GI Flashcards
What contributes to ventral pancreatic bud?
uncinate process, main pancreatic duct
What contributes to dorsal pancreatic bud?
body, tail, isthmus, and accessory pancreatic duct
What contributes to both ventral and dorsal pancreatic bud?
head of pancreas
Unique about spleen origin and blood supply
Arises in the mesentery of the stomach (hence mesodermal) but is supplied by the foregut (celiac artery)
Level of celiac trunk
T12
level of SMA
L1
level of IMA
L3
level of AA bifurcation
L4
What is SMA syndrome?
3rd part (transverse) of duodenum entrapped between SMA and aorta causing intestinal obstruction
Structures supplied by celiac artery
Pharynx (vagus nerve only), lower esophagus (celiac artery only) to proximal duodenum; spleen, pancreas, liver+gallbladder
Gallstones that reach ampulla of vater can cause?
Cholangitis and pancreatitis because of obstruction of common bile duct and main pancreatic duct respectively
What makes up the femoral triangle?
Sartorius muscle, adductor longus, inguinal ligament and contains femoral vein artery and nerve
What contents are in the femoral sheath?
Femoral vein, artery, and canal (deep inguinal lymph nodes) NOT FEMORAL NERVE
Site of protrusion of indirect hernia
internal inguinal ring lateral to inferior epigastric
Site of protrusion of direct hernia
abdominal wall medial to inferior epigastric
Difference in flow in low and high flow states in the pancreas
Low flow-high cl- and subsequently low hco3-
High flow-high hco3- and subsequently low cl-
What converts trypsinogen to trypsin?
Enterokinase/enteropeptidase which is a brush border enzyme on duodenal and jejunal mucosa and they are important for activating other proteases as well that are secreted in zymogen form
What catalyzes the rate limiting step of bile synthesis?
cholesterol 7 alpha hydroxylase
What are bile acids conjugated to making them water soluble?
glycine or taurine
Behcet syndrome triad
Aphthous ulcers, genital ulcers, uveitis
2 most important risk factors for SCC in the US
Alcohol and Tobacco (cigarettes)
hemorrhage ulcer complication location and bleeding
Gastric located on lesser curvature of stomach (bleeding from left gastric artery)
Duodenal (posterior>anterior)–>posterior wall of duodenum with bleeding from gastroduodenal artery
perforation of ulcer complication and bleeding
Duodenal (anterior>posterior)–>may see free air under diaphragm with referred pain to shoulder via phrenic nerve
is duodoneal ulcer associated with cancer?
no
What is the sudan II stain?
1st step in screening for malabsorption syndromes by staining the stool (identifies fecal fat)
What drug can be given to increase liver enzyme synthesis in Criggler najJar type II
Phenobarbital
Triad of hemochromatosis
Hyperpigmentation of particularly sun exposed areas, secondary diabetes, micronodular cirrhosis
Cholestatic pattern of LFTs?
Increased conjugated bilirubin, increased cholesterol, increased ALP
