GI

Question 1

gastroschisis

Answer 1

congenital malformation of ant ab wall –> exposure of abdominal contents

Question 2

omphalocele

Answer 2

herniation of bowel into umbilical cord

Question 3

pyloric stenosis

Answer 3

1. projectile nonbilious vomitting
2. visible peristalsis
3. olive mass

***presents 2 weeks after birth

Question 4

acute gastritis

Answer 4

acid damage to the stomach mucosa

Question 5

acute gastritis risk factors

Answer 5

1. severe burn
2. NSAIDS
3. heavy alc consumption
4. chemotherapy
5. inc intracranial pressure (inc vagal stimulation to parietal cells)
6. shock

Question 6

chronic gastritis

Answer 6

chronic inflammation of stomach mucosa (autoimmune & H. pylori)

Question 7

chronic autoimmune gastritis

Answer 7

antibodies against parietal cells/intrinsic factor
type IV hypersensitivity rxn
body and fundus

Question 8

chronic autoimmune gastritis clinically

Answer 8

1. atrophy of mucosa w/ intestinal metaplasia
2. achlorhydria w/ inc gastrin
3. pernicious anemia
4. inc risk for gastric adenocarcinoma

Question 9

H. pylori

Answer 9

ureases and proteases weaken mucosal defenses
antrum most common site
urea breath test/stool antigen

Question 10

H. pylori risks

Answer 10

1. ulceration
2. gastric adenocarcinoma
3. MALT lymphoma

Question 11

duodenal ulcer

Answer 11

H. pylori, ZE syndrome
pain improves with meals
hypertrophy of Brunner glands
rupture on post wall (but usually on ant wall) –> bleeding from gastroduodenal artery/acute pancreatitis

Question 12

gastric ulcer

Answer 12

H. pylori, NSAIDS, bile reflux
pain worsens with meals
rupture on lesser curvature –> bleeding form left gastric artery
can be caused by gastric carcinoma

Question 13

gastric carcinoma

Answer 13

malignant proliferation of surface epithelial cells
presents late, Leser-Trelat sign
spread to left supraclavicular node & liver

Question 14

intestinal gastric carcinoma

Answer 14

lesser curvature
large, irregular ulcer w/ heaped up margins
mets to periumbilical region (sister mary joseph nodule)

Question 15

intestinal gastric carcinoma risks

Answer 15

intestinal metaplasia
nitrosamines in smoked food
blood type A

Question 16

diffuse gastric carcinoma

Answer 16

signet ring cells diffusely infiltrate
linitis plastica (thickening of stomach wall)
mets to ovaries (krukenberg tumor)

Question 17

duodenal atresia associated with

Answer 17

Down syndrome

Question 18

duodenal atresia signs

Answer 18

double bubble, polyhydramnios

Question 19

meckel diverticulum due to failure of

Answer 19

vitelline duct closure

Question 20

volvus in elderly

Answer 20

sigmoid colon

Question 21

volvus in YA

Answer 21

cecum

Question 22

intessusception in kids due to

Answer 22

lymphoid hyperplasia (commonly due to rotavirus)

Question 23

intessusception in adults due to

Answer 23

tumor :(

Question 24

lactase enzyme breaks lactose into

Answer 24

glucose and galactose

Question 25

celiac dz associated with which HLAs?

Answer 25

HLA-DQ2 and DQ8

Question 26

celiac skin presentation

Answer 26

dermatitis herpetiformis due to IgA deposition at the tips of dermal papillae
usually in the duodenum

Question 27

celiac IgA or IgG antibodies against

Answer 27

endomysium, tTG, or gliadin

Question 28

celiac duodenal biopsy

Answer 28

flattening of villi, hyperplasia or crypts, inc intraepithelial lymphocytes

Question 29

celiac complications

Answer 29

small bowel carcinoma, T-cell lymphoma (EATL)

Question 30

tropical sprue

Answer 30

damage to small bowel villi due to unknown organism

usually in jejunum and ileum

Question 31

whipple dz characterized by

Answer 31

systemic macrophages loaded with T whippelii

Question 32

whipple dz in small bowel

Answer 32

macs in small bowl lamina propria compress lacteals, no fat absorption –> steatorrhea

Question 33

B48 associated with

Answer 33

chylomicron formation

Question 34

B100 associated with

Answer 34

VLDL and LDL

Question 35

carcinoid tumor marker

Answer 35

chromogranin

Question 36

carcinoid tumors secrete

Answer 36

5HT –> liver MAO –> 5-HIAA in urine

Question 37

carcinoid syndrome characterized by

Answer 37

bronchospasm, diarrhea, flushing of skin

Question 38

carcinoid heart dz

Answer 38

right sided valvular fibrosis –> tricusp regurg and pulmonary stenosis

Question 39

carcinoid tumors metastasize to the

Answer 39

liver, their they can produce systemic 5HT