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USMLE STEP 1 > GI > Flashcards

GI Flashcards

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USMLE® Step 1 flashcards
1
Q

sternal defects

A

failure of rostral fold closure

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2
Q

omphalocele, gastroschisis

A

failure of lateral fold closure

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3
Q

bladder exstrophy

A

failure of caudal fold closure

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4
Q

gastroschisis

A

extrusion of abdominal contents through abdominal folds

not covered by peritoneum

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5
Q

omphalocele

A

persistence of herniation of abdominal contents into umbilical cord
covered by peritoneum

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6
Q

duodenal atresia

A

failure to recanalize
trisomy 21
polyhadramnios, double-bubble sign, billous vomiting

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7
Q

jejunal, ileal, colonic atresia

A

due to vascular accident

apple peel atresia (Christmas tree)

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8
Q

ventral pancreatic buds

A

inferior aspect of pancreatic head and main pancreatic duct, uncinate process

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9
Q

annular pancreas

A

abnormal migration of ventral pancreatic bud

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10
Q

adjustable gastric banding

A

placed around gastric cardia

pierces through lesser omentum

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11
Q

falciform ligament

A

liver to anterior abdominal wall
ligamentum teres hepatis
derivative of ventral mesentery

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12
Q

hepatoduodenal ligament

A

portal triad

connects greater and lesser sacs

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13
Q

gastrohepatic ligament

A

liver to lesser curvature of stomach
gastric arteries
separates greater and lesser sacs on the right

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14
Q

gastrocolic ligament

A

greater curvature and transverse colon
gastroepiploic arteries
part of greater omentum

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15
Q

gastrosplenic ligament

A

greater curvature and spleen
short gastric, gastroepiploic vessels
separates greater and lesser sacs on lft

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16
Q

splenorenal ligament

A

spleen to posterior abdominal wall
splenic artery and vein
tail of pancreas

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17
Q

Meissner’s plexus location

A

submucosa

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18
Q

myenteric (auerbach’s) plexus location

A

muscularis externa

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19
Q

duodenum histology

A

brunner’s glands, crypts of lieberkuhn

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20
Q

jejunum histology

A

plicae cercularis, crypts of lieberkuhn

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21
Q

ileum histology

A

peyer’s patches, plicae circularis, crypts of lieberkuhn, goblet cells

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22
Q

SMA syndrome

A 
transverse portion (3rd segment)of duodenum entrapped between SMA and aorta
can occur with recent weight loss
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23
Q

watershed region of hindgut

A

splenic flexure

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24
Q

esophageal varices

A

left gastric–>esophageal

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25
Q

caput medusae

A

paraumbilical–>superficial and inferior epigastric below aumbilicus; superior epigastric and lateral thoracic above

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26
Q

internal hemorrhoids

A

superior rectal–> middle and inferior rectal

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27
Q

internal hemorrhoids blood supply

A

superior rectal artery (branch of IMA)
superior rectal vein–>inferior mesenteric vein–>portal system
lymph–>deep nodes

28
Q

external hemorrhoids blood supply

A

inferior rectal artery (branch of internal pudendal)
inferior rectal vein–>internal pudendal vein–>internal iliac–>IVC
lymph–>superficial inguinal nodes

29
Q

zone III of liver

A

contains P450

30
Q

anal fissure

A

most commonly in posterior midline distal to dentate libe

31
Q

hourglass stomach

A

sliding hiatal hernia

defective development of pleuroperitoneal membrane

32
Q

paraesophageal hernia

A

fundus protrudes into thorax
bowel sounds in lower lung field
lung hypoplasia

33
Q

failure of processus vaginalis to close

A

indirect inguinal hernia

34
Q

weakness of transversalis fascia

A

direct inguinal hernia

35
Q

leading cause of bowel incarceration

A

femoral hernia

36
Q

Na in pancreatic secretions

A

identical to that of plasma

Cl decreases as bicarb increases

37
Q

gastrinoma location

A

pancreas or duodenum

38
Q

gastrin stimulators

A

chronic PPI, phenylalanine, tryptophan

39
Q

can cause duodenal ulcers in atypical locations/distal

A

Zollinger-Ellison syndrome

40
Q

CCK

A 
I cells (duodenum, jejunum)
increase pancreatic secretions, gallbladder contraction
41
Q

secretion

A 
S cells (duodenum)
increase pancreatic bicarb
42
Q

somatostatin

A

D cells (pancreatic islets, GI mucosa)
decrease gastric acid and pepsinogen
decrease insulin and glucagon

43
Q

glucose-dependent insulinotropic peptide (GIP)

A 
K cells (duodenum, jejunum)
decrease gastric H secretion, increase insulin release
oral glucose dose used more rapidly than IV due to GIP
44
Q

VIP

A

parasympathetic ganglia in sphincters, gallbladder, small intestine
increased intestinal water and electrolyte secretion

45
Q

motilin

A

increased in fasting state

erythromycin (agonist) used to stimulate peristalsis

46
Q

intrinsic factor

A

parietal cells

47
Q

gastric acid

A

parietal cells

increased by histamine, ACh, gastrin

48
Q

pepsin

A

chief cells

49
Q

bicarb

A

mucosal cells and bruner glands (duodenum)

50
Q

gastrin

A

increases acid secretion through its effects on ECL cells (leading to histamine release) rather than through direct effects on parietal cells

51
Q

atropine

A

blocks vagal stimulation of parietal cells

vagal stimulation of G cells is unaffected (use GRP instead of ACh)

52
Q

gastric parietal cells

A

found in superficial region of gastric glands

pale, pink, plate-like

53
Q

chief cells

A

found in deeper region of gastric glands

right above muscularis mucosa

54
Q

brunner gland hypertrophy

A

seen in peptic ulcer disease
in duodenal submucosa
secrete alkaline mucus

55
Q

pancreatic secretions

A

low flow->high Cl-

high flow–>high bicarb

56
Q

oligosaccharide hydrolases

A

at brush border of intestine
rate-limiting in carbohydrate digestion
produce monosaccharides

57
Q

D-xylose absorption test

A

distinguishes GI mucosal damage from otehr causes of malabsorption

58
Q

carbohydrate absorption

A

glucose and galactose taken up by SGLT1 (Na dependent)

fructose is taken up by GLUT 5 (facilitated)

59
Q

peyer’s patches

A

unencapsulated lymphoid tissue in lamina propria and submucosa of ileum
M cells that take up antigen
B cells differentiate into IgA-secreting plasma cells

60
Q

bile salts

A

bile acids conjugated to glycine or taurine

antimicrobial (membrane disruption)

61
Q

rate-limiting step of bile

A

catalyzed by cholesterol 7alpha-hydroxylase

62
Q

pleomorphic adenoma

A

benign salivary gland tumor (usually at parotid)
biphasic (cartilage and epithelium)
CN VII involvement, irregular margins

63
Q

Warthin’s tumor

A

benign salivary gland tumor with germinal centers

64
Q

mucoepidermoid carcinoma

A

malignant salivary gland tumor
mucinous and squamous components
painful

65
Q

esophagitis

A

HSV-1: punched out ulcers

CMV: linear ulcers

66
Q

esophageal strictures

A

associated with ye ingestion and acid reflux

67
Q

esophageal cancer lymph node spread

A

upper 1/3: cervical
middle 1/3: mediastinal or tracheobronchal
lower 1/3: celiac and gastric

USMLE STEP 1 (21 decks)

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