GI Flashcards by Monica Medrano

classic paraneoplastic symptoms of small intestine carcinoid tumor?

heart murmur, hepatomegaly, flushing w hypoTN

-rosettes on histo

How well did you know this?

Not at all

Perfectly

What is the best drug for hepatic encephalopathy?

lactulose (traps ammonia)

How well did you know this?

Not at all

Perfectly

What are the findings for esophagus w Scleroderma?

decreased LES tone + decreased peristalsis

How well did you know this?

Not at all

Perfectly

What are the hallmarks of abetalipoproteinemia (Apo B def)?

Chronic mal-absorption leading to signs of severe vitamin deficiencies (retinal degeneration, ataxia, motor dysfunction) + acanthocytosis + low cholesterol

-acanthocyte = RBC w spiny projections

How well did you know this?

Not at all

Perfectly

Which nerve structures increase acid production in the stomach?

vagal trunks (parasymp)

How well did you know this?

Not at all

Perfectly

What causes hereditary hemochromatosis (bronze diabetes)?

increased intestinal Fe absorption in the small intest

How well did you know this?

Not at all

Perfectly

How does alcohol cause acetaminophen toxicity?

induces cytochrome p450 = increased hepatotoxic metabolites

How well did you know this?

Not at all

Perfectly

What are the symptoms of a VIPoma?

Copious Watery Diarrhea, Hypokalemia, and Achlorhydria, hyperglycemia, flushing (vasodilation), big poop

How well did you know this?

Not at all

Perfectly

If smoking can cause adenocarcinoma and squamous cell carcinoma, how to differentiate?

Adenocarcinoma is most common in non-smokers; so smoker = SCC

How well did you know this?

Not at all

Perfectly

What is the Hallmark Triad of Plummer-Vinson syndrome?

Dysphagia (esophageal webs), glossitis, iron deficiency anemia
-others: angular stomatitis, spoon-shaped nails

How well did you know this?

Not at all

Perfectly

What is Necrotizing enterocolitis

Necrosis of intestinal mucosa (primarily colonic)

premature formula-fed infants
colic + bloody diarrhea in the first week of life

How well did you know this?

Not at all

Perfectly

Which branches of the abdominal aorta supplies blood to the spleen?

AA –> celiac trunk –> splenic artery –> spleen

How well did you know this?

Not at all

Perfectly

Which drugs are MOS def used to treat mild-to-moderate Ulcerative colitis?

Mesalamine
Olsalazine
Sulfasalazine

How well did you know this?

Not at all

Perfectly

What affect does atropine have on gastrin, Ach, and histamine to secrete acid from parietal cells?

Gastrin, Ach, and histamine are synergistic, so Atropine DECREASES acid production in all of them.

How well did you know this?

Not at all

Perfectly

What is steatorrhea and its cause?

Bulky, oily, malodorous stool from bacterial overgrowth (acting on undigested lipids)

How well did you know this?

Not at all

Perfectly

What is secretory diarrhea and its cause?

Large vol of watery stool; does not stop w fasting; caused by infectious agents transporting electrolytes into the lumen

How well did you know this?

Not at all

Perfectly

What is osmotic diarrhea and its cause?

Watery diarrhea + bloating, gas that does NOT stop w fasting; caused by malabsorption

How well did you know this?

Not at all

Perfectly

What is the difference between direct and indirect bilirubin?

direct: conjugated by the liver = soluble
indirect: not removed from blood by liver yet = insoluble

How well did you know this?

Not at all

Perfectly

Which enzyme conjugates bilirubin?

UDP-glucuronosyltransferase

How well did you know this?

Not at all

Perfectly

What is Crigler-Najjar Syndrome?

Absent UDP-glucuronosyltransferase =
jaundice, kernicterus (bilirubin deposition in brain), unconjugated bilirubin.
Tx: plasmapheresis and phototherapy.

How well did you know this?

Not at all

Perfectly

What drug is used to treat carcinoid syndrome?

Octreotide (helps w the flushing and diarrhea)

How well did you know this?

Not at all

Perfectly

The splenic artery and vein travel with which ligament?

splenorenal ligament

How well did you know this?

Not at all

Perfectly

Which 3 arteries come off the celiac trunk?

splenic
left gastric
common hepatic

How well did you know this?

Not at all

Perfectly

Which artery supplies the body & tail of the pancreas?

splenic artery

How well did you know this?

Not at all

Perfectly

What is the MOA of the preferred drug to treat cholesterol gallstones?

ursodiol = decreases cholesterol synthesis, secretion, and absorption

What is primary biliary cirrhosis?

``` Autoimmune reaction (anti-mitochondrial abs) = lymphocytic infiltrate + granulomas --> destruction of intralobular bile ducts. ``` -assoc w other autoimmunes

What are the mesodermal defects assoc w tracheoesophageal atresia?

``` VACTERL: Vertebral defects Anal atresia Cardiac defects Tracheo-Esophageal fistula Renal defects Limb defects (bone and muscle) ```

Which drug is contraindicated in pts with alcohol disorder?

metronidazole bc it causes disulfiram rxn w alcohol | acetaldehyde accumulates, contributing to hangover symptoms

Reye syndrome affects which organelles?

mitochondria

What is the cause of duodenal atresia and its hallmarks?

cause: fail of recanalization of duodenal lumen hallmarks: assoc w Down syndrome & "double bubble" on xray

How does H.pylori damage the gastric mucosa?

By increasing mucosal levels of ammonium

Which structures are retroperitoneal?

SAD PUCKER: Suprarenal (adrenal) glands Aorta and IVC Duodenum (2nd through 4th parts) ``` Pancreas (except tail) Ureters Colon (descending and ascending) Kidneys Esophagus (thoracic portion) Rectum (partially) ```

Whats the general function of the duodenal hormones?

They decrease acid secretion rates

What are the hormones secreted by the duodenum?

prostaglandin E2 somatostatin secretin gastric inhibitory peptide (GIP)

What is biggest consequence of duodenal resection?

loss of inhibitory hormones = increase in acid secretion

Your pt has cholecystitis but no jaundice, where do you suspect stones?

Cystic duct or gallbladder (less common)

Your pt has cholecystitis and jaundice, where do you suspect stones?

Common bile duct

Whats the MOA of -azole antifungals?

inhibit fungal cytochrome P-450 lanosterol 12-a-demethylase

Where is the abnormal APC gene located for Familial adenomatous polyposis (FAP)?

5q21

Which artery supplies the DISTAL lesser curvature? the PROXIMAL lesser curvature?

distal: right gastric (dr) proximal: left gastric (pl)

How does gastrin strengthen the mucosal barrier?

Gastrin release initiates cell division in proliferative zone of gastric mucosa

What is primary sclerosing cholangitis? What other diseases is it associated with?

PSC: concentric “onion skin” bile duct fibrosis w alternating strictures and dilation (=“beading” of intra- and extrahepatic bile ducts) -assoc w ulcerative colitis

Which nerve is responsible for the defecation reflex?

pelvic splanchnic nerve

What is Ménétrier disease?

Gastric hyperplasia of mucosa = hypertrophied rugae excess mucus production --> protein loss and parietal cell atrophy with acid production. - increased TGF-a

What hormone causes gallbladder contraction? And which cell secretes it?

CCK from I cells.

Stress ulcers are caused by an increase in what?

pepsin production and gastric acid

Whats the most common location for Menckel's diverticulum?

ileum

Which tumor markers are associated with pancreatic cancer?

CEA and CA19-9

Which organism is responsible for punched-out ulcers in the esophagus of IC pts?

HSV-1

What does serum alkaline phosphatase indicate?

Metastases to bone or liver, Paget disease of bone, seminoma

What drug is used to treat esophageal varices?

Octreotide (decreases portal blood flow)

which pressure changes cause pitting edema?

INC capillary pressure ( INC Pc; e.g., HF) DEC plasma proteins ( DEC πc; e.g., nephrotic syndrome, liver failure) INC capillary permeability ( INC Kf ; e.g., toxins, infections, burns) INC interstitial fluid colloid osmotic pressure ( INC πi; e.g., lymphatic blockage)

Whats the MOA and indication for prochlorperazine?

Antiemetic that blocks dopamine receptors used for chemotherapy pts.

Where is a shunt created to help relieve portal HTN?

splenic vein (portal)-left renal vein (IVC)

What 3 factors stimulate gastric acid secretion in the parietal cells?

1. histimine 2. gastrin 3. vagal stimulation

What is meconium ileus and what is the other disease it is associated with?

In cystic fibrosis, meconium plug obstructs intestine, preventing stool passage at birth.

What are normal levels of unconjugated and conjugated bilirubin in the portal vein?

unconjugated > conjugated

What part of the colon is denervated in Hirschprung's disease?

Distal rectum always involved.

What clinical features would indicate enterovesicular fistula secondary to Crohn's?

- ab pain - brown-yellow urine (fecal contamination) - multiple enteric orgs

Other than motility, what is the other function of migrating motility complexes?

Maintain low bacteria counts in the upper intestine

What is angiosarcoma?

Highly aggressive tumor that arises from blood vessels

What is a major risk factor for angiosarcoma?

Exposure to vinyl chloride

What characterizes carcinoid heart disease?

Right-sided endocardial fibrosis w tricuspid valve damage

Which apoprotein turns on lipoprotein lipase?

CII

Def in apoprotein CII causes what?

hyperlipidemia + high chylo levels

What is Zollinger-Ellison syndrome?

Gastrin-secreting tumor in the pancreas

Parietal cells provide which 2 excretory products?

1. Intrinsic factor | 2. Gastric acid

What 2 fetal abnormalities result in polyhydramnios?

1. tracheoesophageal atresia | 2. anencephaly