GI

Question 1

Olive mass, Projectile vomiting

Answer 1

Congenital pyloric stenosis

Question 2

Duodenal Atresia genetics

Answer 2

Trisomy 21

Question 3

Most common Tracheoesophageal anomaly

Answer 3

Esophageal atresia with distal Tracheoesophageal fistula (85%)

Question 4

Annular Pancreas

Answer 4

Ventral pancreatic bud abnormally encircles 2nd p duodenum, may cause narrowing

Question 5

Pancreas Divisum

Answer 5

Ventral and Dorsal parts fail to fuse at 8 weeks

Question 6

Retroperitoneal structures

Answer 6

SAD PUCKER
(Suprarenal gland, Aorta & IVC, Duodenum (2 & 3), Pancreas, Ureters, Colon (asc & des), Kidneys, Esophagus, Rectum)

Question 7

Pringle Maneuver

Answer 7

Compress Hepatoduodenal ligament (contains portal triad) to control bleeding

Question 8

Gut wall layers

Answer 8

• Mucosa
• Submucosa (w/ Meissner’s (secretory) Plexus)
• Muscularis externa (w/ Auerbach’s (motility) Plexus)
• Serosa

Question 9

Crypts of Lieberkuhn

Answer 9

-Goblet cells & Enterocytes

Question 10

Brunner’s Glands

Answer 10

• Proximal Duodenum submucosa

- Secrete bicarbonate to alkalize chyme

Question 11

SMA syndrome

Answer 11

Duodenum (3) is trapped between SMA and aorta -> intestinal obstruction

Question 12

Pectinate line

Answer 12

Endoderm meets Ectoderm

Question 13

Sphincter of Oddi

Answer 13

Just inside Ampulla of Vater

Question 14

Inguinal hernias: Direct v. Indirect

Answer 14

Abdominal wall v. Internal inguinal ring (into scrotum)

Question 15

Femoral hernia

Answer 15

• Below inguinal ligament

- Leading cause of bowel incarceration

Question 16

Rectal adenocarcinoma presentation

Answer 16

Tenesmus & thin stool

Question 17

Ulcerative colitis presentation

Answer 17

Recurrent grossly bloody stool and low grade fever

Question 18

Left-sided colon cancer presentation

Answer 18

Abdominal cramps, distention, nausea

Question 19

Irritable bowel syndrome presentation

Answer 19

Constipation alternating with diarrhea

Question 20

Right-sided colon cancer presentation

Answer 20

Weight loss and progressive fatigue

Question 21

Calories per gram

Answer 21

4,9,4,7

Question 22

Organism most likely to infect with a very small innoculum

Answer 22

Shigella

-Also C.jejuni, C.perfringens, E.histolytica, G.lamblia

Question 23

Ribavirin MOA, SE

Answer 23

Inhibit viral DNA/RNA replication

Hemolytic anemia, teratogen

Question 24

Stimulate HCl release from parietal cells

Answer 24

Gastrin (+proliferate), Histamine, Acetylcholine

Question 25

Inhibit HCl release from parietal cells

Answer 25

PGE2

Question 26

Whipple disease stain

Answer 26

PAS (glycoprotein)

Question 27

Diphenoxylate | Meperidine

Answer 27

Opioid analgesic - lowers motility, tx diarrhea

Question 28

Octreotide

Answer 28

Secretory diarrhea

Question 29

D-xylose absorption

Answer 29

Normal in pancreatic pathology | Decreased in intestinal pathology

Question 30

Rose spots

Answer 30

Typhoid fever (S. typhi)

Question 31

Celiac antibody

Answer 31

IgA anti-tissue transglutaminase

Question 32

Cystic fibrosis

Answer 32

Mucus plugs of lungs, liver, pancreas Meconium ileus in newborns Nasal polyps

Question 33

Cystic fibrosis susceptibility

Answer 33

Pseudomonas | Staph aureus

Question 34

VIPoma

Answer 34

``` WDHA syndrome (Watery Diarrhea, Hypokalemia, Achlorhydia) Tx with Somatostatin (octreotide) ```

Question 35

Anal fissure location

Answer 35

Posterior midline, distal to dentate line

Question 36

Portal HTN Tx

Answer 36

TIPS (Transjugular Intrahepatic Portosystemic Shunt)

Question 37

Ischemia liver zone

Answer 37

Zone 3 (centrilobular)

Question 38

Viral hepatitis liver zone

Answer 38

Zone 1 (periportal)

Question 39

Alcohol toxicity liver zone

Answer 39

Zone 3 (centrilobular)

Question 40

Sliding hiatal hernia

Answer 40

Upward displaced GE junction | Hourglass stomach

Question 41

Paraesophageal hernia

Answer 41

Normal GE junction | Fundus protrudes into thorax

Question 42

Hesselbach's triangle

Answer 42

Direct inguinal hernia | (inferior epigastrics, inguinal ligament, lateral border of rectus abdominis

Question 43

Zollinger-Ellison syndrome

Answer 43

Gastrinoma - Hyperacidity - Rugal thickening (G cell hyperplasia)

Question 44

Gastrin - source, action, regulation

Answer 44

G cells (antrum) - Gastric H+, gastric motility, gastric growth - Distention, food, vagus; Decreased by acidity

Question 45

CCK - source, action, regulation

Answer 45

I cells (duodenum, jejunum) - Pancreatic secretion, gallbladder contraction, decrease gastric emptying - Fatty acids, AAs

Question 46

Secretin - source, action, regulation

Answer 46

S cells (duodenum) - Pancreatic bicarb secretion, bile secretion, decrease gastric H+ secretion - Acid, FAs in duodenum

Question 47

Somatostatin - source, action, regulation

Answer 47

D cells (pancreatic islets, GI mucosa) - Decrease gastric/pancreatic/intestine secretion, gallbladder contraction, insulin/glucagon release - Acid, decreased by vagus

Question 48

VIP (Vasoactive intestinal polypeptide) - source, action, regulation

Answer 48

Parasym ganglia in sphincters, GB, and small intestine - Intestinal secretions, sphincter relaxation - Distention, vagus; decreased by adrenergic input

Question 49

Motilin - source, action, regulation

Answer 49

Small intestine - Produces MMCs (migrating motor complexes) - Fasting