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ESA 3 - Recap > GI > Flashcards

GI Flashcards

1
Q

Give the typical features of Crohns Disease

A

Transmural inflammation

Fissures

Fibrosis

Submucosal inflammation

Cobblestoning

Crohns’ Thin Friends Fuck Sexy Customers

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2
Q

Give the typical features of Ulcerative Colitis

A

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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3
Q

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
A
  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
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4
Q

Explain the mechanism of secretion of serous saliva

A
  1. Acini produce secretion which is isotonic with iodide and enzymes
  2. Ducts reduce Na and increase K and HCO3.
  3. More rapidly saliva is produced, less modified, except for HCO3 and enzymes.
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5
Q

Name the receptors found on an acinar cell to produce saliva

A

Luminal - Cl in HCO3 out antiporter.

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

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6
Q

What are the sympathetic and parasympathetic innervations of the salivary glands

A

Sympathetic - Superior cervical ganglion

Parasympathetic - Glossopharyngeal

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7
Q

What vertebral levels does the oesophagus extend to?

A

C6-T11

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8
Q

Name the abdominal flat muscles and the direction they run

A

External oblique - inferomedially

Internal oblique - Superiormedially

Transversus abdominis

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9
Q

What spinal level are the kidneys found at?

A

Right - T12 - L3

Left - T11 - L2

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10
Q

What can the greater sac be divided into?

A

Supracolic and infracolic

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11
Q

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

A

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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12
Q

Define a hernia

A

Protrusion of an organ through a weakness in surounding tissue

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13
Q

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

A

Roof - Transversus abdominis

Anterior - Internal oblique

Posterior - Transversus fascia

Floor - Inguinal ligament

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14
Q

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

A

Enterochromaffin like cells

H2 receptors

cAMP

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15
Q

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

A
  1. Chief cells - Pepsinogen
  2. Parietal cells - HCl
  3. Neck cells - Mucus and alkali
  4. G cells - Gastrin
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16
Q

How are enterochromaffin like cells stimulated?

A

by gastrin and ACh

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17
Q

What stimulates and inhibits gastrin secretion

A

Stimulates - Peptides in lumen and distension of stomach

Inhibits - low pH

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18
Q

What is cholestasis? WHat components would be elevated?

A

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

Alkaline phosphatase and bilirubin

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19
Q

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

A

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

Conditions - red cell defects, Gilberts syndrome, infections

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20
Q

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

A

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

Causes - hepatitis, cirrhosis (intrahepatic)

gallstones and carcinoma (extrahepatic)

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21
Q

What are the associated pathologies of portal hypertension?

A

Varices in oesophagus and rectum open to hemorrhage

Toxins in blood bypass liver due to varices.

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22
Q

What are the clinical manifestations of portal hypertension? Name 4

A

Caput medusae

Varices hemorrhaging

ascites

Splenomegaly

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23
Q

What are the signs of hepatic encephalopathy?

A

Flapping tremors

intellectual deterioration

Personality changes

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24
Q

Give 4 possible causes of acute pancreatitis

A

GETSMASHED

Gallstones

Ethanol

Trauma

Steroids

Mumps

Autoimmune

Scorpion bite

Hyperlipiaemia

ERCP

Drugs

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25
Q

What would lab analysis find in pancreatitis?

A

Increase in alkaline phosphatase, pancreatic amylase and glycaemia

Decrease in calcium

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26
Q

What clinical symptoms come with acute pancreatits?

A

Pain, vomiting, dehydration, shock

27
Q

What clinical symptoms would occur in chronic pancreatits?

A

Malabsorption, weight loss, jaundice, pain

28
Q

WHat are the clinical features of a pancreatic carcinoma?

A

Weight loss, jaundice, trousseaus sign (phlebitis)

29
Q

What are the histological features of the large intestine?

A

Large crypts, thick mucosa

No microvilli

Columnar absorptive cells with goblet cells

30
Q

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?

A

Into the lumen - SGLT1

into the blood - GLUT2

31
Q

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

A

Trypsin - Cleaves near basic AAs

Chymotrypsin - Cleaves near armoatic AAs

Carboxypeptidase - Cleaves near C terminal

32
Q

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

A

Facilitated diffusion into cell and then Ca-ATPase into blood

Needs calcitonin cofactor

33
Q

How is iron absorbed in the intestines?

A

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.

34
Q

Name the artery that supplies:

a) caecum and appendix
b) ascending colon
c) Transverse colon
d) descending colon
e) sigmoid colon
f) rectum

A

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

35
Q

Give the clinical symtpoms associated with UC and CD

A

Abdo pain

persistent diarrhoea

Weight loss

Nausea

GI bleeding

Vomiting

Anaemia

36
Q

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

A

Get disease into remission using aminosalicylates and corticosteroids. Then use immosuppressing drugs

UC - You can remove infected bowel

37
Q

Common cuase for ginigivitis?

A

Streptococcus mutans

38
Q

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

A

Intestinal with glands

Diffuse - signet ring cells

39
Q

What are the microscopic features of an adenocarcinoma

A

Occasionally mucinous

Occasionally signet ring cell types

40
Q

What are the microscopic features of a pancreatic carcinoma?

A

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

41
Q

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

A

Gastrin producing tumour of the pancreas

Excess gastrin produced results in acid from parietal cells

42
Q

Name the 9 divisions of the abdomen

A

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

43
Q

Name a PPI and a H2 antagonist drug

A

PPI - omeprazole

H2 antagonist - Cimetidine

44
Q

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

A

Hormones from intestine and rate of acceleration of peristaltic wave

45
Q

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

A

Outpouching of small intestine

2%

2 inches

2 feet away from ileocecal valve in ileum

46
Q

How do you diagnose and treat gastritis?

A

Diagnose with FBC or stool test.

Treat with antibiotics and PPIs

47
Q

How does GORD present?

A

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

48
Q

How do you treat GORD?

A

PPI, lose weight, reduce alcohol, antacids

49
Q

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

A

Clarithromycin and amoxicillin

50
Q

What spinal level is the inferior oesophageal sphincter?

A

T11

51
Q

What spinal level does the coeliac branch from?

A

T12

52
Q

What spinal level does the SMA and IMA branch from?

A

SMA - L1

IMA - L3

53
Q

Give 2 examples of bile acids

A

cholic acid

chenodeoxycholic acid

54
Q

What secretes alkaline juice from the liver?

A

Duct cells

55
Q

What are the secretions of the exocrine pancreas?

A

Peptidases, lipases, amylases, alkaline juice

56
Q

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

A

Enzymes - Acinar cells

Juice - Duct cells

57
Q

What hormone stimulates pancreatic enzymes?

A

CCK

58
Q

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

A

released from duodenal APUD cells

Stimulated by hypertonicity, fats in the duodenum

Inhibits production of acid in the stomach

59
Q

Explain how bile acids digest fats

A
  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
60
Q

What hormone stimulates bile release from gall bladder?

A

CCK - gall bladder contracts

61
Q

How does H pylori modify gastric phsyiology?

A

Stimulates G cells to produce more gastrin

62
Q

What are the features of stimulated saliva?

A

Higher volume , less hypotonic

More enzymes, more alkaline

63
Q

Label

A
64
Q

Label

A

Hepatopancreatic ampulla of Varter

ESA 3 - Recap (6 decks)

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