Amoxicillin

Question 28

Obstructive jaundice and a palpable gallbladder that is NOT tender. Elevated GGT and lipase along with CA-19-9?

Answer 28

Carcinoma of the head of the pancreas

Question 29

Hepatic vein obstruction due to thrombosis. Absence of JVD and is associated with hyper coagulable state and polycythemia vera?

Answer 29

Budd-Chiari syndrome