USMLE > GI > Flashcards

GI Flashcards

(59 cards)

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1
Q

Meckel’s Diverticulum

A

-persistant vitelline duct, Rule of 2’s, presents with intestinal obstruction or rectal bleeding -has 2 types of ectopic tissue, gastric and pancreatic

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2
Q

Drug Toxicity in liver

A

centrilobular or zone 3 necrosis

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3
Q

ZES (Zollinger-Ellison Syndrome)

A

-peptic ulcers in “non-traditional locations”-negative for H. pylori and NSAID use-excessive gastrin production (normally produced by…G-cells)

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4
Q

Wilson’s disease

A

-copper accumulation-psych changes, shuffling rigid gate, kayser-fleischer rings-tx; copper chelators: D-penicillamine

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5
Q

Kuppfer cells

A

-reticuloendothelial cells of the liver, help clear infections from blood- (mesangial cells are equivalent in kidney and spleen)

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6
Q

HLA B27

A

PAIR- psoriasis, ankylosin spondylitis, inflammatory bowel (UC), Reiter’s

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7
Q

hepatic adenoma

A
  • typically benign- classically associated with OCP (resolves when discontinued)
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8
Q

PSC

A
  • commonly associated with UC (70% of PSC have UC, only 4% of UC have PSC)-intrahepatic and extrahepatic bile duct degredation-increased risk of colon cancer- beading on retrograde imaging
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9
Q

PBC

A
  • increased serum anti-mitochondrial antibodies- destruction of small intrahepatic ducts- autoimmune destruction- leads to high cholesterol levels and subsequent deposition, xanthomas
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10
Q

acute pancreatitis

A
  • often brought on after a bout of heavy drinking- complications include pseudocysts after pancreatic enzymes are trapped and damage large portions of tissue
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11
Q

Dubin-Johnson

A
  • unable to excrete conjugated (direct) bili- other liver enzymes normal- generally benign, occasional bouts of icterus/jaundice- liver is black on gross examination- (rotor’s is same deal, less severe, no pigment of hepatocytes)
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12
Q

paneth cells

A
  • release antibacterial and antifungal granules in small intestine
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13
Q

small bowel obstruction (associations)

A
  • common complication of gallstone illeus- air/fluid levels on upright x-ray
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14
Q

tobacco and peptic ulcers

A

twice as likely, particularly duodenal

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15
Q

hereditary hemochromatosis

A
  • due to disorder of HFE gene, resulting in unregulated absorption of iron from GI tract- gynecomastia, cirrhosis, bronze diabetes, spider telangectasias- tx with serial phlebotomy
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16
Q

H. pylori ulcer (location and consequence)

A
  • duodenal - perf, leading to rupture of gastroduodenal artery
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17
Q

Hirschprung Disease

A

-failure of neural crest cells to migrate appropriately-lack innervation needed to relax sphincters, severe constipation and dilation of colon proximal to aganglionic region-associated with downs syndrome

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18
Q

Chron’s (complications)

A

-kidney stones, erythema nodosum, uveitis, migratory polyarthritis- granulomas

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19
Q

hypercalcemia

A

-fatigue, muscle weakness, constipation-high serum calcium, low phosphate and low potassium

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20
Q

carcinoid syndrome

A

-tumor of neuroendocrine cells, produce 5-HT-triad of chronic diarrhea, facial flushing, tricuspid stenosis-only if mets to liver (otherwise 5-HT is metabolized in liver)

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21
Q

annular pancreas

A

-pressure on the duodenum-bilious vomit (green)

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22
Q

Chrons Tx

A

-sulfasalazine, glucocorticoids, azithioprine, methotrexate (immunosuppresives)-infliximab (TNF-alpha inhibitor) for refractory

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23
Q

Brunner’s glands

A

secrete bicarb in the duodenum

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24
Q

Duodenal ulcer vs. peptic ulcer

Study These Flashcards
A

-duodenal ulcer feels better after eating (stimulates brunner’s glands to secrete bicarb, neutralize acid –> weight gain-peptic ulcers feel worse after eating as it increases acid production –> weight loss

25
type A vs type B chronic gastritis
type A - autoimmunie, fundus and bodytype B - H. Pylori, antrum (increased risk of MALT lymphoma)
26
peyer's patches
-lympoid tissue only found in *illeum*-shigella, yersina, mycobacterium avum and some e.coli use peyer's patches M cells to gain access to host
27
VIPoma
-tumor in the tail of the pancreas-causes secretion of water and electrolytes into intestinal lumen as well as relaxing smooth muscle and sphincters... profuse watery diarrhea
28
gastric neoplasm
-almost always adenocarcinoma-sister mary joseph nodule (periumbilical) and/or virchow nodule (supraclavicular) -intestinal, associated with H. pylori-diffuse, linitis plastica
29
crigler-najjar
-lack of glucuronyl transferase -unconjugated hyperbili- (gilbert's is same deal, but less severe deficiency)
30
kasai procedure
-direct connection of intrahepatic bile ducts to small bowel-Tx for extrahepatic biliary atresia, must happen quickly, cirrhosis occurs in 6 mo if untreated-elevated direct bili, clay stools, dark urine (making bili, can't get it where it needs to go, excreted in urine
31
space of disse
-contain stellate cells, which contain vitamin A and produce collagen-cells responsible for fibrosis following liver injury
32
IBS
-diagnosis of exclusion, all lab values should be normal-ish-diffuse abdominal pain that is relieved by defecation
33
achalasia
-loss of neurons in auerbach plexus-leads to dysphagia to solids and liquids-Tx with ballooning-associated with chagas-bird beak
34
terminal illeum
-most commonly involved site of chrons-site for absorption of B12 and fats
35
Hepatitis E
-single stranded non-enveloped RNA-self-resolving, N/V, diarrhea, jaundice-especially dangerous (20% mortality) in pregnant women
36
FAP
-APC gene on chromosome 5... Autosomal DOMINANT-100% convert to colon cancer, Tx: colectomy -Subtypes: garnder– FAP + soft tissue/bone tumors, Turcot– FAP + CNS tumors (turcot...turban)
37
saliva secretion (ion composition)
-starts similar composition to plasma at acinar cells-ductal cells reabsorb Na/Cl, excrete K and bicarb-flow rate increase, less time to change ions-exeption: bicarb, selectively secreted at higher rates w/high flow
38
Weight loss, fatigue, painless jaundice
-think pancreatic adenocarcinoma-in the head of the pancreas, obstructs common bile duct-direct hyperbili
39
indirect vs. direct hernia
-indirect: newborn, failure of process vaginalis to close, passes lateral to the inferior epigastric artery-direct: older men, passes through abdominal wall, medial to inferior epigastric artery
40
Lynch's syndrome
-HNPCC, mismatch repair-80% risk of colon cancer-associated risk of other GI and GU cancers (also female reproductive organs)
41
GI blood supply (celiac, SMA, IMA)
-celiac: foregut... esophagus, stomach, spleen, first part of duodenum, pancreas-SMA: midgut... lower duodenum to first 2/3 of transverse colon-IMA: hindgut... distal 1/3 of colon to rectum
42
Malonyl CoA
-building block for FAS, made from acetyl-CoA by enzyme acetyl-CoA carboxylase (biotin as cofactor)-important INHIBITOR of rate limiting step in beta-oxidation, prevents assoc. with carnatine and subsequent transport into mitochondria
43
intussusception
-sudden onset, colicky pain-most commonly ileocecal-possible complication of henoch-schonlein purpura
44
Nutrient absorption in GI tract (Duodenum, Jejunum, Ileum)
-Duodenum: Iron-Jejunum: Folate-Ileum: B12, vitamins ADEK (fat), FFA, and carbs
45
scleroderma
-autoimmune disease, connective tissue disease-affects the lower 2/3 of smooth muscle in esophagus, dysphagia
46
Barret's Esophagus
-metaplasia of squamous cell to intestinal columnar epithelium
47
acute pancreatitis
-often self-resolving, requiring only supportive tx-electrolyte abnormality: hypocalcemia... leads to hyperexcitability of nerve cells (Chvostek's sign)
48
Chvostek's sign
-pain elicited by tapping over 7th cranial nerve-hypocalcemia
49
Infiltrative liver enzyme tests
-only alk phos is elevated, normal everything else-(one possible cause entamoeba histolytica)
50
Tumor markers in Pancreatic cancer
-CA 19-9 and carcinoembryonic antigen (CEA)-also elevated serum lipase, amylase and alk phos
51
food poisoning.. all of it
see screenshot on desktop
52
celiac sprue
- villous blunting - northern european descent - dermatitis herpetiformis
53
secretin
- causes increases in pancreatic and biliary secretion of bicarb - produced in duodenum in response to high acid levels
54
Tumors of the cheek
- most common: pleomorphic adenoma (well circumscribed, painless, slow growing) - Warthin's: well circumscribed, benign mass of lymphoid cells - less common: poorly circumscribed, mixed cells, think carcinoma
55
Pyoderma gangrenosum
-associated with IBD
56
glucose transporters (glut 2, glut 4, glut 5, sglt-1)
- Glut-2: basolateral intestinal transporter, glucose, galacose and fructose - Glut-4: glucose in muscle and adipose tissue - Glut-5: fructose across apical border of intestine, Na INDEPENDENT - SGLT-1: glucose and galactose across apical border of intestine, Na DEPENDENT
57
Cushing's Ulcer
- acute stress related ulcer (resulting in superficial capillary bleeding into GI tract, related to HEAD INJURY - elevated ICP
58
most common cause of appendicitis in children
-lymphoid mass causing obstruction, typically following viral infection
59
GI cell types
- A: (pancreas) glucagon - B: (pancreas) insulin - D: (pancreas) somatostatin - G: (antrum and dueodenum) gastrin - I: (duodenum and jejunum) cholesystikinin - K: (duodenum and jejunum) gastric inhibitory peptide - S: (duodenum) secretin (inhibits gastric acid, stimulates bicarb)
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