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UWORLD QuestionQuestions > GI > Flashcards

GI Flashcards

LEGEND: MC= Most Common MCC= Most Common Cause

1
Q

Typical histological appearance of Celiac Sprue

A

flat jejunal mucosa with no vili

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2
Q

Stable retroperitoneal hematoma is most likely due to what structure?

A

pancreas (except the tail).

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3
Q

Retroperiotineal Structures?

A 
Suprarenal gland
Abdominal aorta/IVC
Duodenum (part 2,3,4)
Pancreas (not tail)
Ureters
Colon (Asc/Desc)
Kidneys
Rectum
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4
Q

Which galactose metabolism is more severe and what is the enzyme associated with it?

A

Classic galactosemia; Galactose1phosphate uridyl transferase (GALT)

vomiting lethargy failure to thrive with feeding.

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5
Q

Deficiency in Galactokinase will give rise to what symptoms?

what enzyme is upregulated in this deficiency?

A

cataracts ; Aldose Reductase

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6
Q

Bilious vomiting first 24 hours of life =?

A

intestinal obstruction below second part of duodenum.

due to:
intestinal stenosis
atresia

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7
Q

Intraabdominal infections are usually caused by which 2 organisms? -classify them

A

E.Coli- Gram negative
B. Fragilis- Gram negative bacillus

also enterococci, streptococci

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8
Q

Best treatment for long term PUD therapy?

A

Antibiotics for h.pylori infection
(Metronidizole, tetracycline, amoxicillan, clarithromycin)

+ PPi/bizmuth for 14 days

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9
Q

How does sucralfate act?

A

binds to base of mucosal ulcers protecting against gastric acid. Allows for healing.

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10
Q

What drug has prokinetic and antiemetic proprties and is used to treat GI motility disorders like gastroparesis and and prevent nausea/ vomiting? what kind of drug is this?

A

Metoclipramide (dopamine anatagonist)

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11
Q

What is MIsoprostol and how is it used?

A

Prostaglandin E1 aalog used to prevent NSAID induced ulcer disease.

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12
Q

What binds oxaloacetate in the first step of the TCA (krebs) cycle to form citrate?

A

Pantothenic acid (co-enzyme A is active form)

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13
Q

RAS is activated by what to lead to Map kinase activation and eventually gene activation?

A

inactive GDP

RAS = ACTIVE with GTP => Raf=> Map Kinase => transcr. factor activation

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14
Q

Most common malignant hepatic lesion?

A

metastasis from another primary site

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15
Q

What is diffuse hepatic fibrosis with replacement of normal lobular architecture by fibrous-lined parenchymal nodules a sign of?

A

cirrhosis

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16
Q

Hindgut encompasses what 4 parts of the GI Tract? whats its blood supply?

A

distal 1/3 of transverse colon, descending colon, sigmoid,, colon, and rectum.

IMA

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17
Q

does the Inferior mesenteric vein course with the IMA?

A

no

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18
Q

IgA protease is produced by which bacteria? where does it act on IgA?

A

Meningitidis species

Hinge Region

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19
Q

How does IgA protease aid bacterial invasion?

A

cleases IgA protease at hinge region and cannot bind and inhibit the action of pili or fimbriae to mucosal adherenc and penetration

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20
Q

which bacteria use inhibiion of phago-lysozomal fusion to evade host?

A

M. tuberculosis
M. leprae
Legionella
Ehrlichia

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21
Q

which evasion mechanism impairs opsonization and phagocytosis? which bugs do this?

A 
capsule formation
S. pneumoniae
N. meningitidis
H. flu
Cryptococcus neoformans
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22
Q

Which hepatitis has a anticteric (subclinical) infection?

A

Hepatitis A

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23
Q

What test would you use to determine whether an elevated Alk Phos is of hepatic or bony origin?

A

y-glutamyl transpeptidase is predominat in hepatocytes andbiliary epithelia

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24
Q

Why do anti-HepC antibodies not give the host an effective immune response?

A

remarkable variety in the antigenic structure of hepC virus ENVELOPE proteins

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25
Q

5 proteins that can bbind DNA

A 
transcription factors
steroids
thyroid proteins
Vitamin D receptors
retinoic acid receptors
MYC proteins (transc. factors)
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26
Q

Describe Conn’s syndrome + 3 symptoms

A

aldosterone secreting tumor (adenoma) leading to
PRIMARY HYPERadlosteronism

-hypokalemia, met. alkalosis, decr. plasma renin activity

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27
Q

what is an opiate antidiarrheal like meperidine? what receptors does it bind to?

A

Diphenoxylate; mu-opiate receptors=> slow motility

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28
Q

What drug is used for secretory diarrhea?

A

Ocreotide

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29
Q

Which cofactor is necessary for synthesis of delta-aminolevulinic acid? what disease is this d-aminolevulinic acid elevated in?

A

pyridoxal phosphate

lead poisoning

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30
Q

What mechanisms and triggers are in the cephalic phase of digestion

A

vagal and cholinergic mechanisms

thought of, smell, sight of food

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31
Q

a delta agent infection refers to what? what is else necessary for this infection?

A

Hep D infection

co-infection with hepatitis B

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32
Q

where are parietal cells found in gastric glands? what do they secrete?

A

Superficial layer

intrinsic factor
HCL

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33
Q

where are chief cells found in gastric glands? what do they secrete?

A

DEEP layers

pepsinogen

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34
Q

Most common benign vascular tumors in adults?

A

Cherry Hemangiomas

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35
Q

What type of diverticulum is Meckels?

what does this mean?

A

True diverticulum

3 layers (mucosa, submucosa, muscularis)

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36
Q

Presentation and findings in Meckel’s diverticulum patient

A

Failure to obliterate the omphalomesenteric duct;

Ectopic acid secreting gastric tissue cells=> Rectal bleeding, intestinal obstruction but usually asymptomatic

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37
Q

What enzyme initiates pancreatic damage in acute necrotizing pancreatitis?

A

activation of trypsinogen to trypsin which activates zymogens (protease, elastase, phospholipase)

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38
Q

what enzyme of pancreatitis is activated for pancreatic autodigestion?

A

tyrpsin activates

PROTEASES

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39
Q

Vascular damage and hemorrhage of pancreatitis is accomplished by which enzyme?

A

Elastase (which is activated by trypsin)

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40
Q

Fat necrosis seen in pancreatitis is done by which enzymes?

A

lipase/phospholipase

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41
Q

what is the systemic circulation shunt for paraumbilical veins? clinical manifestation?

A

Sup/Inf epigastric veins

Esophageal varices

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42
Q

left gastric vein utilizes which portosystemic shunt?

A

esophageal veins

esophageal varices

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43
Q

superior rectal veins drain to what systemic shunt if portal system is blocked?

A

middle & inferior rectal veins

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44
Q

gall bladder disease risk factors?

A

female, fat, forties

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45
Q

What is responsible for contraction of gallbladder?

Where is it produced?

A

CCK

I-cells of Duodenum

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46
Q

chemotactic agents?

A 
IL-8
N-formylated peptides
Leukotriene B4
5-HETE
C5a
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47
Q

Where does Iron Absorption occur?

A

duodenum/proximal jejunum.

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48
Q

what might a gastrojujunostomy cause?

A

Iron deficiency anemia;

also B12 malabsorpotion, folate, VitD (fat solubles) and calcium in other gastric bypass SXs

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49
Q

what part of mRNA is NOT TRANSCRIBED?

A

PolyA tail

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50
Q

how does HepB increase risk for HCC

A

virus integrates its DNA into the host genome => Chronic liver cell injury (more likely to have mutations), encodes HBx which binds p53 (cannot suppress)

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51
Q

ETEC produces which to toxins?

A

Heat Labile (LT/ cholera-like) = adenylate cyclase=incr cAMP

Heat Stable Enterotoxin =Guanylate cyclase =incr. cGMP

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52
Q

When does Extrahepatic biliary atresia usually present

A

3rd-4th week of life with Jaundice

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53
Q

lab findings of biliary atresia

A

increased direct biliruubin
increased alk phos,
increased y-glutamyl transferase

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54
Q

liver biopsy of biliary atresia

A

marked intrahepatic ductule proliferation
portal tract edema and fibrosis
Parenchymal cholestasis

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55
Q

Gilbert syndrome presentation?

deficient enzyme?

A

mild unconjugated hyperbilirubinemia

UDP-glucuronyl transferases

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56
Q

What is the marker for hgh infectivity in chronic Hep B

A

HBeAg

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57
Q

What is present in window phase of Hepatitis B infection?

A

Anti-HBc IgM

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58
Q

Effects of Alcohol on catabolism? (Ratio & which process of glucose is affected)

A

NADH/NAD+ ratio is increased

Gluconeogenesis is inhibited

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59
Q

Cocaine does what to glucose levels?

A

hyperglycemia due to adrenergic activation

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60
Q

C-labeled urea test is used to detect what?

A

Urease produced by H.pylori infection

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61
Q

Most common benign liver tumor? microscopic description?

A

Cavernous hemangioma

Carvernous blood filled vascular spaces with single epithelial layer

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62
Q

hyperestrinism can cause? 4

A

gynecomastia
spider angiomata
testicular atrophy
decreased body hair

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63
Q

Impaired B-oxidation is usually due to which enzyme? timing of and description of symptoms that are seen?

A

Acteyl coA dehydrogenase (first enzyme in process?

fasting from 16-24 hrs…. failure to produce ketone bodies, hypoglycemia ( gluconeogenesis is impaired)

64
Q

Calcification of gallbladder diffusely is known as what condition? and is associated with risk of which disease?

A

porcelain gallbladder

up to 33% gallbladder carcinoma

65
Q

Chronic liver disease with autoimmune destruction of the intrahepatic bile ducts and cholestasis describes which disease?

A

Primary biliary cirrhosis

66
Q

What symptoms are seen with Primary biliary cirrhosis?

A

Pruritus, fatigue, pale stools, xanthelesma

jaundice, steatorrhea, portal hypertension and osteopenia if it prgresses

67
Q

When is air in biliary tree seen? (pneumobilia)

A

Gallstone ileus (large gallstone erodes intestinal lumen)

68
Q

Conditions associated with Primary Biliary Cirrhosis

A 
Sjogrens syndrome
Raynauds
scleroderma
autoimmune thyroid 
hyperthyroidism
celiac disease
69
Q

Diffuse esophageal spasms mimics what disease clinically? Describe DES?

A

periodic non-peristaltic contractions of esophagus, dysphagia & chest pain

Angina Pectoris

70
Q

Difference between an Ulcer and a Erosion?

A

ULCER- Deeper = into submucosa

EROSION- shallow= into but not through the Muscularis Mucosa

71
Q

1g of protein = ?calories
1g of carbs=?calories
1g of fat=?calories

A 
protein= 4calories/g protein
carbs=   4calories/g carb
fat=        9calories/g of fat
72
Q

What side effect can be seen in opiod analgesic treatment?

A

contraction of sphincter of oddi=> incr. common bile duct pressure=> gallbladder pressure=> biliary colic & RUQ pain

73
Q

Common complication associated with Uclerative Colitis?

A

Toxic megacolon? moreso in UC than Chron’s

74
Q

How do you diagnose toxic megacolon?

A

plain XRAY Film

75
Q

What accumulates in Cori’s Disease? what is the enzyme? symptoms

A

small chain dextrin-like matrerial within hepatocytes.

Debranching enzyme

hypoglycemia, hypertriglyceridemia, ketoacidosis, hepatomegaly.

76
Q

Fixing damaged DNA process: 5 steps

A

Glycosylase cleaves the altered base leaving AP Site

Endonuclease cleaves 5’ end

lyase cleaves 3’ sugar phosphate

DNA polymerase and
Ligase fill the single nucleotide gaps

77
Q

What classification of virus is HepB?

What is its mechanism of replication?

A

Double stranded circular DNA enveloped virus

Reverse Transcriptase (RNA-dependent DNA-polymerase activity)

78
Q

Three enzymes that stimulate gastric acid secretion (HCL)?

A

acetylcholine (vagal stimulation)
Histamine
Gastrin

79
Q

What can block gastric acid secretion?

A

Proton pump inhibitors block the final common pathway of HCL secretion from pareietal cells (the parietal cell apical membrane H+/K+-ATPase proton pump)

PGE2
secretin
VIP

80
Q

what bug is Gram - OXIDASE + comma shaped rods that grow on alkaline medium.

A

Vibrio Cholerae

NOT CAMPYLOPACTER JEJUNI

81
Q

MOA of Vibrio Cholerae?

similar to which bug?

A

Cholera toxin increases cAMP in intestinal mucosa, inreased efflux of sodium & chloride (water follows = no blood or leukocytes seen)

Heat LABILE toxin of ETEC

82
Q

Erythrocytes and Leukocytes in diarrhea is diagnostic of which bugs?

A

EIEC and Shigella

83
Q

Pus with diarrhea is characteristic of which pathogen?

A

Salmonella Species (enteritidis)

84
Q

AZT full name

A

Zidovudine

nrti= thyymidine analog without 3’-OH group making 3’-5’ phosphodiester bon formation impossible.

85
Q

How is HepAV transmitted

A

fecal oral route

overcrowding/ poor sanitation = contaminated food/water/raw&steamed shellfish

Think of dirty ass seafood markets.

86
Q

when would (perianal/bladder/vaginal/retroperitoneal) fistulae + nonbloody diarrhea/fever & Malaise be seen?

what locations are involved?

A

Crohn’s disease

any portion of GI Tract from mouth to anus

87
Q

how does hepatitis cause cell damage

A

Viral HBsAg on cell surface stimulate CD*+ Tcells to destroy infected hepatocytes

88
Q

Secretins function and what produces it?

A

increases bicarb and secretion of alkaline pancreatic juices. INHIBITS gastric acid secretion + pyloric sphincter contraction

S cell of Small Intestine

89
Q

Acute viral hepatitis necrosis + ?

VIral Hepatitis
Hepatocyte injury =?
Hepatocyte death =?

final result

A

Hepatocyte Necrosis + Apoptosis ( acidophilic bodies/councilman bodies/apoptotic bodies)

diffuse swelling & ballooning degeneration

Lobular architectual disruption and confluent hepatocyte necrosis = bridging necrosis

monouclear inflammation develops in the sinusoids/portal tracts

90
Q

Gastrin does what 2 things?

A

facilitates HCL secretion

proliferation/hyperplasia of parietal cells

91
Q

Which 2 bugs have toxins that inhibit the 60s ribosomal subunit in human cells blocking protein synthesis preventing binding of tRNA?

A

Shigella dysenteriea

EHEC shiga like toxin

92
Q

Most diverticula are which type? and whats another name for these and why?

A

False

Pulsion, herniation through the wall => painless rectal bleeding

93
Q

Dimercaperol is the chlating agent used for which poisoning?

A

Arsenic

94
Q

CaNa2EDTA is the chelating agent used for which poisoning (2)? MOA

A

lead
Mercury

Complexes with mono-/di-/trivalent ions

95
Q

Deferoxamine is the chelating agent used for which poisoning? MOA

A

Iron poisoning

Binds to iron in bloodstream=> urinary excretion

96
Q

Cyanide poisoning antidote?

Cyanomethemoglobin is the poisonous agent or or blocking agent?

A

Amyl Nitrite forms cyanomethemoglobin blocking binding to ETC enzymes

97
Q

Pb (lead) toxicity symptoms? at least 3

microscopic finidings?

A 
abdominal colic
constipation
headache
lead line
peripheral neuropathy

microcytic hypochromic anemia + basophilic stippling

98
Q

Risk factors for HCC?

A 
HCV
HBV
alcoholic cirrhosis
aflatoxis
hemochromatosis
(elevated AFP) with cirrhosis
99
Q

How does HBV cause cancer (HCC)?

A

Viral DNA integration into host genome=> Hbx activates synthesis of insulin-like growth factor II and receptors for insulin-like growth factor I.

100
Q

prolonged Cholestatis can cause what deficiencies?

A

Intestinal malabsorption and nutritional deficiencies of fat soluble (ADEK) vitamins

+VitD def=> osteomalacia

101
Q

Causes of cholestatis? (intra v extrahepatic)

A

Intrahepatic= Drug induced, PrimaryBiliary Cirhossis, Primary Sclerosing Cholangitis

Extrahepatic= Choledocholithiasis, Malignancy, Primary Sclerosing Cholangitis (its both)

102
Q

Significance of Adenomatous polyps? how does aspirin effect these?

A

contain dysplastic mucosa which are premalignant

decrease there formation and stop progression to colon adenocarcinoma

103
Q

Cox-2 overexpression is seen in what disease?

A

Colon Adenocarcinoma

104
Q

How is REYES syndrome cause liver damage? (Macro v Micro?) mechanism?

A

inborn METABOLIC error that makes them sensitive to toxic effects of salicylates

Microvesicular steatosis of hepatocytes

105
Q

Which type of adenomatous polyp is more likely to undergo malignant transformation?

A

Villous > Tubular

to become adenocarcinoma

106
Q

Name 4 non-neoplastic polyps

A

Hyperplastic
Hamartoumous
Inflammatory
Lympoid

107
Q

Which strain of E.COLI cannot ferment sorbitol and does not produce a glucuronidase?

A

EHEC O157:H7

108
Q

Location of Chrons v UC?

A

Crohn- Anwhere (perianal fistula/strictures common

UC- Colorectal intestine, RECTUM ALWAYS

109
Q

Wall involvement of Chrons v UC

A

Chron- Entire wall inflammation, Noncaseating granulomas, skip lesions

UC- Mucosa + Submucosa only, continuous

110
Q

Clincal pres of Chron v UC

A

more abdominal pain

v.

bloody diarrhea (both have abd. &diarrheal invoment)

111
Q

Lynch Syndrome mutations?

mutation type?

A

MSH2 MLH 1 (mutS mutL human homologs)

Mismatch repair types

112
Q

Whipple disease findings? bug?

A

distended macrophages in lamina propria of SI. M0 conain PAS positive Tropheryma whippelii bacilli (rod shaped)

113
Q

Microscopic findings of clear/foamy cytoplasm of enterocytes is characteristic of?

A

abetalipoproteinemia

114
Q

Infection with HCV usually leads to what outcome?

A

stable chronic hepatitis > chronic hepatitis progressing to cirrhosis (close 2nd))

115
Q

Difference between EIEC & EHEC

A

EIEC- bloody diarrhea (similar to shigellosis) + FEVER

EHEC- shiga-like toxin = bloody diarrhea (NO FEVER)

116
Q

Most common cause of Hyatid cysts in humans?

In which organ AND how does it manifest?

A

Echinococcus Granulosus from foreign countries (new zealand, austrailia, medditerannean)

LIVER GRANULOMA. (also lung, muscle, bone)

117
Q

What disease causes an obstruction of the Hepatic Vein? how does this normally drain?
What is seen on liver biopsy?

A

Budd-Chiari Syndrome

drains liver/portal circ. to systemic circ

Centrilobular congestion & Fibrosis

118
Q

A patient receiving total parental nutrition can develop what? treat how? Pathenogenesis (2)?

A

Gallstones; exogenous CCK

1) Biliary Stasis due to Decreased CCK release (absent enteral stimulation)
2) in ileal resection- supersaturation of bile with Cholesterol (enterohepatic bile acid circulation disturbances)

119
Q

Hemachromatosis description ?

Including Mechanism/Mutation/Proteins/Location

A

Auto-Recessive

Abnormally high gastrointestinal iron absorption due to mutation of HFE [@chrom6= basolateral epithelial surface protein that detects amounts of circulating IRON] => Unregulated uptake of iron/TRANSFERRIN complex into small intestine crypts

p.s. HFE protein binds to Transferrin receptor for regulation

120
Q

Clinical Manifestations of Hemachromatosis (6)

A 
Skin hyperpigmentation
Diabetes (due to pancreatic islet cell destruction)
Abdominal pain
HCC
Liver Cirrhosis w/ hepatomegaly
Cardiac Dysfxn/ enlargement
Arthopathy
Impotenence
121
Q

Gallbladder hypomotility can cause what?

A

Biliary SLUDGE

122
Q

What types of stones are associated with crohn’s disease and why?

A

OXALATE STONES IN KIDNEY (not particularly calcium- see below.)

Bile normally absorbed in ileum is not absorbed therefore bile is excreted leading to decreased lipid absorption as well. These lipids now stay in lumen of GI and bind CALCIUM (which normally binds OXALATE for fecal excretion). Now the Oxalate is absorbed and can precipitate as stones in Kidney.

123
Q

6 organs/systems Crohns disease can effect + How?

A

Intestines- fistulas, abcesses, perianal dx, incr. adenocarcinoma

Liver-cholangiocarcinoma

Malabsorption- Oxalate renal stones, hypoproteinemia, b12/folate deficiencies, gallstones

Skin-erethyma nodosum

Joints-anthritis , ankylosing spodylitits

Eyes- Iritis, uveitis, episcleritis

124
Q

F=?

A

AUC oral curve/ AUC IV curve …… AUC= Area under the curve.

125
Q 
BLOTS:
North
West
South
Southwetern
A

N-mRNA
W- Proteins
S- DNA
SW- DNA–bound protein

126
Q

Protease Inhibitor
MOA
side effects

A

inhibit cleavage of polypeptide precursor into mature viral proteins

hyperglycemia
lipodystrophy-buffalo hump
inhibition of p-450

127
Q

Pathogenetic toxins of C.DIff.

Clinical manifestations

Rx

A

Enterotoxin A- watery Diarrhea
Cytotoxin B- colonic epithelial cell necrosis & fibrin deposition.

Toxic megacolon, white/yellow psuedomembranes

PCR detection treated with Metronidazole

128
Q

DOC for Giardia Lambia? which others are treated similarly

A

Metronidazole

H.pylori
amembiasis
trichomoniasis

129
Q

indications for:
Cipro/fluoroquinolones in diarrhea
Mebendazole
Albendazole

A

Blood + mucousy diarrhea (EIEC + Shigella)inflammatory travelers diarrhea.
Exept C. Jejuni=?____mycin

Anti-helminthic works on microtubules for roundworms (ancylostomata, Asccaris, Enterobius)

tapeworm (cestodes)- echinococcus Granulosus = no diarrhea = liver cysts instead
c.jej = erythro

130
Q

Most Common Location of Colon Adenocarcinoma?

A

Rectosigmoid colon

2nd= Right Sided-Ascending colon ( more likely to bleed= Iron Def. Anemia)

131
Q

Common Coenzymes for Mitochondrial processes?
pyruvate dehydrogenase
aKG Dehydrogenase
branched-chain ketoacidDehydrogenase

A 
Thiamine
LIPOIC ACID
CoA
FAD
NAD+
132
Q

Defiency of Methylonate mutase can be due to deficiency in which cofactor?

A

methylmalonic aciduria = vitamin B12 dependent process

133
Q

Homocytinuria is characterized by which enzyme deficiency and which primary symptom?
what cofactors are necessary?

A

Cystathione synthase

premature atherosclerosis

b6= cystathionase/synthase
b12/folate= methionine conversion
134
Q

how does VIP/ VIPoma function?

what inhibits VIP and is used to treat VIPoma symptoms?

A

oversecretion of intestinal chloride loss into the stool (brings with it Na, K, and WATER) and INHIBITS gastric acid secretion

Somatostatin blocks this

135
Q

total gastrectomy leads to supplementation of what in pts? (think what gastric cells secrete yo)

A

Water-soluble vitamins B12

136
Q

Lactose name?

A

Galactosyl B1,4 glucose

137
Q

lesser omenta coverage & ligaments?

A

(liver-> lesser curvature of stomach)

hepatoduodenal
hepatogastric

138
Q

Gram Negative - Non lactose fermenter (what diagnostic test) No-H2S producing? what other classification is true of this bug?

A

Shigella (mackonkeys agar)

Oxidase Neg (TSI agar to determine H2S producer)

139
Q

CEEKS = what bugs & classifications

A

CEEKS = gram negative, lactose Fermenters on MacConckey’s agar

Citrobacter + Serratia = SLOW fermenters

Enterobacter + E.Coli + Klebsiella= FAST fermenters

140
Q

ShYPPS= what bugs & Classications

A

MacConkeys Agar Lactose Fermenters

Sh + Y= shigella/yersinia

P.Aeru= OXIDASE + (ALL others Oxidase -)

P + S = Proteus/Salmonella

141
Q

Fenoldopam

A

dopamine-1 receptor agonist. arteriolar dilation and natriuresis.

142
Q

Where does Sorbitol Dehydrogenase work? (2)

where does it get sorbitol from?

A

Seminal vesicles
lens

from Aldose Reductase converting glucose to Sorbitol

143
Q

Vitamin D deficiency? (Common cause of this)

serum findings?

symptoms?

A

Celiac disease =Vit D malabsorption

decr. serum phosporus, decr serium calcium
incr. serium parathyroid hormone (2ndary hyperparathyroidism)

Bone pain & Muscle weakness

144
Q

Malignant transformation of an adenoma to a carcinmoma requires the mutation of which TWO genes?

Overall pathway to carcinoma

A

p53 & DCC

APC tumor suppressor (polyp formation) –> K-ras protooncogene (cell proliferation)–> p53 & DCC = malignant

145
Q

Lethal fulminant hepatitis can be caused by?

Presents how & with what symptoms?

A

Inhaled anesthetics (halothane)

Acute viral hepatitis;

  • elevated Aminotransferase levels
  • prolonged prothrombin time
  • eosinophilia
146
Q

Short acting Insulin types? Time frame for ea:

which one is used for IV DKA?

which is best for post-meal hyperglycemia?

A

Regular (2-4hrs) = DKA

Lispro/Aspart/Glulisine (45-75min) = Postmeal hyperglycemia

147
Q

Secretory IgA is found where?

A

mucus
tears
saliva
colostrum

148
Q

Why are non-selective B-blockers contraindicated in DM pts?

A

They will mask adrenergic symptoms associated with Hypoglycemia (leading to worsened hypoglycemia.

149
Q

Adrenergic effects of hypoglycemia? When are they seen?

A

increased sympathetics=>

stimulate: lipolysis @ periphery & gluconeogenesis in in liver
decrease: perhipheral glucose consumption

Early in hypoglycemia

150
Q

What is the volume of the plasma compartment? what are the characteristic of drugs that stay in plasma?

A

high molecular weight
high plasma protein binding
high charge
hydrophilicity

151
Q

why would D-xylose be measured?

A

to differentiate between Pancreatic or Intestinal Malabsorption.

it is a monosaccharide and does not require pancreatic enzymes

152
Q

how do TZDs affect adiponectin of DM pts?

A

low in DM patients

TZDs increase Adiponectin in these patietnts

153
Q

What metabolic effect can be seen in alcoholic patients?

A

Metabolic Alkalosis due to vomiting from Malory weiss tear

154
Q

difference between Mallory Weis tear

& Boerhaave syndrome

A

Bor= TRANSMURAL TEAR (air/fluid leak to mediastinum/pleura)

vs mallory = mucosal tear

155
Q

what enzyme is a glucose sensor in Pancreatic cells?

A

Glucokinase

*Decr. in hereditary gestational diabetes

UWORLD QuestionQuestions (12 decks)

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