Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

STEP 1 > GI > Flashcards

GI Flashcards

1
Q

Achalasia

A
  • Disordered esophageal motility and inability to relax LES
  • due to damaged inhibitory ganglion cells of the myenteric plexus
  • **“birds beak” sign on barium swallow study
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Giardia

A

Sx: diarrhea, flatulence, foul smelling stools, abd cramping, malabsorption
HPI: hiking and drinking contaminated water, most common enteric parasite in US and Canada
Histo: stool sample reveals elippsoidal cysts smooth well defined walls and 2+ nuclei
-infects duodenal and jejunal mucosal lining
Tx: metrobendizole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Pernicious anemia

A

Ab CD4 mediated destruction of parietal cells in gastric fundus and body (parietal cells secrete IF necessary for the absorption of B12 in ileum)
–> megaloblastic anemia , affects upper glandular layer (oxyntic)
Sx: fatigue and lower extremity paresthesias , elevated pH, increased secretion of gastrin

Chief cells found in lower glandular layer (pepsinogen); parietal cells secrete IF and HCl

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Hirschprung disease

A
  • Abnormal migration of neural crest cells during embryogenesis (move caudally along vagus nerve)
  • neural crest cells give rise to ganglion cells (parasympathetic) make submucosal and myenteric plexuses –> responsible for peristalsis
  • sx: affected segment becomes narrowed bc it can’t relax (always involves rectum and anus)
  • can lead to megacolon
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Celiac disease

A

Histo: villous atrophy, crypt hyperplasia, lymphocytic inflitration in duodenum and proximal jejunum

  • chronic malabsorptive disorder caused by hypersensitivity to gluten (found in wheat, barely and rye)–> gliadin triggers autoimmune mediated rxn
  • presents brown ages of 6-24 months with the introduction of gluten into diet
  • elevated IgA and anti transglutaminase Ab
  • tx: gluten free diet
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Polyethylene glycol

A

Osmotic laxative used to tx constipation (non absorbable and pulls water into lumen osmotically)

Magnesium hydroxide is another osmotic laxative often used

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Zollinger-Ellison syndrome

A
  • Gastrin secreting tumor
  • Gastrin hypersecretion induces parietal cell hyperplasia (increased HCl), enlargement of gastric folds
  • excess acid causes peptic ulcer disease, heartburn and diarrhea
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Secretin

A
  • produced by S cells in the small intestine
  • increases bicarb production by the pancreas and watery, alkaline pancreatic juice
  • inhibits gastric acid secretions and stimulates pyloric sphincter contraction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Kehr sign

A

Any abdominal process irritating the phrenic nerve sensory fibers around the diaphragm can cause referred pain to the C3-C5 shoulder region
-phrenic nerve irritation can also cause hiccups

-phrenic nerve originates from C3-C5 and provides motor function to the diphragm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Extra intestinal manifestations of Crohns disease

A

Ankylosing spondylitis and peripheral arthritis which manifest as low back pain and joint stiffness that is worst at night

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Mallory-Weiss tear

A

Upper GI mucosal tear near GEJ; caused by forceful vomiting through tight LES (retching or vomiting)

  • repetitive omitting leads to metabolic alkalosis due to loss of gastric acids
  • commonly occurs among alcoholics
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Acute pancreatitis due to EtOH abuse

A

> 2 AST:ALT ratio and absence of gallstones

  • chronic pancreatitis: macrocytosis is seen due to poor nutrition (i.e. Folate deficiency)
  • after gallstones, 2nd most common cause of acute pancreatitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Hepatoduodenal ligament

A

Surrounds the portal triad (hepatic artery, portal vein and common bile duct)

  • occlusion of the hepatoduodenal ligament called “the Pringles maneuver”
  • technique used to distinguish RUQ bleed; if bleeding doesn’t stop w Pringle maneuver then bleeding is from IVC or hepatic veins
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Urease test

A
  • used in the Dx of H. Pylori infection
  • h. Pylori secretes ureases which convert urea to carbon dioxide and ammonia, causing a pH increase and color change of the phenol red pH indicator indicating alkalinization of the solution
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

NK cells

A

Recognize and kill cells w decreased or absent MHC class 1 antigen cell surface expression, such as virus-infected cells and tumor cells ; kill target cells by inducing apoptosis

  • don’t express CD4, CD8 or CD3
  • don’t require maturation in the thymus
  • don’t require antigen activation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

CCK

A
  • hormone responsible for gallbladder contraction
  • produced by cells of duodenum and jejunum when fat protein rich chyme enters the duodenum
  • increases pancreatic enzyme secretion and decreases gastric emptying
  • risk factors for gallbladder disease: forty, fat and female
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Secretin

A

Promotes bicarb secretion from pancreas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Base excision repair

A

-used to correct single-base DNA defects
Order:
-glycoylases remove defective base
-sugar-phosphate site cleaved and removed by endonucleases and lyase
-DNA polymerase replaces missing nucleotide
-Ligase seals reminding nick

***nitrates promote deamination of cytosine, adenine and guanine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Mu opioid analgesics and RUQ abdominal pain

A

Can cause contraction of smooth muscle cells in sphincter of oddi leading to spasm and increase in in common bile duct pressures
-use NSAID instead
I.e. Morphine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Porcelain gallbladder

A
  • late complication of chronic cholecyctitis assoc w cholelethiasis (gallstones)
  • CT: palpable mass that include thickened gallbladder wall and rim of patchy or uniform calcification
  • increased risk for adenocarcinoma of the gallbladder
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

HIV associated esophagitis

A

3 most common causes:

  • Candida ( patches of grey white pseudomembrane on erythematous mucosa)**most common
  • CMV (linear ulcerations); inclusion bodies; CMA esophagitis also occurs in transplant recipients
  • HSV-1 (small vesicles-> punched out ulcers); cowdry bodies

All present as dysphasia and/or odynophagia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Intestinal atresias

A

Duodenal: failure of recanalization at 8-10 weeks gestation; bilious or non bilious emesis, “double bubble” sign on x ray; assoc w Down syndrome

Jejunum/ileum: vascular injury; bilious emesis, abdominal distention; associated w gastroschisis

Colonic: Unknown; constipation, abdominal distention; assoc w Hirschprungs disease

“Apple peel” atresias occur when the SMA is occluded

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Lead poisoning in adults

A

Risk factors: occupational exposure (lead paint, batteries, ammunition, construction)
Clinical features: GI (constipation), neurological (peripheral neuropathy), hematologic (anemia), bluish pigmentation at the gum-tooth line
Lab findings: microcytic anemia, elevated venous lead levels, basophilic stippling on peripheral smear; normal iron studies

-lead inhibits the heme synthesis pathway

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Howell Jewel bodies

A

Nuclear DNA remnants inclusions in peripheral RBCs that are normally removed by the spleen during circulation. Presence indicates decreased or absent spleen function (i.e. Post splenectomy)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Systemic mastocytosis

A

Clonal mast cell proliferation in bone marrow, skin and other organs.
Assoc w mutation in KIT receptor TK
Excessive histamine release from degranulation of mast cells leads to syncope, flushing, hypotenison, pruritis and urticaria
Histamine also induces gastric acid secretion via parietal cells causing diarrhea

Histamine: vasodilation and fall in BP, gastric acid release, itching

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Meckel diverticulum

A

Failed obliteration of vitelline (omphalomesenteric) duct
Sx: painless lower GI bleed
Ectopic gastric mucosa secretes acid via parietal cells
Tc-pertechnetate binds parietal cells
True diverticulum; transmural

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Diverticulosis

A

Hematochezia w abnormal outpouchings from colonic epithemlium
Pathogenesis involves pulsion, increased intraluminal pressure during strained bowel movements
Only mucosa and submucosa herniate through weakness in muscularis
Most commonly in sigmoid colon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Right sided vs left sided colon cancer

A

Right sided (ascending colon)

  • grow as large bulky masses that protrude into colonic lumen, more likely to bleed and cause iron def anemia, don’t develop intestinal obstruction bc right colon is larger and stool is more liquid
  • Sx: anorexia, malaise, unintentional weight loss
Left sided (rectosigmoid colon)
-smaller, infiltrate wall if the colon narrowing the lumen causin obstruction,

Lung and liver are common sites of metastasis
Most common GI malignancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Most common causes of acute pancreatitis

A

Gallstones and alcoholism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Tx of Hep C

A

Interferon alpha and ribavirin

Ribavirin: interferes w duplication of viral genetic material, lethal hypermutation, inhibiting RNA polymerase, defective 5’cap formation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Abetalipoproteinemia

A

Autosomal recessive, loss of function mutation in MTP gene
Impaired formation of apolipoprotein B containing lipoproteins (i.e. Chylomicrons and VLDL)
Sx: accumulation of lipids in the absorptive cells of the intestinal epithelium; enterocytes contain clear or foamy cytoplasm
Malabsorption of fat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Villous adenoma

A

Mass w long glands and villi-like projections in colon
Large sessile and can have a velvety or cauliflower like projections
Most likely to go malignant transformation
Secrete large quantities of watery mucus, leading to secretory diarrhea, hypovolemia and electrolyte imbalance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Indirect vs direct inguinal hernias

A

Indirect:

  • more common
  • failure of processus vaginalis to obliterate, allowing contents to protrude through deep inguinal ring
  • above epigastric vessels and inguinal ligament
  • may descend into scrotum via inguinal canal and out ext inguinal ring

Direct:

  • Protrude through Hasselbachs triangle, weak spot on ant abd wall
  • rectus abdominus muscle medially, inferior epigastric vessels laterally and inguinal ligament inferiorly
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Chronic pancreatitis presentation

A

Epigastric pain and pancreatic exocrine insufficiency resulting in fat malabsorption/ steatorrhea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Inhaled anesthetic hepatotoxicity

A

Assoc w highly lethal fulminant hepatitis that cannot be distinguished from viral hepatitis. Patients have significantly elevated aminotransferase (AST) levels due to massive hepatocellular injury and a prolonged PT time due to failure of hepatic synthetic function

I.e. Halothane

36
Q

Tx of nasuea (Antiemetic)

A

5-HT3 receptor antagonist for tx of visceral nausea due to GI (i.e. Odansetron)
Anti histamines and anti cholinergics for vestibular nausea, motion sickness and vertigo
Dopamine antagonist for nasuea w migraines

All hit area posterma in medulla which controls nausea and vomitting

37
Q

Small intestinal bacterial overgrowth

A

Often assoc with gastric bypass surgery resulting in the overproduction of Vit K and folate (bacterial synthesis) assoc w nausea, vomiting, bloating, abd discomfort and malabsorption
–> results in def of most other vitamins and zinc
Excessive bacterial proliferation in blind ended gastroduodenal segment that is anastamosed to jejunum dismally

38
Q

Diagnostic test for Celiac

A

Duodenal biopsy

39
Q

Small bowel syndrome

A

Malabsorptive condition that typically occurs in patients with massive bowel resection or Crohns disease
-loss of absorptive surface, decrease in transit time leading to post prandial voluminous diarrhea and weight loss due to malabsorption of nutrients

40
Q

Presentation of appendicitis

A
  • dull visceral pain at the umbilicus due to afferent nerve fibers entering spinal cord at T10
  • progressive inflammation irritates parietal peritoneum and abd wall to cause more sever somatic pain shifting to McBurney point

Visceral pain is dull and non localized (luminal distention and stretching of smooth muscle
Somatic pain is severe and well-localized

41
Q

Most common malignant hepatic lesion

A

Metastasis from another primary site (breast, lung, colon), not hepatocellular carcinoma
-CT shows multiple hypodense masses in the liver–> may result in hepatomegaly

42
Q

Colorectal carcinoma in pts with IBD

A
  • long standing ulcerative colitis is assoc w increased risk of colorectal cancer
  • duration and extent are he most significant risk factors
  • compared to sporadic cases of CRC, colitis assoc CRC affect younger pts, progress from flat and non-polypoid dysplasia, appear mutinous and/or have signet ring morphology, develop p53 mutation early and APC mutations late (opposite), multifocal in nature
43
Q

Trypsin

A

Trypsinogen is activated by enterokinase in the duodenum to trypsin. Trypsin then activates all other enzymes in the duodenum from the pancreas; can also activate other trypsinogen molecules

  • SPINK 1 is a trypsin inhibitor, trypsin can also serve as its own inactivator
  • main activator of pancreatic digestive proenzymes
44
Q

Supplementation for breastfed infants

A

Vitamin D

  • risk factors: exclusively breastfeeding, lack of sunlight exposure, dark skin pigmentation
  • prevent rickets

Iron
-risk factors: pre term/ low birth weight

***vit K injection supplementation at birth to prevent hemorrhagic disease

45
Q

Statins

A

1st line therapy for hypercholestrolemia; competitively inhibit HMG CoA reductase (rate limiting step in hepatic cholesterol synthesis)
-causes increased uptake of LDL from circulation

Bile acid binding resins bind bile acids in the GI tract, resulting in synthesis of more bile salts therefore consuming more cholesterol stores; but decreased hepatic cholesterol is a activating factor for HMG CoA reductase and results in increased hepatic cholesterol synthesis; block w a statin

46
Q

Kaposi’s Sarcoma

A

Usually involves the skin and GI tract and is common is HIV patients not on antiretroviral therapy
Endoscopy: redish/violet flat maculopapular lesions to raised hemorrhagic nodules or polyploid masses
Biopsy: spindle cells, neovascularization, and extravasated RBCs

HHV-8

47
Q

Location of esophagus

A

Located btwn the trachea and vertebral body in superior thorax; typically collapsed and w no visible lumen on CT

48
Q

2 types of gastric adenocarcinomas

A

Intestinal

  • well formed glands
  • grow as modular, polypoid, and well demarcated masses that rapidly expand
  • lesions ulcerated and bleed

Diffuse

  • don’t form glands
  • signet ring carcinomas (cell w abundant mucin droplet that pushes the nucleus to one side)
  • diffuse involvement due to loss of E-Cadherin protein
  • cause “leather bottle stomach”- Linitis plastica
49
Q

Dublin Johnson Syndrome

A

Benign autosomal recessive disorder w defective hepatic excretion of conj bilirubin due to mutation in canalicular membrane transport protein
Direct (conjugated) hyperbilirubinemia
Liver may appear black due to impaired excretion of epi metabolites that accumulate within lysosomes

50
Q

3rd part of the duodenum

A

Courses horizontally across the abd aorta and IVC at the level of the 3rd lumbar vertebra
Superior mesenteric vessels lie anterior to the duodenum

51
Q

Hyperestrinism in liver cirrhosis

A

Arises likely due to increases in androstenedione production, androgen aromatization, and SHBG (preferentially binds testosterone). Impaired estrogen metabolism by the liver may also contribute.
Sx: gynecomastia, testicular atrophy, decreased body hair and spider angiomata

52
Q

Most common intra abdominal organ injured during blunt trauma

A

Spleen

  • mesodermal origin (the dorsal mesentery)
  • although it is supplied by the splenic artery (branch of major foregut vessel, the celiac trunk), it is not foregut derived
53
Q

Acute viral hepatitis A presentation

A

Histo: “spotty necrosis” w ballooning degeneration (hepatocyte swelling), Councilman bodies (eosinophilic apoptotic hepatocytes) and mononuclear cell infiltrates
Sx: fever, malaise, anorexia, nausea/vomitting, and RUQ pain.
After 1 week signs of cholestasis such as jaundice, pruritis, dark colored urine (due to increased conj bilirubin) and acholic stools (lacks bilirubin pigment)

54
Q

Groin hernias

A

Indirect inguinal

  • male infants
  • patent process vaginalis, contents protrude through deep inguinal ring, travels lateral to the inferior epigastric vessel

Direct inguinal

  • older men
  • weakness of transversalis fascia, contents protrude through Hesselbachs triangle, travels medial to epigastric vessels, protrude through external inguinal ring and are covered by spermatic fascia

Femoral
-woman
Weakness of proximal femoral canal, contents protrude through femoral ring, travels inferior to inguinal ligament

55
Q

Gallbladder

A

Functions to actively absorb water from bile. Gallbladder hypomotility causes bile concentration, which promotes precipitation and accumulation of viscous billiary sludge that predisposes to gallstone formation and bile duct obstruction

Risk factors: pregnancy, rapid weight loss, high spinal cord injures, prolonged use of total parenteral nutrition or octeotride

56
Q

Portacaval anastomoses

A

Esophageal varices, left gastric vein, esophageal vein
Hemorrhoids, superior rectal vein, middle and inferior rectal veins
Caput medusa, paraumbilical veins, superficial and inferior epigastric veins

57
Q

Vit A deficiency

A

Night blindness and hyperkeratosis (coarse and dry)

58
Q

Adenoma to carcinoma sequence

A

1) mutation in APC tumor suppressor gene-increased risk for polyp
2) K-RAS (polyp formation)
3) p53 (carcinoma)

59
Q

Ectopy

A

Microscopically and functionally normal cells/tissue found in abnormal location due to abnormal embryonic maladaption

I.e. Meckels diverticulum with pancreatic cells

Vs Metaplasia: replacement of one type of epithelium with another not typical for location; occurs during adult life and is initially a compensatory process

60
Q

Cavernous hemangioma

A

Most common benign tumor of the liver
Cavernous, blood filled spaces of variable some lined by single epithelial layer
Biopsy not recommend as can cause fatal hemorrhage

61
Q

Retroperitoneal abdominal organs

A

SAD PUCKER

Suprarenal (adrenal glands)
Aorta and IVC
Duodenum except 1st part

Pancreas head and body
Ureters and bladder
Colon (ascending and descending)
Kidneys 
Esophagus
Rectum
62
Q

Sudan III stain

A

Qualitative assay of stool that can easily ID unabsorbed fat and confirm malabsorption
Fats are typically the earliest and most severely affected nutrient during in generalized malabsorption

63
Q

Shigella

A

Infectious GI disease most commonly caused by S sonnei
Invades GI mucosa by gaining access to microfold (M) cells in ileal Peyers patches through endocytosis
Sx: diarrhea w blood and mucus

64
Q

Pseudoemembranes

A

White/yellow plaques with fibrin on colonic mucosa

Assoc w C.diff

65
Q

Rifaximin

A

Non absorbable antibiotic that alters the GI flora to decrease intestinal production and absorption of ammonia (from nitrogen products)

GI bleed ->catabolism of Hb increases nitrogen products ->nitrogen converted to ammonia by gut
Excess dietary protein -> increases ammonia

Lactulose increases conversion of ammonia to ammonium

66
Q

Gastric erosions vs ulcers

A

Erosions are mucosal defects that do not fully extend through the muscularis mucosa (only mucosal layer)
Ulcers penetrate through the mucosal layer and into the submucosa

67
Q

Odynophagia

A

New onset usually indicates the progression to erosive esophagitis and the formation of an ulcer in the setting of chronic GERD

68
Q

Breast milk jaundice

A

Hyperbilirubinemia that peaks at 2 weeks
Beta-glucuronidase in breast milk deconjugates bilirubin -> increased absorption and enterohepatic circulation of bilirubin

69
Q

Arsenic poisoning

A

Binds to sulfhydryl groups and disrupts cellular respiration and gluconeogenesis
Sources: pesticide, contaminated water from wells, pressure treated wood
Manifestations: garlic breath, vomitting, watery diarrhea, QTc prolongation
Tx: dimercaprol (cheating agent that increases urinary excretion of heavy metals by forming non toxic soluble chelates

70
Q

Gastroduodenal artery

A

Supplies the pylorus, proximal part of the duodenum and indirectly the pancreatic head (ant and post superior pancreaticoduodenal arteries)

71
Q

Tracheoesophageal fistula with esophageal atresia

A

Failure of the primitive foregut to appropriately divide into separate trachea and esophageal structures
Sx: infant with excessive secretions and choking/cyanosis during feeding
Dx: inability to pass NG tube into stomach

72
Q

Gallstone ileus

A

Complication of long withstanding cholelethiasis in elderly women
Gallstone causes a cholecysternic fistula btwn the gallbladder and the gut
Gallstone passes to intestine and creates a small bowel obstruction (high pitched bowel sounds)
Gas may enter biliary tree

73
Q

Acute appendicitis

A

Obstruction of the lumen of the appendix
Fecaliths, hyperplastic lymphoid follicles, foreign bodies or tumors may cause obstruction
RLQ pain, nausea, vomiting, diarrhea, and fevers are typical
Starts as peri umbilical pain and moves to RLQ

74
Q

Splenic vein thrombosis

A

Pancreatic inflammation (pancreatitis, pancreatic cancer) can cause a blood clot within the splenic vein, which can increase pressure in the short gastric veins and lead to gastric varies only in the fundus

75
Q

Toxic megacolon

A

Complication of ulcerative colitis
Pts typically present with abdominal pain/distention, bloody diarrhea, fever and signs of shock (hypotension and tachycardia)
Plain abdominal X-ray (colonic dilation w multiple air-fluid levels

76
Q

Uncomplicated umbilical hernia

A

Defect at the linea alba covered by skin-incomplete closure of the umbilical ring
Reducible bulge at umbilicus, notably with increased abdominal pressure (crying, passing bowel movements)
Assoc w Down syndrome, hypothyroidism, beckwith-wiedmann syndrome

77
Q

H. Pylori

A

Noninvasive found attached to the gastric mucosa
Produce urease which converts urea to ammonia alkalinizing the surround pH which allows the bacteria to survive
Antral gastritis: Chronic inflammation leads to decreased somatostatin, increased gastrin, increased parietal cells, increased acid which leads duodenal ulcers
High prevalence in individuals from China
Tx: triple therapy (amoxicillin, clarithromycin, PPI)

78
Q

Necrotizing enterocolitis

A 
Common GI emergency affecting newborns
Bacterial invasion (immunological immaturity) and ischemic necrosis of bowel wall, assoc w prematurity and initiation of enteral feeding
Abdominal X-ray shows pneumoatosis intestinalis (air in the bowel wall) confirms Dx -> thin curvilinear areas of lucency
Bowel becomes congested and gangrenous with the formation of intramural gas collections
79
Q

Blood supply of stomach

A

Proximal lesser curvature: celiac -> L gastric
Distal lesser curvature: celiac-> common hepatic -> proper hepatic-> R gastric
Proximal greater curvature: celiac-> splenic-> L gastroepiploic
Distal greater curvature: celiac-> common hepatic-> gastroduodenal-> R gastroepiploic
Proximal greater curvature above splenic artery: celiac-> splenic-> short gastric arteries

80
Q

Stress-related mucosal disease

A

Acute gastric mucosal defects that develop in response to severe physiologic stress (eg. Shock, extensive burns, sepsis, severe trauma, intracranial injury). Multiple small, circular lesions in the stomach, ranging from superficial erosions to full thickness ulcers. Ulcers may bleed.
Usually caused by local ischemia

Curlings ulcers (ulcers in proximal duodenum assoc. w severe trauma/burns) and Cushings ulcers (direct vagus nerve stimulation)

81
Q

Common serum tumor markers

A

Alpha fetoprotein: hepatocellular carcinoma and germ cell tumors
CA 19-9: pancreatic
CA 125: ovarian
Carcinoembryonic antigen: GI (colorectal)
HCG: choriocarcinoma and germ cell tumors
PSA: prostate

82
Q

Diffuse esophageal spasm (DES)

A

Periodic, simultaneous and non-peristaltic contractions of the esophagus due to impaired inhibitory innervation within the esophageal myenteric plexus. Present w dysphagia, and chest pain. “Corkscrew” esophagus on barium esophogram

83
Q

Adenocarcinoma at the head of the pancreas

A

Palpable but non tender gallbladder (Courvoisier sign), weight loss and obstructive jaundice (assoc w pruritis, dark urine, and pale stools)–> cancer of the head of the pancreas compressing the bile duct

84
Q

Chronic mesenteric ischemia

A

Atherosclerosis of the mesenteric arteries, resulting in diminished blood flow to the intestine after meals. Causes post prandial epigastric pain (“intestinal angina”) w associated food aversion/weigh loss. Similar to angina pectoris

85
Q

Beta glucouronidase

A

Bacterial or helminthic infection of the biliary tract results in the release of beta-glucouronidase by injured hepatocytes and bacteria. Hydrolyzes bilirubin glucouronides and increases the amount of unconjugated bilirubin -> development of brown pigment gallstones
-common in East Asian countries

STEP 1 (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions