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DIT > GI > Flashcards

GI Flashcards

1
Q

most common salivary gland tumor

A

pleomorphic adenoma
epithelial and mesenchymal tissue
often affects the parotid gland as a painless mobile mass

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2
Q

second most common benign salivary tumor

A

Warthin’s tumor

double layer of epithelial tissue around a benign germinal center (lymphoid like)

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3
Q

most common malignant salivary tumor

A

mucoepidermoid carcinoma
mucinous and squamous components
painful mass that involves facial nerve commonly

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4
Q

extruding viscera covered by sac and sometimes includes liver

A

omphalocele

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5
Q

extruding viscera not covered by sac

A

gastroschisis

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6
Q

esophageal diverticula and location

A

Zenker diverticulum: above UES
Traction: middle esophagus
Epiphrenic: above LES

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7
Q

Plummer-Vinson syndrome

A

Dysphagia (esophageal webs), glossitis, and iron deficiency anemia

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8
Q

hematemesis with retching

A

Mallory-Weiss syndrome

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9
Q

specialized columnar epithelium on biopsy of esophagus

A

Barrett’s

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10
Q

biopsy of a pt with esophagitis reveals large pink intranuclear inclusions and host cell chromatin that is pushed to the edge of the nucleus

A

HSV-1

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11
Q

biopsy of pt with esophagitis reveals enlarged cells, intranuclear and cytoplasmic inclusions, and a clear perinuclear halo

A

CMV: cytomegalovirus

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12
Q

esophageal biopsy reveals lack of ganglion cells between inner and outer muscular layers

A

Achalasia

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13
Q

protrusion of the mucosa in the upper esophagus

A

esophageal web

associated with Plummer-Vinson

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14
Q

outpouching of all layers of the esophagus found just above the LES

A

epiphrenic diverticulum

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15
Q

goblet cells seen in the distal esophagus

A

Barrett’s

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16
Q

a PAS stain on a biopsy obtained from pt with esophagitis reveals hyphate organisms

A

candida

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17
Q

esophageal pouch found in the upper esophagus

A

Zenker diverticulum

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18
Q

esophageal adenocarcinoma

A

progressive dysphagia and weight loss
Barrett’s, smoking, obesity and GERD predispose
most common in US

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19
Q

esophageal squamous cell carcinoma

A

progressive dysphagia and weight loss
alcohol, diverticula, esophageal web, and hot liquids predispose
most common worldwide

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20
Q

what receptors increase acid production

A

M3: ACh from vagus (atropine blocks)
H2: histamine from ECL cells stimulated by gastrin (H2 blockers)
CCKB: gastrin
prostaglandins and somatostatin inhibit

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21
Q

stimulators of gastrin

A

phenylalanine, tryptophan, calcium

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22
Q

stomach biopsy reveals neutrophils above the basement membrane, loss of surface epithelium, and fibrin-containing purulent exudate

A

acute gastritis

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23
Q

stomach biopsy reveals lymphoid aggregates in the lamina propria, columnar absorptive cells, and atrophy of glandular structures

A

chronic gastritis

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24
Q

diffuse thickening of gastric folds, elevated serum gastrin levels, biopsy reveals glandular hyperplasia without foveolar hyperplasia

A

Zollinger-ellison syndrome

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25
Q

antacid causing diarrhea

A

magnesium hydroxide

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26
Q

antacid causing constipation

A

aluminum hydroxide

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27
Q

antacid causing hypercalcemia

A

calcium carbonate

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28
Q

antacid causing hypokalemia

A

all 3 antacids

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29
Q

Virchow’s node

A

stomach cancer with mets to left supraclavicular node

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30
Q

Krukenberg’s tumor

A

bilateral mets to ovaries from stomach cancer

signet ring cells

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31
Q

Sister Mary Joseph nodule

A

stomach cancer met to periumbilical nodes

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32
Q

mucin-filled cell with a peripheral nucleus

A

signet ring cell (gastric and LCIS)

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33
Q

most common type of stomach cancer

A

adenocarcinoma (US)

squamous cell worldwide

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34
Q

ovarian metastasis from gastric cancer

A

Krukenberg tumor

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35
Q

Gastric ulcerations and high gastrin levels

A

Zollinger-Ellison syndrome

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36
Q

acute gastric ulcer associated with elevated ICP or head trauma

A

Cushing ulcer

brain injury causes increased vagal stimulation which increases ACh and acid

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37
Q

acute gastric ulcer associated with severe burns

A

Curling ulcer

burns decreases plasma volume and cause sloughing of gastric mucosa

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38
Q

retroperitoneal structures

A

A DUCK PEAR

adrenal glands, duodenum, ureters, colon, kidneys, pancreas, esophagus, aorta, rectum

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39
Q

Prokinetic agents

A

cholinergic agonists (-chol)
AChE inhibitors
metocloproamide (5-HT4 agonist and D2 antagonist)
macrolides (stimulate motilin receptors for MMC)

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40
Q

antibodies associated with celiac sprue

A

anti-gliadin
anti-transglutaminase
anti-endomysial

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41
Q

small intestinal muscosa laden with distended macrophages in the lamina propria (filled with PAS+ granules and rod-shaped bacilli seen on EM)

A

Whipple’s disease

Tropheryma whipplei bacteria

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42
Q

defect in chylomicron exportation

A

abetaliprproteinemia

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43
Q

cramping associated with milk product

A

Lactase deficiency

disaccharidase def

44
Q

weight loss, diarrhea, arthritis, fever, adenopathy, and hyperpigmentation

A

Whipple disease

45
Q

common causes of small bowel obstruction

A

Adhesions
Bulge/Hernia
Cancer/Tumor (metastatic colorectal cancer)

46
Q

Classic symptoms of carcinoid syndrome

A

Bronchospasm
Flushing
Diarrhea
Right sided heart murmur (valvular disease)

47
Q

which pathological lesions of the colon are precancerous

A

adenomatous polyps

48
Q

most common cancer of the appendix

A

carcinoid

49
Q

GI hamartomas, hyperpigmentation of the mouth and hands

A

Peutz-Jeghers syndrome

50
Q

multiple colon polyps, osteomas, soft tissue tumor

A

Gardner syndrome

51
Q

“apple core” lesion on barium enema

A

colon cancer

52
Q

treatment for diverticulitis

A

metronidazole and fluoroquinalone or TMP-SMX

53
Q

most common cause of acute RLQ pain

A

appendicitis

54
Q

most common cause of acute LLQ pain

A

diverticulitis

55
Q

most common cause of acute RUQ pain

A

cholecystitis

56
Q

colonoscopy reveals very friable mucosa extending from the rectum to the distal transverse colon

A

ulcerative colitis

57
Q

most common site of colonic diverticula

A

sigmoid

58
Q

“string sign” on contrast x-ray

A

Crohn’s

59
Q

“lead pipe” appearance of colon on contrast x-ray

A

Ulcerative colitis

60
Q

what hormones stimulate pancreatic secretion

A

CCK and secretin

61
Q

rate-limiting step of carbohydrate digestion

A

oligosaccharide hydrolases

62
Q

causes of acute pancreatitis

A 
BAD HITS
biliary
alcohol
drugs (esp HIV protease inhibitors)
Hypertriglyceridemia/hypercalcemia
idiopathic
trauma
scorpion sting
63
Q

painless jaundice

A

pancreatic cancer

64
Q

most common cause of acute pancreatitis

A

gallstones and alcohol

65
Q

most common cause of chronic pancreatitis

A

alcohol

66
Q

enzyme responsible for conjugation of bilirubin

A

UDP glucuronyl transferase

67
Q

mildly decreased UDPGT

A

Gilbert syndrom

68
Q

completely absent UDPGT

A

Crigler-Najjar type I

69
Q

grossly black liver

A

dubin-johnson

70
Q

responds to phenobarbital

A

Crigler-Najjar type II

71
Q

treatment includes plasmapharesis and phototherapy

A

Crigler-Najjar type I

72
Q

asymptomatic unless under physical stress

A

Gilbert syndrome

73
Q

severe hyperbilirubinemia in a neonate

A

Crigle-Najjar type I

74
Q

mild, benign hyperbilirubinemia

A

Gilbert syndrome

75
Q

signs of portal HTN

A

caput medusae, esophageal varices, hematemesis and melena, hemorrhoids, splenomegaly, ascites

76
Q

drug cocktail for severe cirrhosis pt

A

diuretics, B-blocker, vit K, lactulose (for encephalopathy)

77
Q

triglyceride accumulation in hepatocytes

A

fatty liver disease

78
Q

eosinophilic inclusion in the cytoplasm of hepatocytes

A

Mallory bodies

seen in alcoholic hepatitis

79
Q

cancer closely linked to cirrhosis

A

hepatocellular carcinoma

80
Q

what is Budd-Chiari syndrome

A

occlusion of IVC or hepatic veins

81
Q

what is associated with Budd-Chiari syndrome

A

polycythemia vera, pregnancy, hepatocellular carcinoma

82
Q

mech of aspirin in Reye syndrome

A

aspirin inhibits mitochondrial enzymes which decreases B oxidation

83
Q

underlying problem in Wilson’s disease

A

impaired copper excretion and accumulation in liver

84
Q

asterixis, basal ganglia degeneration, Parkinsonian, Kayser-Fleischer rings, decreased ceruloplasmin, cirrhosis

A

Wilson’s disease

85
Q

treatment of Wilson’s

A

penicillamine

86
Q

Diabetes, bronze skin, and cirrhosis

A

classic triad of hemochromatosis

87
Q

lab tests and treatment for hemochromatosis

A

increased ferritin, transferrin saturation, and serum iron, decreased TIBC
TX: phlebotomy and deferoxamine

88
Q

risk factors for hepatocellular carcinoma

A

hep B and C, hemochromatosis, alpha 1 antitrypsin dis, hepatic adenoma, cirrhosis

89
Q

hepatomegaly, abdominal pain, ascites

A

Budd-Chiari syndrome

90
Q

green/yellow corneal deposits

A

Kayser-Fleischer rings (Wilson’s disease)

91
Q

low serum ceuloplasmin

A

Wilson disease

92
Q

cirrhosis, diabetes, hyperpigmentation

A

hemochromatosis

93
Q

cholelithiasis

A

gallstones

94
Q

cholecystitis

A

inflammation/infection of gallbladder

95
Q

cholangitis

A

inflammation/infection of biliary tree

96
Q

choledocholithiasis

A

gallstones in biliary tree

97
Q

intrahepatic causes of biliary obstruction

A

primary biliary cirrhosis
primary sclerosing cholangitis
drugs

98
Q

extrahepatic causes of biliary obstruction

A

pancreatic neoplasms
sclerosing cholangitis
cholangiocarcinoma
choledocholithiasis

99
Q

Primary biliary cirrhosis

A

autoimmune infection in middle aged females

anti-mitochondrial antibodies (AMA)

100
Q

primary sclerosing cholangitis

A

fibrosis of bile duct in men over 40

positive pANCA and beads on a string sign

101
Q

50yo woman presents with pruritis without jaundice and lab reveals positive AMA

A

primary biliary cirrhosis

102
Q

patient with GI bleeding has buccal pigmentation

A

Peutz-Jeghers syndrome

103
Q

60yo woman with RA and no alcohol history presents with fatigue and right abdominal pain; lab studies reveal high levels of ANA and ASMA, elevated serum IgG, and no viral serologic markers

A

autoimmune hepatitis (classic)

104
Q

liver biopsy on a 23yo woman with elevated levels of LKM-1 antibodies, no alcohol history, and no viral serologic markers; shows infiltration of the portal and periportal area with lymphocytes

A

autoimmune hepatitis

105
Q

ERCP reveals alternating strictures and dilation

A

primary sclerosing cholangytis

106
Q

weight lifter undergoes emergency surgery for life threatening condition. examination of section of small bowel reveals focal hemorrhages. what is responsible

A

incarcerated inguinal hernia

107
Q

in addition to colon cancer, what is one of the most common causes of GI bleeding in the elderly

A

angiodysplasia

DIT (28 decks)

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