GI

Question 1

What contributes to ventral pancreatic bud?

Answer 1

uncinate process, main pancreatic duct

Question 2

What contributes to dorsal pancreatic bud?

Answer 2

body, tail, isthmus, and accessory pancreatic duct

Question 3

What contributes to both ventral and dorsal pancreatic bud?

Answer 3

head of pancreas

Question 4

Unique about spleen origin and blood supply

Answer 4

Arises in the mesentery of the stomach (hence mesodermal) but is supplied by the foregut (celiac artery)

Question 5

Level of celiac trunk

Answer 5

T12

Question 6

level of SMA

Answer 6

L1

Question 7

level of IMA

Answer 7

L3

Question 8

level of AA bifurcation

Answer 8

L4

Question 9

What is SMA syndrome?

Answer 9

3rd part (transverse) of duodenum entrapped between SMA and aorta causing intestinal obstruction

Question 10

Structures supplied by celiac artery

Answer 10

Pharynx (vagus nerve only), lower esophagus (celiac artery only) to proximal duodenum; spleen, pancreas, liver+gallbladder

Question 11

Gallstones that reach ampulla of vater can cause?

Answer 11

Cholangitis and pancreatitis because of obstruction of common bile duct and main pancreatic duct respectively

Question 12

What makes up the femoral triangle?

Answer 12

Sartorius muscle, adductor longus, inguinal ligament and contains femoral vein artery and nerve

Question 13

What contents are in the femoral sheath?

Answer 13

Femoral vein, artery, and canal (deep inguinal lymph nodes) NOT FEMORAL NERVE

Question 14

Site of protrusion of indirect hernia

Answer 14

internal inguinal ring lateral to inferior epigastric

Question 15

Site of protrusion of direct hernia

Answer 15

abdominal wall medial to inferior epigastric

Question 16

Difference in flow in low and high flow states in the pancreas

Answer 16

Low flow-high cl- and subsequently low hco3-

High flow-high hco3- and subsequently low cl-

Question 17

What converts trypsinogen to trypsin?

Answer 17

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

Question 18

What catalyzes the rate limiting step of bile synthesis?

Answer 18

cholesterol 7 alpha hydroxylase

Question 19

What are bile acids conjugated to making them water soluble?

Answer 19

glycine or taurine

Question 20

Behcet syndrome triad

Answer 20

Aphthous ulcers, genital ulcers, uveitis

Question 21

2 most important risk factors for SCC in the US

Answer 21

Alcohol and Tobacco (cigarettes)

Question 22

hemorrhage ulcer complication location and bleeding

Answer 22

Gastric located on lesser curvature of stomach (bleeding from left gastric artery)
Duodenal (posterior>anterior)–>posterior wall of duodenum with bleeding from gastroduodenal artery

Question 23

perforation of ulcer complication and bleeding

Answer 23

Duodenal (anterior>posterior)–>may see free air under diaphragm with referred pain to shoulder via phrenic nerve

Question 24

is duodoneal ulcer associated with cancer?

Answer 24

no

Question 25

What is the sudan II stain?

Answer 25

1st step in screening for malabsorption syndromes by staining the stool (identifies fecal fat)

Question 26

What drug can be given to increase liver enzyme synthesis in Criggler najJar type II

Answer 26

Phenobarbital

Question 27

Triad of hemochromatosis

Answer 27

Hyperpigmentation of particularly sun exposed areas, secondary diabetes, micronodular cirrhosis

Question 28

Cholestatic pattern of LFTs?

Answer 28

Increased conjugated bilirubin, increased cholesterol, increased ALP