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SMART 1 > GI > Flashcards

GI Flashcards

1
Q

A new holosystolic murmur is preceeded by

A

Bacterial infection

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2
Q

What cause Vitamin B12 deficiency?

A
  1. Poor nutrition (elderly and alcoholics)

2. Malabsorption Syndromes

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3
Q

Autoimmune Disorder mainly affecting women presents with dry eyes and dry mouth and lack of normal saliva production

A

Sjogren syndrome

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4
Q

A bleeding Esophageal varices is from a chronic shunt of blood from

A

Left Gastric vein

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5
Q

What test is highly sensitive and highly specific for EBV infection

A

Heterophile antibody test

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6
Q

Patients with acute tubular necrosis regain renal function through

A

Tubular re-epithelization

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7
Q

Linear IgG and C3 deposit on immunofluorescence and Crescent formation on light microscopy

A

Goodpasture Syndrome

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8
Q

What is the cause of air in the gall bladder and biliary tree of a patient with gallstones

A

Lodged Gallstone in Illeum

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9
Q

What is the best land mark for distinguishing an INDIRECT HERNIA from a DIRECT HERNIA

A

Inferior epigastric vessels

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10
Q

Acquired autoimmune condition characterized by weakness of facial, periocular, bulbar and pelvic girdle muscle

A

Myasthenia Gravis

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11
Q

The lower part of the rectum ( the inferior aspect) drain into

A

Internal Iliac lymph nodes

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12
Q

Which virus commonly infects B cells, stimulating them to proliferate continuously (transformation or immortalization)

A

Epstein-Barr virus

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13
Q

What is the difference between causes of Tropical Sprue and Celiac dz?

A

Celiac - Pseudo-autoimmune

Tropical Sprue - Infectious (occurs in the tropics)

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14
Q

In Appendicitis what can be used as a land mark during surgery

A

Tenia Coli

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15
Q

Phosphodiesterase inhibitors (SILDENAFIL) decrease the degradation of

A

cGMP

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16
Q

Neuromuscular disorder presenting with proximal muscle weakness, cranial nerve involvement (ocularbulbar) and autonomic symptoms

A

Lambert-Eaton Myasthenic Syndrome (LEMS)

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17
Q

In Turner Syndrome what pathway is stimulated by GH to promote growth

A

JAK-STAT pathway

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18
Q

Inability to walk down stairs or up-close reading which is compensated by tilting head away from affected eye is caused by

A

Trochlear Nerve

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19
Q

Point mutation in Neurophysin is the mostly the underlining cause of

A

Diabetes Insipidus

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20
Q

Treatment for Wilsons

A

D-penicillamine (chelators of copper)

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21
Q

In the presence of oxygen, pyruvate produced during glycolysis is converted by

A

Pyruvate dehydrogenase to acetyl-coA

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22
Q

Acute tubular Necrosis mainly affects

A

Proximal tubule and Thick Ascending Limb of Henle

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23
Q

What are the lab Findings in Wilsons Disease

A

Increase Urinary Copper, Decrease Ceruloplasmin and Increase Copper on Liver biopsy

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24
Q

What are the 2 types of gastritis?

A
  1. Non-infectious - NSAID, Alcohol, Stress induced

2. Infectious - H. pylori

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25
Q

Side effect of Nitroprusside

A

Cyanide Toxicity

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26
Q

Intracellular Signaling of sildenafil is most similar to

A

Brain Natriuretic peptide and Atrial Natriuretic peptide

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27
Q

Where is the mutation in Jarvell and Lange-Nielsen

A

Voltage-Gated Potassium Channels

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28
Q

Fracture to the orbital floor will cause

A

Reduced sensation over

  1. Upper lip,
  2. Upper Cheek and
  3. Upper Gingiva
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29
Q

What extraintestinal complication of Ulcerative Colitis should be suspected in pt presenting with signs of obstructive jaundice?

A

Primary Sclerosing Cholangitis

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30
Q

Zenker Diverticulum is caused by

A

Increased Intraluminal Pressure (Pulsion)

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31
Q

What extraintestinal complication with IBD namely Crohns vs UC should be suspected?

A

Ankylosing Spondylitis (Bamboo spine on imaging)

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32
Q

If inadequate oxygen is present in tissues, pyruvate is converted to

A

Lactate by Lactate dehydrogenase

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33
Q

What test is used to determine the cause of B12 deficiency?

A

Shilling test

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34
Q

Midgut rotation around the superior mesenteric artery can cause extrinsic compression of the

A

Duodenum

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35
Q

Renal biopsy in PSGN on electron microscopy

A

Discrete sub-epithelial humps

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36
Q

What is the cause of Linear ulceration in a patient hospitalized for Pneumocystis jirovecii pneumonia / or (HIV)

A

Cytomegalovirus

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37
Q

Calcium kidney stones is a condition characterized by

A

Normal serum calcium levels with hypercalciuria

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38
Q

What is indicative of poor prognosis of alcoholic cirrhosis

A

Prolonged Prothrombin Time

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39
Q

What is the lymphatic drainage of the PARARECTAL RECTUM (above the dentate line)

A

Inferior mesenteric nodes

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40
Q

What helps the most to down-regulate GASTRIC SECRETION

A

Intestinal influence

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41
Q

which medication are used to selectively dilate arterioles

A

Hydralazine, Minoxidil

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42
Q

What symptoms are associated with chronic pancreatitis?

A
  1. Abdominal pain
  2. Diarrhea
  3. Weight loss
  4. Calcification of pancreas seen on XR
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43
Q

Palpable spleen, bleeding esophageal varices and vomiting bright red blood is caused by

A

Portal Vein Thrombosis

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44
Q

What autoimmune (Type A chronic) gastritis cause?

A
  1. Pernicious anemia (inhibit IF)

2. Achlorhydia (inhibit HCl)

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45
Q

Retroperitoneal hematomas are commonly associated

A

Abdominal and pelvic trauma

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46
Q

Which DNA polymerase has the unique 5’ to 3’ exonuclease activity

A

DNA polymerase I

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47
Q

The growth promoting effect in gigantism is mediated by

A

Insulin-like growth factor-1 (IGF-1)

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48
Q

What are the M/C cause of chronic pancreatitis?

A
  1. Severe alcohol consumption

2. Gallstones (obstruction)

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49
Q

Classic triad of cirrhosis, secondary diabetes mellitus and bronze skin

A

Primary Hemochromatosis

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50
Q

What is the clinical presentation of tracheo-esophageal fistula?

A

Coughing and cyanosis on first feeding

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51
Q

A drug that relaxes arterioles but not veins will cause

A

Sodium and fluid retention

52
Q

Main risk factors of adenocarcinoma of the esophagus (lower 1/3)

A

Barretts Esophagus and Gastroesophageal Reflux

53
Q

Failure to pass meconium, empty rectal vault on digital examination and massive dilatation of bowl proximal to the obstruction

A

Hirschsprung Disease

54
Q

What is the treatment difference between Tropical Sprue and Celiac dz?

A

Celiac responds to gluten free diet, Tropical Sprue does not.

55
Q

Fatigue, pale stool and Xanthelesma with extensive lymphocyte infiltration and granulomatous destruction of interlobular (intrahepatic) bile ducts

A

Primary Biliary Cirrhosis

56
Q

What is the clinical presentation of carcinoid syndrome?

A
  1. Wheezing/bronchospasm
  2. Diarrhea
  3. Flushing
  4. Rt sided heart murmur that increase on inspiration
57
Q

What is the inheritance pattern of Neurofibromatosis-1

A

Single-gene autosomal dominant

58
Q

IRON absorption occurs predominantly in

A

Duodenum and Proximal jejunum

59
Q

What are the symptoms and labs associated with acute pancreatitis?

A
  1. Sudden epigastric pain –> radiates to back
  2. Nausea and vomiting
  3. Fever (low grade)
  4. Epigastric tenderness on PE
  5. Hypotension
  6. Absent bowel sounds on PE
  7. Hypocalcemia
  8. Increased Serum Amylase and Lipase
  9. Leukocytosis
60
Q

Defective relaxation and peristalsis of rectum and distal sigmoid colon associated with Down Syndrome

A

Hirschsprung Disease

61
Q

What are the 2 primary causes of chronic gastritis?

A
  1. Non-infectious - Type A = autoimmune destruction of parietal cells in the fundus and body of stomach
  2. Infectious - Type B - H. pylori colonization of antrum of stomach
62
Q

Metabolic abnormalities seen in hypervitaminosis D is most similar to the once found in

A

Sarcoidosis

63
Q

Glomerular basement membrane (GBM) disruption and deposition of fibrin

A

Goodpasture syndrome

64
Q

What do you hear on auscultation on small bowel obstruction?

A

High pitched tinckling sound on auscultation of the abdomen

65
Q

What are the B12 associated malabsorption syndromes?

A
  1. Pernicious anemia
  2. Celiac dz
  3. Crohn’s dz
  4. Pancreatic insufficiency
  5. Bacterial overgrowth
  6. Diphyllobothrium latum infection
66
Q

What is the first mutation of Familial Adenomatous Polyposis as it progresses to Colorectal Cancer

A

APC tumor suppressed

67
Q

Muddy brown Casts are pathognomonic for

A

Acute Tubular necrosis

68
Q

What enzyme plays a role in Calcium Bilirubinate pigment stones

A

Beta-Glucuronidase

69
Q

A blind pouch connected to the ileu

A

Meckel Diverticulum

70
Q

hypersegmented neutrophils associated with epigastric tenderness = (a) and associated with Neurological changes = (b)?

A

(a) Folate and Vitamin B12 deficiency

(b) Vitamin B12 deficiency

71
Q

What is the path of a catheter to the sigmoid colon

A

External Iliac—> Common Iliac—> Abdominal Aorta—> Inferior Mesenteric

72
Q

Brisk non-pulsatile bleeding seen behind the liver that is not stopped by occlusion of hepatoduodenal ligament is from

A

Inferior Vena Cava

73
Q

Gene mutation that renders trypsin insensitive to cleavage inactivation can cause

A

Pancreatitis

74
Q

Enzyme deficient in Alkaptonuria

A

Homogentisic acid dioxygenase

75
Q

A gene mutation that decreases activity of NF-kappaB pathway will decrease

A

Cytokine Production

76
Q

Glucose clearance is typically calculated by the clearance of

A

INULIN

77
Q

What substance is used to determine renal plasma flow

A

PAH

paraaminohippuric acid

78
Q

The virulence factor found in the peptidoglycan cel wall of Staphylococcus aureus is

A

Protein A

79
Q

alternating binging and compensatory weight reduction behaviors

A

Bulimia Nervosa

80
Q

What is sulfasalazine?

A

NSAID used to treat Crohns (inflammatory). Becomes active in the distal/terminal ileum.

81
Q

In children acute appendicitis is caused by

A

Lymphoid Hyperplasia

82
Q

What is the clinical presentation of duodenal atresia?

A

Bilious vomiting
Double bubble sign on radiograph
Presents 1st day of life
Associated with Down Syndrome

83
Q

What mediates the damage to the kidneys in Alcohol hepatitis

A

Acetaldehyde

84
Q

In what situation does transmural inflammation of the colon occur in Ulcerative Colitis?

A

Toxic Megacolon ==> Medical Emergency

85
Q

A defect in HFE gene, usually C282Y (cysteine is replaced by tyrosine) leading to Excessive intestinal absorption

A

Primary Hemochromatosis

86
Q

What type of hemorrhoids is observed below the pectinate/ dentate line

A

External Hemorrhoids (painful)

87
Q

What is the cause of Hirschsprung

A

Failure of GANGLION CELLS ( neural crest-derived) to descend into myenteric and submucosal plexus

88
Q

Meckel Diverticulum that secrets PANCREATIC ACINI in the mucosa is

A

Ectopic

89
Q

Cardia Arrhythmias, mild hepatomegaly, DARK TAN despite avoiding sun exposure

A

Hemochromatosis

90
Q

Blood supply to INTERNAL HEMORRHOIDS is

A

Inferior Mesenteric Vein Tributries

91
Q

Acute Appendicitis in adults mainly is caused by

A

Obstruction of the Lumen

92
Q

What causes Hirschsprung dz?

A

Failure of neural crest cells to migrate to colon ==> congenital megacolon or aganglionic megacolon

93
Q

Medication used in the symptomatic treatment of myasthenia Gravis to increase acetylcholine concentration is

A

Pyridostigmine

94
Q

Mechanism of Protein A in Staphylococcus Aureus

A

Binds to the Fc portion of IgG

(lead to complement activation, opsonization and phagocytosis

95
Q

What is carcinoid syndrome?

A

Tumor of neuroendocrine cells

96
Q

Defective Hepatic excretion of bilirubin (jaundice) during stressful event with dark liver

A

Dubin-Johnson Syndrome

97
Q

Myasthenia Gravis is an autoimmune disease caused by autoantibodies directed against

A

Nicotinic acetylcholine receptors

98
Q

Hemolytic anemia, thrombocytopenia and acute kidney injury

A

Hemolytic Uremic Syndrome

99
Q

What is frequent cause of retroperitoneal hematomas

A

Pancreatic injury

100
Q

Edema, hematuria and proteinuria a few weeks following a skin or pharyngeal infection in a young child

A

Post-streptococcal Glomerulonephritis (PSGN)

101
Q

Where is the mutation in Dubin-Johnson Syndrome

A

Bilirubin Canalicular Transport protein

102
Q

A person vaccinated against hepatitis B virus(HBV) will show

A

Anti-HBS

103
Q

Clinical improvement with Edrophonium administration indicates that the patient in under-treated for Myasthenia gravis so

A

Increase Dose of Pyridostigmine

104
Q

What is the nerve supply of the EXTERNAL ANAL area below pectinate line

A

Inferior rectal nerve a branch of the PUDENDAL

105
Q

Lab Findings in Hemochromatosis

A

Increase Ferritin, Decrease TIBC, Increased Serum Iron and Increase % saturation

106
Q

What substance inhibit 1-alpha-hydroxylase preventing the conversion of 25-hydroxyvitamin D to 1,25 dihydroxyvitamin D

A

Calcium (Ca2+)

107
Q

Diffuse blue-black deposit in connective tissue with sclerae and ear cartilage hyper-pigmentation

A

Alkaptonuria

108
Q

Rigid abdomen, left shoulder pain, hypotension and tachycardia from vehicular accident most likely has

A

Splenic Laceration

109
Q

Profound Bilateral Sensorineural hearing loss and Prolong QT interval

A

Jarvall and Lange-Nielsen Syndrom

110
Q

Extensive smoking history, painless hematuria, polycythemia and left-sided renal mass is consistent with

A

Renal Cell Carcinoma

111
Q

What is the collateral circulation of Descending Colon

A

Superior Mesenteric Artery

112
Q

Which receptors are bound/ recognized by Zinc fingers

A

Steroid, Thyroid, Fat Soluble vitamins (ADEK)

113
Q

Diffuse esophageal spasm characterized by simultaneous and non-peristaltic contractions of esophagus caused by

A

Impaired neural inhibition (myenteric plexus)

114
Q

What is cholestyramine?

A

Bile acid sequestrant that binds bile salts

115
Q

What is the origin of the spleen

A

Mesoderm

116
Q

Nerve supply to the posterior part of the EXTERNAL AUDITORY CANAL (PINNA)

A

Vagus Nerve

117
Q

Diffuse thickening of glomerular capillary walls on light microscopy

A

Membranous Glomerulopathy

118
Q

Dark, Brown, soft gallstones composed of Calcium Bilirubinate with cholesterol

A

Pigment Stones

119
Q

Meckel Diverticulum arises from failure of

A

Vitelline Duct to involute

120
Q

Abdominal pain that presents with guarding and rebound tenderness

A

Peritonitis

121
Q

Main risk factors of Squamous cell carcinoma of the esophagus (upper 2/3)

A

Alcohol and Tobacco, N- Nitroso food

122
Q

Renal biopsy in PSGN on immunofluorescence

A

Coarse granular deposits of IgG and C3 (lumpy-bumpy)

123
Q

Which embryological process failed when there is a Fibrous band seen extending from the cecum and right colon retroperitoneum

A

Midgut rotation around the superior mesenteric artery

124
Q

What are the clinical presentation for Small Bowel Obstruction?

A
  1. Collicky abdominal pain
  2. Abdominal distention
  3. Vomiting
  4. Constipation
  5. Inability to pass gas (severe obstruction)
125
Q

Cirrhosis, behavior changes, dementia, Kayser-Fleisher rings in cornea

A

Wilson’s Disease

126
Q

Which substance activity is impaired with the absence of ENTEROPEPTIDASE

A

Trypsin

127
Q

What is the mechanism of Risedronate (Bisphosphonate)

A

Inhibit bone resorption by mature osteoclast

SMART 1 (14 decks)

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