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USMLE STEP 1 > GI > Flashcards

GI 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
caput medusae
paraumbilical-->superficial and inferior epigastric below aumbilicus; superior epigastric and lateral thoracic above
26
internal hemorrhoids
superior rectal--> middle and inferior rectal
27
internal hemorrhoids blood supply
superior rectal artery (branch of IMA) superior rectal vein-->inferior mesenteric vein-->portal system lymph-->deep nodes
28
external hemorrhoids blood supply
inferior rectal artery (branch of internal pudendal) inferior rectal vein-->internal pudendal vein-->internal iliac-->IVC lymph-->superficial inguinal nodes
29
zone III of liver
contains P450
30
anal fissure
most commonly in posterior midline distal to dentate libe
31
hourglass stomach
sliding hiatal hernia | defective development of pleuroperitoneal membrane
32
paraesophageal hernia
fundus protrudes into thorax bowel sounds in lower lung field lung hypoplasia
33
failure of processus vaginalis to close
indirect inguinal hernia
34
weakness of transversalis fascia
direct inguinal hernia
35
leading cause of bowel incarceration
femoral hernia
36
Na in pancreatic secretions
identical to that of plasma | Cl decreases as bicarb increases
37
gastrinoma location
pancreas or duodenum
38
gastrin stimulators
chronic PPI, phenylalanine, tryptophan
39
can cause duodenal ulcers in atypical locations/distal
Zollinger-Ellison syndrome
40
CCK
``` I cells (duodenum, jejunum) increase pancreatic secretions, gallbladder contraction ```
41
secretion
``` S cells (duodenum) increase pancreatic bicarb ```
42
somatostatin
D cells (pancreatic islets, GI mucosa) decrease gastric acid and pepsinogen decrease insulin and glucagon
43
glucose-dependent insulinotropic peptide (GIP)
``` K cells (duodenum, jejunum) decrease gastric H secretion, increase insulin release oral glucose dose used more rapidly than IV due to GIP ```
44
VIP
parasympathetic ganglia in sphincters, gallbladder, small intestine increased intestinal water and electrolyte secretion
45
motilin
increased in fasting state | erythromycin (agonist) used to stimulate peristalsis
46
intrinsic factor
parietal cells
47
gastric acid
parietal cells | increased by histamine, ACh, gastrin
48
pepsin
chief cells
49
bicarb
mucosal cells and bruner glands (duodenum)
50
gastrin
increases acid secretion through its effects on ECL cells (leading to histamine release) rather than through direct effects on parietal cells
51
atropine
blocks vagal stimulation of parietal cells | vagal stimulation of G cells is unaffected (use GRP instead of ACh)
52
gastric parietal cells
found in superficial region of gastric glands | pale, pink, plate-like
53
chief cells
found in deeper region of gastric glands | right above muscularis mucosa
54
brunner gland hypertrophy
seen in peptic ulcer disease in duodenal submucosa secrete alkaline mucus
55
pancreatic secretions
low flow->high Cl- | high flow-->high bicarb
56
oligosaccharide hydrolases
at brush border of intestine rate-limiting in carbohydrate digestion produce monosaccharides
57
D-xylose absorption test
distinguishes GI mucosal damage from otehr causes of malabsorption
58
carbohydrate absorption
glucose and galactose taken up by SGLT1 (Na dependent) | fructose is taken up by GLUT 5 (facilitated)
59
peyer's patches
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
bile salts
bile acids conjugated to glycine or taurine | antimicrobial (membrane disruption)
61
rate-limiting step of bile
catalyzed by cholesterol 7alpha-hydroxylase
62
pleomorphic adenoma
benign salivary gland tumor (usually at parotid) biphasic (cartilage and epithelium) CN VII involvement, irregular margins
63
Warthin's tumor
benign salivary gland tumor with germinal centers
64
mucoepidermoid carcinoma
malignant salivary gland tumor mucinous and squamous components painful
65
esophagitis
HSV-1: punched out ulcers | CMV: linear ulcers
66
esophageal strictures
associated with ye ingestion and acid reflux
67
esophageal cancer lymph node spread
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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