GI Flashcards
1
Q
A new holosystolic murmur is preceeded by
A
Bacterial infection
2
Q
What cause Vitamin B12 deficiency?
A
- Poor nutrition (elderly and alcoholics)
2. Malabsorption Syndromes
3
Q
Autoimmune Disorder mainly affecting women presents with dry eyes and dry mouth and lack of normal saliva production
A
Sjogren syndrome
4
Q
A bleeding Esophageal varices is from a chronic shunt of blood from
A
Left Gastric vein
5
Q
What test is highly sensitive and highly specific for EBV infection
A
Heterophile antibody test
6
Q
Patients with acute tubular necrosis regain renal function through
A
Tubular re-epithelization
7
Q
Linear IgG and C3 deposit on immunofluorescence and Crescent formation on light microscopy
A
Goodpasture Syndrome
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
9
Q
What is the best land mark for distinguishing an INDIRECT HERNIA from a DIRECT HERNIA
A
Inferior epigastric vessels
10
Q
Acquired autoimmune condition characterized by weakness of facial, periocular, bulbar and pelvic girdle muscle
A
Myasthenia Gravis
11
Q
The lower part of the rectum ( the inferior aspect) drain into
A
Internal Iliac lymph nodes
12
Q
Which virus commonly infects B cells, stimulating them to proliferate continuously (transformation or immortalization)
A
Epstein-Barr virus
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)
14
Q
In Appendicitis what can be used as a land mark during surgery
A
Tenia Coli
15
Q
Phosphodiesterase inhibitors (SILDENAFIL) decrease the degradation of
A
cGMP
16
Q
Neuromuscular disorder presenting with proximal muscle weakness, cranial nerve involvement (ocularbulbar) and autonomic symptoms
A
Lambert-Eaton Myasthenic Syndrome (LEMS)
17
Q
In Turner Syndrome what pathway is stimulated by GH to promote growth
A
JAK-STAT pathway
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
19
Q
Point mutation in Neurophysin is the mostly the underlining cause of
A
Diabetes Insipidus
20
Q
Treatment for Wilsons
A
D-penicillamine (chelators of copper)
21
Q
In the presence of oxygen, pyruvate produced during glycolysis is converted by
A
Pyruvate dehydrogenase to acetyl-coA
22
Q
Acute tubular Necrosis mainly affects
A
Proximal tubule and Thick Ascending Limb of Henle
23
Q
What are the lab Findings in Wilsons Disease
A
Increase Urinary Copper, Decrease Ceruloplasmin and Increase Copper on Liver biopsy
24
Q
What are the 2 types of gastritis?
A
- Non-infectious - NSAID, Alcohol, Stress induced
2. Infectious - H. pylori
25
Side effect of Nitroprusside
Cyanide Toxicity
26
Intracellular Signaling of sildenafil is most similar to
Brain Natriuretic peptide and Atrial Natriuretic peptide
27
Where is the mutation in Jarvell and Lange-Nielsen
Voltage-Gated Potassium Channels
28
Fracture to the orbital floor will cause
Reduced sensation over
1. Upper lip,
2. Upper Cheek and
3. Upper Gingiva
29
What extraintestinal complication of Ulcerative Colitis should be suspected in pt presenting with signs of obstructive jaundice?
Primary Sclerosing Cholangitis
30
Zenker Diverticulum is caused by
Increased Intraluminal Pressure (Pulsion)
31
What extraintestinal complication with IBD namely Crohns vs UC should be suspected?
Ankylosing Spondylitis (Bamboo spine on imaging)
32
If inadequate oxygen is present in tissues, pyruvate is converted to
Lactate by Lactate dehydrogenase
33
What test is used to determine the cause of B12 deficiency?
Shilling test
34
Midgut rotation around the superior mesenteric artery can cause extrinsic compression of the
Duodenum
35
Renal biopsy in PSGN on electron microscopy
Discrete sub-epithelial humps
36
What is the cause of Linear ulceration in a patient hospitalized for Pneumocystis jirovecii pneumonia / or (HIV)
Cytomegalovirus
37
Calcium kidney stones is a condition characterized by
Normal serum calcium levels with hypercalciuria
38
What is indicative of poor prognosis of alcoholic cirrhosis
Prolonged Prothrombin Time
39
What is the lymphatic drainage of the PARARECTAL RECTUM (above the dentate line)
Inferior mesenteric nodes
40
What helps the most to down-regulate GASTRIC SECRETION
Intestinal influence
41
which medication are used to selectively dilate arterioles
Hydralazine, Minoxidil
42
What symptoms are associated with chronic pancreatitis?
1. Abdominal pain
2. Diarrhea
3. Weight loss
4. Calcification of pancreas seen on XR
43
Palpable spleen, bleeding esophageal varices and vomiting bright red blood is caused by
Portal Vein Thrombosis
44
What autoimmune (Type A chronic) gastritis cause?
1. Pernicious anemia (inhibit IF)
| 2. Achlorhydia (inhibit HCl)
45
Retroperitoneal hematomas are commonly associated
Abdominal and pelvic trauma
46
Which DNA polymerase has the unique 5' to 3' exonuclease activity
DNA polymerase I
47
The growth promoting effect in gigantism is mediated by
Insulin-like growth factor-1 (IGF-1)
48
What are the M/C cause of chronic pancreatitis?
1. Severe alcohol consumption
| 2. Gallstones (obstruction)
49
Classic triad of cirrhosis, secondary diabetes mellitus and bronze skin
Primary Hemochromatosis
50
What is the clinical presentation of tracheo-esophageal fistula?
Coughing and cyanosis on first feeding
51
A drug that relaxes arterioles but not veins will cause
Sodium and fluid retention
52
Main risk factors of adenocarcinoma of the esophagus (lower 1/3)
Barretts Esophagus and Gastroesophageal Reflux
53
Failure to pass meconium, empty rectal vault on digital examination and massive dilatation of bowl proximal to the obstruction
Hirschsprung Disease
54
What is the treatment difference between Tropical Sprue and Celiac dz?
Celiac responds to gluten free diet, Tropical Sprue does not.
55
Fatigue, pale stool and Xanthelesma with extensive lymphocyte infiltration and granulomatous destruction of interlobular (intrahepatic) bile ducts
Primary Biliary Cirrhosis
56
What is the clinical presentation of carcinoid syndrome?
1. Wheezing/bronchospasm
2. Diarrhea
3. Flushing
4. Rt sided heart murmur that increase on inspiration
57
What is the inheritance pattern of Neurofibromatosis-1
Single-gene autosomal dominant
58
IRON absorption occurs predominantly in
Duodenum and Proximal jejunum
59
What are the symptoms and labs associated with acute pancreatitis?
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
Defective relaxation and peristalsis of rectum and distal sigmoid colon associated with Down Syndrome
Hirschsprung Disease
61
What are the 2 primary causes of chronic gastritis?
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
Metabolic abnormalities seen in hypervitaminosis D is most similar to the once found in
Sarcoidosis
63
Glomerular basement membrane (GBM) disruption and deposition of fibrin
Goodpasture syndrome
64
What do you hear on auscultation on small bowel obstruction?
High pitched tinckling sound on auscultation of the abdomen
65
What are the B12 associated malabsorption syndromes?
1. Pernicious anemia
2. Celiac dz
3. Crohn's dz
4. Pancreatic insufficiency
5. Bacterial overgrowth
6. Diphyllobothrium latum infection
66
What is the first mutation of Familial Adenomatous Polyposis as it progresses to Colorectal Cancer
APC tumor suppressed
67
Muddy brown Casts are pathognomonic for
Acute Tubular necrosis
68
What enzyme plays a role in Calcium Bilirubinate pigment stones
Beta-Glucuronidase
69
A blind pouch connected to the ileu
Meckel Diverticulum
70
hypersegmented neutrophils associated with epigastric tenderness = (a) and associated with Neurological changes = (b)?
(a) Folate and Vitamin B12 deficiency
| (b) Vitamin B12 deficiency
71
What is the path of a catheter to the sigmoid colon
External Iliac---> Common Iliac---> Abdominal Aorta---> Inferior Mesenteric
72
Brisk non-pulsatile bleeding seen behind the liver that is not stopped by occlusion of hepatoduodenal ligament is from
Inferior Vena Cava
73
Gene mutation that renders trypsin insensitive to cleavage inactivation can cause
Pancreatitis
74
Enzyme deficient in Alkaptonuria
Homogentisic acid dioxygenase
75
A gene mutation that decreases activity of NF-kappaB pathway will decrease
Cytokine Production
76
Glucose clearance is typically calculated by the clearance of
INULIN
77
What substance is used to determine renal plasma flow
PAH
| paraaminohippuric acid
78
The virulence factor found in the peptidoglycan cel wall of Staphylococcus aureus is
Protein A
79
alternating binging and compensatory weight reduction behaviors
Bulimia Nervosa
80
What is sulfasalazine?
NSAID used to treat Crohns (inflammatory). Becomes active in the distal/terminal ileum.
81
In children acute appendicitis is caused by
Lymphoid Hyperplasia
82
What is the clinical presentation of duodenal atresia?
Bilious vomiting
Double bubble sign on radiograph
Presents 1st day of life
Associated with Down Syndrome
83
What mediates the damage to the kidneys in Alcohol hepatitis
Acetaldehyde
84
In what situation does transmural inflammation of the colon occur in Ulcerative Colitis?
Toxic Megacolon ==> Medical Emergency
85
A defect in HFE gene, usually C282Y (cysteine is replaced by tyrosine) leading to Excessive intestinal absorption
Primary Hemochromatosis
86
What type of hemorrhoids is observed below the pectinate/ dentate line
External Hemorrhoids (painful)
87
What is the cause of Hirschsprung
Failure of GANGLION CELLS ( neural crest-derived) to descend into myenteric and submucosal plexus
88
Meckel Diverticulum that secrets PANCREATIC ACINI in the mucosa is
Ectopic
89
Cardia Arrhythmias, mild hepatomegaly, DARK TAN despite avoiding sun exposure
Hemochromatosis
90
Blood supply to INTERNAL HEMORRHOIDS is
Inferior Mesenteric Vein Tributries
91
Acute Appendicitis in adults mainly is caused by
Obstruction of the Lumen
92
What causes Hirschsprung dz?
Failure of neural crest cells to migrate to colon ==> congenital megacolon or aganglionic megacolon
93
Medication used in the symptomatic treatment of myasthenia Gravis to increase acetylcholine concentration is
Pyridostigmine
94
Mechanism of Protein A in Staphylococcus Aureus
Binds to the Fc portion of IgG
(lead to complement activation, opsonization and phagocytosis
95
What is carcinoid syndrome?
Tumor of neuroendocrine cells
96
Defective Hepatic excretion of bilirubin (jaundice) during stressful event with dark liver
Dubin-Johnson Syndrome
97
Myasthenia Gravis is an autoimmune disease caused by autoantibodies directed against
Nicotinic acetylcholine receptors
98
Hemolytic anemia, thrombocytopenia and acute kidney injury
Hemolytic Uremic Syndrome
99
What is frequent cause of retroperitoneal hematomas
Pancreatic injury
100
Edema, hematuria and proteinuria a few weeks following a skin or pharyngeal infection in a young child
Post-streptococcal Glomerulonephritis (PSGN)
101
Where is the mutation in Dubin-Johnson Syndrome
Bilirubin Canalicular Transport protein
102
A person vaccinated against hepatitis B virus(HBV) will show
Anti-HBS
103
Clinical improvement with Edrophonium administration indicates that the patient in under-treated for Myasthenia gravis so
Increase Dose of Pyridostigmine
104
What is the nerve supply of the EXTERNAL ANAL area below pectinate line
Inferior rectal nerve a branch of the PUDENDAL
105
Lab Findings in Hemochromatosis
Increase Ferritin, Decrease TIBC, Increased Serum Iron and Increase % saturation
106
What substance inhibit 1-alpha-hydroxylase preventing the conversion of 25-hydroxyvitamin D to 1,25 dihydroxyvitamin D
Calcium (Ca2+)
107
Diffuse blue-black deposit in connective tissue with sclerae and ear cartilage hyper-pigmentation
Alkaptonuria
108
Rigid abdomen, left shoulder pain, hypotension and tachycardia from vehicular accident most likely has
Splenic Laceration
109
Profound Bilateral Sensorineural hearing loss and Prolong QT interval
Jarvall and Lange-Nielsen Syndrom
110
Extensive smoking history, painless hematuria, polycythemia and left-sided renal mass is consistent with
Renal Cell Carcinoma
111
What is the collateral circulation of Descending Colon
Superior Mesenteric Artery
112
Which receptors are bound/ recognized by Zinc fingers
Steroid, Thyroid, Fat Soluble vitamins (ADEK)
113
Diffuse esophageal spasm characterized by simultaneous and non-peristaltic contractions of esophagus caused by
Impaired neural inhibition (myenteric plexus)
114
What is cholestyramine?
Bile acid sequestrant that binds bile salts
115
What is the origin of the spleen
Mesoderm
116
Nerve supply to the posterior part of the EXTERNAL AUDITORY CANAL (PINNA)
Vagus Nerve
117
Diffuse thickening of glomerular capillary walls on light microscopy
Membranous Glomerulopathy
118
Dark, Brown, soft gallstones composed of Calcium Bilirubinate with cholesterol
Pigment Stones
119
Meckel Diverticulum arises from failure of
Vitelline Duct to involute
120
Abdominal pain that presents with guarding and rebound tenderness
Peritonitis
121
Main risk factors of Squamous cell carcinoma of the esophagus (upper 2/3)
Alcohol and Tobacco, N- Nitroso food
122
Renal biopsy in PSGN on immunofluorescence
Coarse granular deposits of IgG and C3 (lumpy-bumpy)
123
Which embryological process failed when there is a Fibrous band seen extending from the cecum and right colon retroperitoneum
Midgut rotation around the superior mesenteric artery
124
What are the clinical presentation for Small Bowel Obstruction?
1. Collicky abdominal pain
2. Abdominal distention
3. Vomiting
4. Constipation
5. Inability to pass gas (severe obstruction)
125
Cirrhosis, behavior changes, dementia, Kayser-Fleisher rings in cornea
Wilson's Disease
126
Which substance activity is impaired with the absence of ENTEROPEPTIDASE
Trypsin
127
What is the mechanism of Risedronate (Bisphosphonate)
Inhibit bone resorption by mature osteoclast
