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USMLE Step 1 Random Facts > GI > Flashcards

GI Flashcards

1
Q

what structure contains the ligamentum teres hepatis?

A

falciform ligament

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2
Q

what structure contains the portal triad?

A

hepatoduodenal ligament

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3
Q

what is the portal triad?

A

hepatic artery, portal vein, common bile duct

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4
Q

what structure connects the greater and lesser omentum sacs?

A

hepatoduodenal ligament

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5
Q

what structure contains the gastric arteries?

A

gastrohepatic ligament (liver to LESSER CURVATURE of stomach) - cut during surgery to access lesser sac

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6
Q

what structure contains the gastroepiploic arteries?

A

gastrocolic ligament (GREATER CURVATURE and transverse colon) - part of GREATER omentum

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7
Q

what structure contains short gastric and left gastroepiploic vessels?

A

gastrosplenic ligament (GREATER curvature + spleen)

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8
Q

what structure separates the greater and lesser sacs on the right?

A

gastrohepatic

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9
Q

what structure separates the greater and lesser sacs on the left?

A

gastrosplenic

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10
Q

what structure contains the splenic artery and vein, and tail of the pancreas?

A

splenorenal

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11
Q

ulcers can extend to?

A

submucosa

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12
Q

erosions can extend to?

A

mucosa only (epithelium, lamina propria, muscularis mucosa)

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13
Q

this part of the pancreas is formed from the VENTRAL bud alone

A

uncinate process

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14
Q

pancreas derived from?

A

foregut

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15
Q

ventral pancreatic buds form?

A

inferior/posterior part of head
main pancreatic duct of Wirsung
uncinate process

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16
Q

dorsal pancreatic buds form?

A 
body
tail
isthmus
accessory pancreatic duct
MOST of head
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17
Q

third part of duodenum trapped b/w?

A

aorta and SMA

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18
Q

only duodenal part not retroperitoneal?

A

1st

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19
Q

2nd part of duod in ass w/?

A

head of pancreas (ampulla of Vater)

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20
Q

3rd part of duod in ass w/?

A

uncinate process of pancreas

SMA/SMV

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21
Q

RF for increased incidence of cholangiocarcinoma

A

primary sclerosing cholangitis
infection w/ Clonorchis sinenus
ulcerative colitis

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22
Q

carcinoid synd produces what?

A

high levels of serotonin

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23
Q

when is carcinoid synd not seen?

A

if limited to GI tract (bc serotonin undergoes first-pass metab in liver)

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24
Q

sympt of carcinoid synd

A

recurrent diarrhea, cutaneous flushing, asthmatic wheezing, right-sided valvular disease

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25
dx/tx of carcinoid synd
**increased 5-HIAA (metabolite of serotonin) in urine niacin deficiency tx = octreotide (somatostatin analog)
26
window period in Hep B?
when HbsAg is (-), AND HbsAb (-), but HbcAb (+)
27
virchow's node involves the
left supraclavicular node (mets from stomach)
28
sister mary joseph nodule involves
subcut periumbilical metastasis
29
what PUD causes pain w/ eating?
gastric ulcer
30
what PUD causes relief w/ eating?
duodenal ulcer
31
bleeding from what artery w/ ruptured gastric ulcer on lesser curvature?
left gastric artery
32
bleeding from what artery w/ ulcer on posterior wall of duodenum?
gastroduodenal artery
33
most common stomach cancer
adenocarcinoma
34
ligaments cut when removing spleen
gastrosplenic + splenorenal ligaments
35
arterial supply/venous drainage above pectinate line (proximal)?
A: superior rectal artery (branch of IMA) V: superior rectal vein --> inferior mesenteric vein --> portal system
36
hemorrhoid/cancer seen above pectinate line?
internal hemorrhoid - NOT painful (bc visceral innerv) adenocarcinoma
37
arterial supply/venous drainage below pectinate line (distal)?
A: inferior rectal artery (branch of internal pudendal artery) V: inferior rectal v. --> internal pudendal v. --> internal iliac v. --> IVC
38
hemorrhoid/cancer seen below pectinate line?
external hemorrhoid - painful! (bc somatic innerv - inferior rectal branch of pudendal n.) squamous cell carcinoma
39
autoimmune gastritis located in what part of stomach?
fundus/body
40
H.pylori chronic gastritis located in what part of stomach?
antrum
41
Mallory bodies typically seen w/?
alcoholic hepatitis
42
triad of Budd-Chiari synd
hepatomegaly ascites abdominal pain
43
cholelithiasis is
gallstones
44
cholecystitis is
inflamm/infection of GB
45
cholangitis is
inflamm/infection of biliary tree
46
choledocholithiasis is
gallstones in bile ducts
47
area of colon most suscept to infarction?
watershed area of splenic flexure
48
hereditary hyperbilirubinemia responding to phenobarbitol
Crigler-Najjar type II Gilbert synd bc increases liver enzyme synth
49
hereditary hyperbilirubinemia w/ black liver
Dubin-Johnson synd
50
air seen in GB and biliary tree a sign of?
cholecystenteric fistula leading to gallstone ileus (stone stuck in ileocecal valve)
51
level of celiac trunk
T12
52
level of SMA
L1
53
level of LEFT renal artery
L1
54
level of IMA
L3
55
level of bifurcation of aorta
L4
56
receives blood from both SMA + IMA
``` splenic flexure (watershed area) first affected in hypotension ```
57
the 4 anastomoses + origins
sup epigastric (internal thoracic/mammary) inf epigastric (external iliac) sup pancreaticoduod (celiac) inf pancreaticoduod (SMA) middle colic (SMA) inf colic (IMA) sup rectal (IMA) middle + inf rectal (internal iliac)
58
3 portal systemic shunts
forms varices! 1) left gastric v. esophageal v. 2) paraumbilical v. superficial and inf epigastric v. (BELOW umbilicus), sup epigastric and lateral thoracic v. (ABOVE umbilicus) 3) sup rectal middle + inf rectal
59
rectal drainage above + below pectinate line
above: sup rectal v. --> IMV --> portal system below: inf rectal v. --> internal pudendal v. --> internal iliac v. --> IVC
60
zone I of liver
affected 1st by viral hepatitis
61
zone III of liver
pericentral vein zone - affected 1st by ischemia (bc farthest from O2 blood) - contains P450 system - most sensitive to toxic inj (acetaminophen OD, alc tox) - site of alcoholic hepatitis
62
blood flows from
zone 1 --> 3
63
bile flows from
zone 3 --> 1
64
tumor of pancreatic head blocks
common bile duct ONLY
65
diaphragmatic hernia in infants can be due to
defective dev't of pleuroperitoneal membrane
66
potent gastrin stimulators
phenylalanine tryptophan Calcium
67
bile acids conjugated to what substances?
glycine or taurine
68
rate-limiting enzyme in bile prod
cholesterol 7alpha-hydroxylase
69
bilirubin conjugated to what to make soluble?
glucuronic acid
70
tx of esoph varices
vasopressin
71
duodenal ulcer perforation usually in
anterior > posterior
72
rectal SPARING
Crohn's!
73
continuous lesions w/ RECTUM ALWAYS involved
UC
74
unique ass w/ Crohn's (vs. UC)
migratory polyarthritis erythema nodosum kidney stones strictures
75
unique ass w/ UC (vs. Crohn's)
pyoderma gangrenosum (tissue necrosis causing deep ulcers) primary sclerosing cholangitis toxic megacolon
76
colorectal cancer presenting w/ Fe-def anemia is located where
ascending
77
tx for ulcer hemorrhages
somatostatin (octreotide) - bc decreases splanchnic blood flow
78
microvesicular fatty change
Reye's synd
79
macrovesicular fatty change
hepatic steatosis (mod alc intake)
80
why is AST >> ALT in alcoholic hep?
bc B6 def decreases ALT
81
centrilobular congestion + necrosis
halogenated inhalation anesthetics injury nutmeg liver Budd-Chiari
82
cirrhosis w/ PAS positive globules in liver
alpha1-antitrypsin def
83
tx for physiological neonatal jaundice?
phototherapy (converts UCB to water soluble form)
84
tx of PBC
ursodiol
85
black pigment stones
ass w/ hemolysis | radiopaque (white)
86
brown pigment stones
ass w/ infection | radiolucent (black)
87
air in biliary tree ass w/
``` cholecystenteric fistula in SI (b/w GB and SI) gallstone ileus (stone obstructing ileocecal valve) ```
88
positive Murphy's sign usually in
cholecystitis
89
charcot's triad of cholangitis? Reynold's pentad?
triad - jaundice, fever, RUQ pain | pentad - triad + hyPOtension, altered mental status
90
pancreatic pseudocyst = complic of what? and lined by?
acute pancreatitis | lined by granulation tissue
91
signs of pancreatic cancer
- abd pain radiating to back - wt loss - Trousseau's sign (migratory thrombophlebitis) - Courvoisier's sign (palpable, NONTENDER [aka painLESS] GB w/ obstructive jaundice)

USMLE Step 1 Random Facts (35 decks)

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