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Step 1 Crush 250! - Hans > GI 357 - 361 > Flashcards

GI 357 - 361 Flashcards

1
Q

name 3 causes for acute (erosive) gastritis

A
  1. NSAIDs usage –> dec PGE2 –> dec mucosal protection
  2. Burns (Cushing ulcer) –> dec plasma volume –> sloughing of gastric mucosa
  3. Brain injury (Cushing ulcer) –> inc vagal stimulation –> inc ACh –> inc H+ production
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2
Q

what type of GI cell is inhibited by inc vagal stimulation?

A

D cells in pancreatic islets, GI mucosa

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3
Q

how is heme metabolized?

A

by heme oxygenase to biliverdin, which is reduced to bilirubin

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4
Q

explain how bilirubin is being excreted

A

unconjugated bilirubin is removed by liver, conjugated with glucuronate, and excreted in bile

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5
Q

where does RBCs –> heme –> unconjugated bilirubin

A

macrophage

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6
Q

what happens to the unconjugated bilirubin in the bloodstream?

A

binds with albumin

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7
Q

what is responsible for the yellow color of urine?

A

urobilin

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8
Q

what is responsible for the brown color of the stool?

A

stercobilin

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9
Q

what test do you use to diagnose pancreatic insufficiency?

A

D-xylose absorption test

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10
Q

do you get normal D-xylose absorption test in pancreatic insufficiency?

A

yes

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11
Q

in what situation do you get dec excretion of the D-xylose absorption test?

A

with intestinal mucosa defects or bacterial overgrowth

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12
Q

inc neutral fat in the stool indicate

A

pancreatic insufficiency

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13
Q

chronic inflammation, atrophy, calcification of the pancreas can lead to

A

pancreatic insufficiency

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14
Q

what mutation can cause chronic pancreatic insufficiency?

A

CFTR mutation

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15
Q

old men with whipple dz will present what 3 main symptoms?

A
  1. cardiac symptoms
  2. arthralgias
  3. neurologic symptoms
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16
Q

salivary gland tumors are gengerally

A

benign and occur in parotid gland

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17
Q

what is the most common salivary gland tumor?

A

pleomorphic adenoma

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18
Q

pleomorphic adenoma is also called

A

benign mixed tumor

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19
Q

pleomorphic adenoma is composed of 2 things

A
  1. chondromyxoid stroma

2. epithelium

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20
Q

presentation of pleomorphic adenoma (benign mixed tumor) is

A

painless and mobile mass

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21
Q

what is the most common malignant tumor?

A

mucoepidermoid carcinoma

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22
Q

presentation of mucoepidermoid carcinoma?

A

painless, slow growing

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23
Q

what are the components of mucoepidermoid carcinoma?

A

mucinous and squamous

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24
Q

what is the name of the benign cystic tumor with germinal center?

A

warthin tumor

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25
Q

what is another name for warthin tumor?

A

papillary cystadenoma lymphomatosum

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26
Q

2 causes for secondary achalasia?

A
  1. chagas dz (T. cruzi infection)

2. malignancies (mass effect or paraneoplastic)

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27
Q

achalasia is due to failure of relaxation of LES due to loss of

A

myenteric (Auerbach) plexus

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28
Q

what 2 factors in achalasia lead to progressive dysphagia to solids and liquids (vs. obstruction - solids only)?

A

high LES resting pressure and uncoordinated peristalsis

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29
Q

what is the consequence of untreated achalasia?

A

esophageal sq. cell carcinoma

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30
Q

what path is associated with pts with rheumatoid arthritis taking NSAIDs daily?

A

acute (erosive) gastritis

31
Q

name 2 types of chronic gastritis

A
  1. type A (fundus/body)

2. type B (antrum)

32
Q

what is the most common type of chronic (nonerosive) gastritis?

A

type B (antrum) caused by H. pylori infection

33
Q

which type of chronic gastritis is associated with inc risk of MALT lymphoma?

A

type B (antrum)

34
Q

what is the cause for type A (fundus/body) chronic gastritis?

A

autoantibodies to parietal cells, pernicious anemia, achlorhydria

35
Q

what path is associated with rugae of stomach so hypertrophied that they look like brain gyri

A

menetrier dz

36
Q

explain the pathophysio of menetrier dz

A

gastric hyperplasia of mucosa –> hypertrophied rugae, excess mucus production with resultant protein loss and parietal cell atrophy with dec acid production

37
Q

is menetrier precancerous?

A

yes

38
Q

what are the 3 causes for pancreatic insufficiency?

A
  1. cystic fibrosis
  2. obstructing cancer
  3. chronic pancreatitis
39
Q

what will be the result of the lactose tolerance test for pts with disacchraridase def?

A

administration of lactose produces symptoms and serum glucose rises

40
Q

why does self limited lacatse def occur following injury such as viral enteritis?

A

b/c lactase is located at tips of intestinal villi

41
Q

diff btw celiac sprue and tropical sprue?

A

tropical sprue has similar findings as celiac sprue (affects small bowel), but responds to antibiotics

42
Q

what is the cause for tropical sprue?

A

unknown, but seen in residents or recent visitors to tropics

43
Q

name 3 antibodies found in celiac?

A
  1. anti-endomysial
  2. anti-tissue transglutaminase
  3. anti-gliadin
44
Q

what type of cancer is associated with celiac?

A

T-cell lymphoma, small bowel carcinoma

45
Q

what is the problem in celiac?

A

autoimmune mediated intolerance of gliadin (gluten protein found in wheat)

46
Q

what genes are associated with celiac?

A

HLA-DQ2, HLA-DQ8

47
Q

what is the name for subcutaneous periumbilical metastasis in stomach cancer?

A

sister mary joseph nodule

48
Q

in stomach cancer, what node is involved with Lt supraclavicular node by metastasis from stomach cancer?

A

virchow node

49
Q

what is the name of the stomach tumor that is associated with bilateral metastases to ovaries with abundant mucin secreting signet ring cells?

A

krukenberg

50
Q

what is the characteristic description of the stomach wall in diffuse type stomach cancer?

A

stomach wall grossly thickened and leathery (linitis plastica)

51
Q

5 causes for intestinal stomach cancer?

A
  1. H. pylori
  2. dietary nitrosamines (smoked food)
  3. tobacco smoking
  4. achlorhydria
  5. chronic gastritis
52
Q

what is the most common location of intestinal stomach cancer?

A

lesser curvature

53
Q

how does the intestinal stomach cancer lesion look like?

A

ulcer with raised margins

54
Q

what are the 3 signs for stomach cancer?

A
  1. weight loss
  2. early satiety
  3. acanthosis nigricans
55
Q

what are the 2 types of ulcer complications?

A
  1. hemorrhage

2. perforation

56
Q

where does hemorragic ulcer take place?

A

gastric, duodenal (post > ant)

57
Q

two arteries that are ruptured in hemorrhagic ulcer?

A

1 .Lt gastric a from ruptured gastric ulcer on the lesser curvature of stomach
2. gastroduodenal a from ulcer on the post wall of duodenum

58
Q

where does perforation take place as ulcer complication?

A

duodenal (ant > post)

59
Q

what are the 2 unique characters of perforation from ulcer complication?

A
  1. free air under diaphragm

2. referred pain to the shoulder via phrenic nerve

60
Q

what additional procedure must take place for pt with gastric ulcer?

A

biopsy margins to rule out malignancy

61
Q

causes of gastric ulcer?

A

NSAIDs

62
Q

cause for duodenal ulcer?

A

ZES

63
Q

compare the pain from gastric vs. duodenal ulcer

A

in gastric, pain can be greater with meals, but pain dec with meals in duodenal ulcer

64
Q

which type of ulcer has 100% association with H. pyroli?

A

duodenal

65
Q

name 10 risk factors for esophageal cancer

A
  1. achalasia
  2. alcohol (squamous)
  3. barret (adeno)
  4. cigarettes - both
  5. diverticula (Zenker, squamous)
  6. esophageal web (squamous)
  7. familial
  8. fat
  9. GERD
  10. hot liquids (sq.)
66
Q

what esophageal path is associated with dec LES pressure?

A

sclerodermal esophageal dysmotility

67
Q

what causes the low LES pressure in sclerodermal esophageal dysmotility?

A

esophageal smooth muscle atrophy

68
Q

what causes punched out ulcers?

A

HSV 1

69
Q

what causes linear ulcers?

A

CMV

70
Q

path associated with mucosal lacerations seen in alcoholics and bulimics?

A

mallory weiss

71
Q

path associated with glossitis, esophageal webs with inc risk of esophageal sq cell carcinoma

A

plummer vinson syndrome

72
Q

which path is unresponsive to GERD therapy?

A

eosinophilic esophagitis

73
Q

what esophageal path is associated with lye ingestion?

A

esophageal strictures

Step 1 Crush 250! - Hans (41 decks)

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