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PPE > GI > Flashcards

GI Flashcards

1
Q

dysphagia causes

A

anasthetic, neuro defects, oesophageal tumour

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2
Q

saliva contains

A

amylase, Iodide, alkaline, calcium, lysozymes

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3
Q

secretions of salivary glands?

A

parotid - serous
sub max - mixed
sublingual - mucus

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4
Q

saliva secretion cell

A

ductal side has NaKATPase and HCO3-Cl antiporter. ECF side has Na-KATPase, KCl symporter, and Na-H antiporter

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5
Q

stimulated saliva and resting properties

A

stimulated - increase volume, hco3, enzymes, more hypotonic

resting - slightly alkaline

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6
Q

sympathetic and PS innervation of salivary glands

A

symp - superior cervical ganglion (decrease volume)

PS - glossopharyngeal (increase volume)

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7
Q

swallowing process

A

bolus to pharynx then pressure receptor in palate. Glottis closes, larynx lifts, resp inhibited

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8
Q

solids and liquids dysphagia. or solids then liquids

A

solids and liquids - motility problem

solids then liquids - mechanical obstruction

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9
Q

what is achalasia

A

failure of smooth muscle to contract e.g. upper oesophageal sphincter

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10
Q

components of lower oeso sphincter

A

+ve intra-abdo pressure, gastric rugae, acute angle, right cruz of diaphragm

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11
Q

gastric cells and secretions

A

Neck - mucus and HCO3
parietal - HCl and intrinsic
Chief - pepsinogen
G cell - gastric

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12
Q

cephalic, gastric and intestinal phase

A

cephalic - CNS stimulates acid
gastric - neutralisation, peptides and distention stimulate gastrin
intestinal - decrease pH and peptides stimulates secretin secretion which inhibits gastrin.

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13
Q

Where secretin from. what stimulate and its action. CCK too

A

from S cells of duodenum
stimulates HCO3 from pancerase and bile from liver
stimulated by low ph in duodenum

CCK from duodenal APUD cells. stimulates enzymes from pancreas and gall bladder and stim by FAs and AAs in duodenum

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14
Q

what causes atresias, stenosis, exampholos, gastroichisis

A

atresia - failure of anal membrane to rupture
stenosis - failure of recanalisation usually in duodenum
exampholos - gut and peritoneum herniates through umbilical cord
gastroischisis - failure of abdo wall to close, no sac

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15
Q

action of obliques

A

fleex trunk, rotate, compress and support abdo viscera

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16
Q

what is divariation recti and ectopia cordia and meckels

A

DR - widening of linea alba
ectopia - heart outside thoracic due to failure of ventral mesoderm
meckels - 2 ft from ilieocecal valve, gastric or pancreatic tissue, 2 inches

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17
Q

referred pain from cardic, gastric, duodenum, gallbladder, hepatic, retroperitoneal

A

cardiac - chest, neck, left shoulder
oesophagus - epigastric
gastric - back
duodenum - epigastric or umbilicus
gallbladder - right hypochondriac, R lumbar and R shoulder
hepatic - epigastric, R hypochondriac, R neck shoulder and back
retroperitoneal - back pain

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18
Q

diaphragmatic irritation causes

A

spleen, ectopic pregnancy, perforated ulcer

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19
Q

borders hasselbachs triangle

A

inguinal ligament, inf epigastric artery and vein, rectus sheath

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20
Q

inguinal canal borders

A

ant - internal oblique fascia
post - transversalis fascia
inf - inguinal ligament
sup - aponeurosis of obliques

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21
Q

which strangulated more inguinal or femoral

A

femoral

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22
Q

presentation, treat gastritis

A

presents - GORD. dyspepsia, epigastric pain, lying down and hot drinks worse
treat - lose weight, decrease alcohol and fatty foods. Amoxicillin and clarithromycin and omeprazole. Endoscopy

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23
Q

symptoms of gastric and duodenal ulcer. treat?

A

gastric - worse at night, worse when aeating. relieved with antacids. N&V. weight loss, haematemssis. treat with clarith and amoxici and omeprazole

duodenal - better when eating. delayed pain when acid secreted into duodenum

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24
Q

where are the stomach cells found? stomach histology

A

columnar cells with glands.
cardia - G cells
Fundus and body - neck, parietal, chief cells
pylorus - neck and g cells

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25
Q

gastric vsculature

A

see book

coeliac trunk, gastroepiploic, R L short gastric, proper hepatic, gastroduodenal, splenic

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26
Q

drainge of gastric and gastroeipoloic

A

gastric into hepatic

gastroepiploic into superior mesenteric

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27
Q

properties of chyme

A

hypertonic, acidic, partially digested

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28
Q

components of liver bile acid dependent and independent

A

dependent - cells lining canalliculi secrete. cholesterol, bile acid (e.g. chenodeoxycholic acid) and pigments
independent - cells lining bile ducts. alkaline juices

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29
Q

describe how bile acid recycled

A

reabsorbed in terminal ileun post bacterial conjugation and then back to liver

30
Q

gall stones symptoms

A

right hypochondriac pain, radiate to back or R shoulder, N&V, fatty meal = worse

31
Q

endocrine pancreas secertionsq

A

alkaline juice and enzyme (chymotrypsinogen, trypsinogen, carboxypeptidase, amylase, lipase)

32
Q

what is cholecystatis and symptoms

A

cystic duct obstructed. fever, oedema, increase WCC,

33
Q

what is biliary cholic and symptoms

A

biliary duct obstructed. jaundice.

34
Q

how duct cells secrete hco3

A

basolateral side - NaKatpase, naHantiporter

CO2 diffuses in then becomes HCO3 and then into lumen

35
Q

how fats digested in guts

A

bile acids emulsify. lipases. FAs to unstirred layer. RME. made into TAGs then chylomicrons.

36
Q

ligaments of liver

A

see book

triangular, coronary, falciform

37
Q

biliary tree

A

see book

R L hepatic, common hepatic, common bile, cystic, pancreatic, sphincter of oddi

38
Q

pancreas artery

A

splenic

39
Q

pancreatic drainage

A

head - superior mesenteric

tail - splenic

40
Q

adaptive and innate GI defences

A

adaptive - GALT

innate - acid, enzymes, mucus, peristalsis

41
Q

achlorhydra symptoms

A

anemia (impaired iron absorption). increase infection from salmonella, shigella, cholera, H pylori

42
Q

liver failure symptoms

A

hepatic encephalopathy, portal hypertension in cirrhosis

43
Q

symptoms of portal hypertension and cirrhosis

A

caput medusa, varices, shunting, splenomegaly, palmar erthyema, dupuytrens, jaundice, anemia, flapping tremor,, spider naevi, ascites

44
Q

investigations for hepatitis

A

jaundice, increase ALT (and AST), clotting increased

45
Q

which is specifc to liver ALT or AST

A

ALT. L for liver

46
Q

test for cholecystitis

A

bilirubin (conjugated) and ALP

47
Q

prehepatic signs and causes

A

unconj bilirubin, increase LDH, anaemia

immune cause, infection (malaria), spherocytosis

48
Q

hepatic jaundice signs and causes

A

increase ALT and AST, increase conj and unconj, clotting abnormal.
cirrhosis, hepatitis B virus, alcohol, paracetemol

49
Q

post hepatic signs and causes

A

increase conj, and ALP

gall stones, cancer, pancreatitis

50
Q

alcohol disease on liver

A

fatty liver due to increase NADH leading to FA and TAG deposits. THEN hepatitis due to acetaldehyde. then cirrhosis and wernickes encephalopathy

51
Q

causes of cirrhosis

A

wilsons, alcohol, hep B, autoimune

52
Q

portal system anastamosis

A

oesophageal, rectal, caput medusae (para umbilical veins)

53
Q

pancreatitis symptoms

A

shock, pain, vomiting, sepsis, increase insulin

chronic - malabsorption, decrease weight, DM, jaundice

54
Q

glucose into cell

A

SGLT1 and then into ECF via GLUT2

55
Q

what does large intestine absorb

A

vitamins and water

56
Q

how calcium absorbed and taken into guts

A

absorbed by PTH via Vit D activation. Via facilitated diffusion into cell and then Ca-ATPase into ECF

57
Q

explain how iron absorbed

A

iron + gastric acid then to transferrin and then RME

58
Q

what does oral rehydration contain

A

glucose and na

59
Q

how segmenting in intestine works

A

pacemakers fire quicker at stomach end than at large intestine end.

60
Q

features of jejunum and ileum

A

jejunum - dark red, thick wall, no peyers

ileum - pink, thin, peyers

61
Q

which one does smoking help with UC or CD?

A

UC

62
Q

features of UC

A

continous, rectal involvement, gross bleeding, mucosal ffriability, pseudopolyps

63
Q

CD and UC treatment

A

CD - corticosteroids, methotrexate, azathioprine

UC - same and colectomy

64
Q

why baxcteria in gut good

A

vitamins, kill pathogens, MALT stimulate

65
Q

what bacteria cause gastroentiritis

A

campylobacter, salmonella, listeria

66
Q

what causes gingivitis and travellers diarrhoea

A

gingivitis - strep mutans

travellers diarrhoea - e coli

67
Q

gastric cancer symptoms and appearances and spread

A

epigastric pain, vomiting, weight loss
appearance - fungating, ulcerative, infiltrative
spread - local, trans-coelemic (liver, peritoneum, ovaries), lymph

68
Q

large intestine cancer cause

A

familial adenomatous polyposis, DCC gene

69
Q

what is ileus, toxic megacolon and lead pipe colon

A

ileus - loss of peristalsis
toxic megacolon - v dilated colon (IBS deterioratioN)
lead pipe - severe UC. no haustra

70
Q

small bowel colic symptoms and cuases

A

vomiting, distention, constipation, pain 2-3 mins

cause - adhesions, hernia, tumour, inflamm

71
Q

large bowel colic symptoms and cuases

A

symptoms - vomit faeces, distention, consitpation,. pain 10-15 mins
cause - hernia, cancer, volvulus

PPE (18 decks)

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