State the rules regarding the type of bacteria if: 1. Ends in coccus 2. is a Neisseria 3. Is TB or lactobacillus 4. Is clostridia 5. Is bacteroides fragilis 6. Everything else

1. Aerobic, gram positive, coccus 2. Aerobic, gram negative, coccus 3. Aerobic, gram positive, bacilli 4. Anaerobic, gram positive, bacilli 5. Anaerobic, gram negative, bacilli 6. Aerobic, gram negative, bacilli

GI Flashcards by Osaama Aldabbagh

Give the typical features of Crohns Disease

Transmural inflammation

Fissures

Fibrosis

Submucosal inflammation

Cobblestoning

Crohns’ Thin Friends Fuck Sexy Customers

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Give the typical features of Ulcerative Colitis

Continuous Anatomical distribution

Rectal involvement

Gross bleeding

Mucosal friability

Only in Colon

Continuous Rectal involvement results in Gross bleeding and Mucosal Friability of Colon

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State the rules regarding the type of bacteria if:

Ends in coccus
is a Neisseria
Is TB or lactobacillus
Is clostridia
Is bacteroides fragilis
Everything else

Aerobic, gram positive, coccus
Aerobic, gram negative, coccus
Aerobic, gram positive, bacilli
Anaerobic, gram positive, bacilli
Anaerobic, gram negative, bacilli
Aerobic, gram negative, bacilli

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Explain the mechanism of secretion of serous saliva

Acini produce secretion which is isotonic with iodide and enzymes
Ducts reduce Na and increase K and HCO3.
More rapidly saliva is produced, less modified, except for HCO3 and enzymes.

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Name the receptors found on an acinar cell to produce saliva

Luminal - Cl in HCO3 out antiporter.

Basolateral - NaKATPase, K Cl symporter, Na-H antiporter, CO2 diffuses in.

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What are the sympathetic and parasympathetic innervations of the salivary glands

Sympathetic - Superior cervical ganglion

Parasympathetic - Glossopharyngeal

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What vertebral levels does the oesophagus extend to?

C6-T11

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Name the abdominal flat muscles and the direction they run

External oblique - inferomedially

Internal oblique - Superiormedially

Transversus abdominis

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What spinal level are the kidneys found at?

Right - T12 - L3

Left - T11 - L2

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What can the greater sac be divided into?

Supracolic and infracolic

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What is the difference between males and females in the peritoneum? Why is there a differnece? Why is it clinically relevant?

Difference is males is closed, females it isnt

Due to uterorectal pouch having an opening.

Infections of vagina and uterus can spread to peritoneum

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Define a hernia

Protrusion of an organ through a weakness in surounding tissue

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Regarding the inguinal canal, what is the roof, floor, anterior, and posterior made up of?

Roof - Transversus abdominis

Anterior - Internal oblique

Posterior - Transversus fascia

Floor - Inguinal ligament

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How does histamine act on parietal cells? What is the intracellular signaling mechanism? What cells release it?

Enterochromaffin like cells

H2 receptors

cAMP

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Name the 4 cell types found in the gastric pits and their secretions

Chief cells - Pepsinogen
Parietal cells - HCl
Neck cells - Mucus and alkali
G cells - Gastrin

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How are enterochromaffin like cells stimulated?

by gastrin and ACh

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What stimulates and inhibits gastrin secretion

Stimulates - Peptides in lumen and distension of stomach

Inhibits - low pH

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What is cholestasis? WHat components would be elevated?

Cholestasis is blocking of the cystic duct, bile cant reach duodenum

Alkaline phosphatase and bilirubin

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What lab findings would there be in prehepatic jaundice? Name some conditions that can lead to this type of jaundice

Findings - hyperbilirubinaemia, anaemia, decrease in haptoglobin, increase in LDH

Conditions - red cell defects, Gilberts syndrome, infections

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What causes cholestatic jaundice? What lab findings would there be?

Findings - hyperbilirubinaemia, bilirubin in urine (dark), increase in liver enzymes

Causes - hepatitis, cirrhosis (intrahepatic)

gallstones and carcinoma (extrahepatic)

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What are the associated pathologies of portal hypertension?

Varices in oesophagus and rectum open to hemorrhage

Toxins in blood bypass liver due to varices.

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What are the clinical manifestations of portal hypertension? Name 4

Caput medusae

Varices hemorrhaging

ascites

Splenomegaly

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What are the signs of hepatic encephalopathy?

Flapping tremors

intellectual deterioration

Personality changes

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Give 4 possible causes of acute pancreatitis

GETSMASHED

Gallstones

Ethanol

Trauma

Steroids

Mumps

Autoimmune

Scorpion bite

Hyperlipiaemia

ERCP

Drugs

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What would lab analysis find in pancreatitis?

Increase in alkaline phosphatase, pancreatic amylase and glycaemia Decrease in calcium

What clinical symptoms come with acute pancreatits?

Pain, vomiting, dehydration, shock

What clinical symptoms would occur in chronic pancreatits?

Malabsorption, weight loss, jaundice, pain

WHat are the clinical features of a pancreatic carcinoma?

Weight loss, jaundice, trousseaus sign (phlebitis)

What are the histological features of the large intestine?

Large crypts, thick mucosa No microvilli Columnar absorptive cells with goblet cells

What is the name of the receptor that takes glucose into the intestinal epithelial cell from the lumen? What is the name of the receptor that takes the glucose into the blood stream?

Into the lumen - SGLT1 into the blood - GLUT2

What enzymes are used to break down peptides? How does each peptidase work?

Trypsin - Cleaves near basic AAs Chymotrypsin - Cleaves near armoatic AAs Carboxypeptidase - Cleaves near C terminal

How is calcium absorbed in the intestines and what cofactors are needed?

Facilitated diffusion into cell and then Ca-ATPase into blood Needs calcitonin cofactor

How is iron absorbed in the intestines?

Iron --\> gastric acid --\> gastroferrin --\> transferrin --\> cell --\> transferrin Iron solubilised by gastric acid and then transferred to gastroferrin. Mucosal cells secrete transferrin and take complex in using receptor mediated endocytosis.

Name the artery that supplies: a) caecum and appendix b) ascending colon c) Transverse colon d) descending colon e) sigmoid colon f) rectum

a) ileocolic arteries b) right colic artery c) middle colic artery d) left colic artery e) sigmoidal artery f) superior rectal artery

Give the clinical symtpoms associated with UC and CD

Abdo pain persistent diarrhoea Weight loss Nausea GI bleeding Vomiting Anaemia

How do you manage CD and UC? What can you do to UC that you cant do to CD?

Get disease into remission using aminosalicylates and corticosteroids. Then use immosuppressing drugs UC - You can remove infected bowel

Common cuase for ginigivitis?

Streptococcus mutans

What are the 2 types of microscopic features a gastric malignancy can take?

Intestinal with glands Diffuse - signet ring cells

What are the microscopic features of an adenocarcinoma

Occasionally mucinous Occasionally signet ring cell types

What are the microscopic features of a pancreatic carcinoma?

Well formed glands with or without mucin. May contian zymogen granules

What is a gastrinoma and how does it cause gastric ulcers?

Gastrin producing tumour of the pancreas Excess gastrin produced results in acid from parietal cells

Name the 9 divisions of the abdomen

Epigastric, umbilical, suprapubic, hypochondriac, lumbar and iliac.

Name a PPI and a H2 antagonist drug

PPI - omeprazole H2 antagonist - Cimetidine

What affects the volume of each squirt of chyme into the duodenum?

Hormones from intestine and rate of acceleration of peristaltic wave

What is meckels diverticulum? What proportion of people have one. WHere is it located and how long?

Outpouching of small intestine 2% 2 inches 2 feet away from ileocecal valve in ileum

How do you diagnose and treat gastritis?

Diagnose with FBC or stool test. Treat with antibiotics and PPIs

How does GORD present?

Dyspepsia worse on lying down, bent over or drinking a hot drink

How do you treat GORD?

PPI, lose weight, reduce alcohol, antacids

What antibiotics would you use to treat an ulcer due to H pylori?

Clarithromycin and amoxicillin

What spinal level is the inferior oesophageal sphincter?

T11

What spinal level does the coeliac branch from?

T12

What spinal level does the SMA and IMA branch from?

SMA - L1 IMA - L3

Give 2 examples of bile acids

cholic acid chenodeoxycholic acid

What secretes alkaline juice from the liver?

Duct cells

What are the secretions of the exocrine pancreas?

Peptidases, lipases, amylases, alkaline juice

What secretes the enzymes and what secretes the alkaline juice in the pancreas?

Enzymes - Acinar cells Juice - Duct cells

What hormone stimulates pancreatic enzymes?

CCK

Where is CCK released from and what stimulates it? What does CCK inhibit?

released from duodenal APUD cells Stimulated by hypertonicity, fats in the duodenum Inhibits production of acid in the stomach

Explain how bile acids digest fats

1. Acids emulsify lipids 2. lipids digested by pancreatic lipases 3. Micelles form which are carried to the unstirred layer of intestine 4. Diffuses into cell 5. Taken into chylomicron into lymphatics

What hormone stimulates bile release from gall bladder?

CCK - gall bladder contracts

How does H pylori modify gastric phsyiology?

Stimulates G cells to produce more gastrin

What are the features of stimulated saliva?

Higher volume , less hypotonic More enzymes, more alkaline

Label

Hepatopancreatic ampulla of Varter