GI

Question 1

Histology of esophagus

Answer 1

Nonkeratinized stratified squamous epithelium.

Question 2

Histology of stomach

Answer 2

Gastric glands.

Question 3

Histology of duodenum

Answer 3

Villi and microvilli

Question 4

Histology of jejunum

Answer 4

Plicae circulares and crypts of Lieberkühn.

Question 5

Histology of ileum

Answer 5

Peyer patches (lamina propria, submucosa), plicae circulares (proximal ileum), and crypts of Lieberkühn.

Largest number of goblet cells in the small intestine.

Question 6

Histology of colon

Answer 6

Colon has crypts of Lieberkühn but no villi; numerous goblet cells.

Question 7

What is zone I of the liver?

Answer 7

Zone I: periportal zone:

• Affected 1st by viral hepatitis
• Ingested toxins (e.g., cocaine)

Question 8

What is zone II of liver?

Answer 8

Zone II: intermediate zone.

Question 9

What is zone III of liver? what is is significant about this area?

Answer 9

Zone III: pericentral vein (centrilobular) zone:

• Affected 1st by ischemia
• Contains cytochrome P-450 system
• Most sensitive to metabolic toxins
• Site of alcoholic hepatitis

Question 10

What are the borders of Hesselbach triangle?

Answer 10

• Inferior epigastric vessels
• Lateral border of rectus abdominis
• Inguinal ligament

Question 11

What are the functions of bile?

Answer 11

• Digestion and absorption of lipids and fat-soluble vitamins
• Cholesterol excretion (body’s only means of eliminating cholesterol)
• Antimicrobial activity (via membrane disruption)

Question 12

elevated ALP

Answer 12

Obstructive hepatobiliary disease, HCC, bone disease

Question 13

elevated Aminotransferases (AST and ALT)

Answer 13

Viral hepatitis (ALT > AST) 
Alcoholic hepatitis (AST > ALT)

Question 14

elevated amylase

Answer 14

Acute pancreatitis, mumps

Question 15

Low ceruloplasmin

Answer 15

Wilson disease

Question 16

elevated γ-glutamyl transpeptidase (GGT)

Answer 16

elevated in various liver and biliary diseases (just as ALP can), but not in bone disease; associated with alcohol use

Question 17

elevated lipase

Answer 17

Acute pancreatitis (most specific)

Question 18

Name the retroperitoneal structures

Answer 18

SAD PUCKER:
Suprarenal (adrenal) glands
Aorta and IVC
Duodenum (2nd through 4th parts) 
Pancreas (except tail)
Ureters 
Colon (descending and ascending) 
Kidneys
Esophagus (lower 2/3) 
Rectum (partially)

Question 19

Name the connection & structures contained of the falciform ligament. What is it a derivative of?

Answer 19

connects liver to anterior abdominal wall

Contains ligamentum teres hepatis (derivative of fetal umbilical vein)

Derivative of ventral mesentery

Question 20

Name the connection & structures contained of the hepatoduodenal ligament. What does it border?

Answer 20

Liver to duodenum

Portal triad: proper hepatic artery, portal vein, common bile duct

Borders mental foramen which connects greater & lesser sacs

Question 21

Describe the pringle maneuver in relationship to hepatoduodenal ligament

Answer 21

ligament may be compressed bw thumb & index finger placed in mental foramen to control bleeding

Question 22

Name the connection & structures contained of the gastrohepatic ligament. What does it separate? what is significant during surgery?

Answer 22

liver to lesser curvature of stomach

gastric arteries

separates greater & lesser sacs on right

may be cut during surgery to access lesser sac

Question 23

Name the connection & structures contained of the gastrocolic ligament. What is this ligament a part of?

Answer 23

greater curvature & transverse colon

Gastroepiploic arteries

part of greater momentum

Question 24

Name the connection & structures contained of the gastrosplenic ligament. What does it separate?

Answer 24

greater curvature & spleen

short gastrics, left gastroepiploic vessels

separates greater & lesser sacs on left

Question 25

Name the connection & structures contained of the splenorenal ligament.

Answer 25

spleen to posterior abdominal wall

splenic artery & vein; tail of pancreas

Question 26

Name the artery, PANS innervation, vertebral level & structures supplied by the embryonic foregut region

Answer 26

Artery: celiac
PANS: Vagus
Vertebral level: T12/L1
Structures supplied: Pharynx to proximal duodenum; liver, gallbladder, pancreas, spleen (mesoderm)

Question 27

Name the artery, PANS innervation, vertebral level & structures supplied by the embryonic midgut region

Answer 27

Artery: SMA
PANS: Vagus
Vertebral level: L1
Structures supplied: Distal duodenum to proximal 2/3 of transverse colon

Question 28

Name the artery, PANS innervation, vertebral level & structures supplied by the embryonic hindgut region

Answer 28

Artery: IMA
PANS: Pelvic
Vertebral level: L3
Structures supplied: Distal 1/3 of transverse colon to upper portion of rectum; splenic flexure is a watershed region

Question 29

If branches off of the abdominal aorta are blocked, which arterial anastomoses compensate? (from origin)

Answer 29

Superior epigastric (internal thoracic/mammary) ↔ inferior epigastric (external iliac)

Superior pancreaticoduodenal (celiac trunk) ↔ inferior pancreaticoduodenal (SMA)

Middle colic (SMA) ↔ left colic (IMA)

Superior rectal (IMA) ↔ middle & inferior rectal (internal iliac)

Question 30

Describe the transjugular intrahepatic portosystemic shunt (TIPS) Tx

Answer 30

shunt b/w portal vein & hepatic vein percutaneously relieves portal hypertension by shunting blood to the systemic circulation

Question 31

What is the portal to systemic shunt w/ clinical sign of esophageal varices? Caput medusae? Anorectal varices (not internal hemorrhoids)?

Answer 31

Left gastric ↔ esophageal

Paraumbilical ↔ small epigastric veins of the anterior abdominal wall.

Superior rectal ↔ middle and inferior rectal

Question 32

What is the most common cause of megaloblastic anemia?

Answer 32

chronic gastritis