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Kaplan Step 1 > GI > Flashcards

GI Flashcards

1
Q

Name the retroperitoneal organs of the GI tract

A 
Suprarenal glands (adrenal), 
Aorta + IVC
Duodenum (2-4 parts)
Pancreas
Ureter
Colon (ascending and descending)
Kidneys
Esophagus (lower 2/3)
Rectum
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2
Q

Spinal cord level of celiac trunk

A

T12

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3
Q

Spinal cord level of superior mesenteric artery

A

L1

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4
Q

Spinal cord level of inferior mesenteric artery

A

L3

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5
Q

Divisions of celiac trunk and supply

A

Splenic artery, left gastric and common hepatic. CH splits into gastroduodenal and proper hepatic. Proper hepatic gives off right gastric

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6
Q

Divisions of SMA

A

inferior pancreato-duodenal, middle colic, right colic, ileocolic

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7
Q

Divisions of IMA

A

left colic, sigmoidal, superior rectal

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8
Q

Fracture of 10th and 11th ribs may result in injury of what organ?

A

Spleen

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9
Q

Zollinger-Ellison is a _______ secreting tumor

A

Gastrin

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10
Q

What hormone normally inhibits gastrin secretion, but increases gastrin secretion in gastrinomas?

A

Secretin

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11
Q

Gastrin is secreted by _______ and normally functions to _______

A

G cells; increase acid secretion by parietal cells, increase gastric motility increase growth of mucosa

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12
Q

Secretin is secreted by _______ and normally functions to _______

A

S cells; inhibit gastrin secretion

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13
Q

Muscles of esophagus

A

Upper 1/3 is striated, Middle is mixed, and lower 1/3 is smooth muscle

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14
Q

Hyperplastic polyps are ______ (benign/malignant) growths characterized by ______ on histology

A

Benign (and the most common); saw-tooth appearance

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15
Q

Intussusception is caused by ______ (deformity) and presents with ______ stools.

A

Telescoping of bowel segment (typically ileum into cecum). Bloody “jelly” stools.

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16
Q

Most common age of presentation for intussusception is

A

3-6 months

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17
Q

Pyloric stenosis presents with ______ at ______ (age)

A

Forceful, nonbilious vomiting at 3-6 weeks

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18
Q

Pyloric stenosis can be detected through _______

A

Abdominal ultrasound

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19
Q

Lab values in pyloric stenosis show

A

hyperchloremic metabolic alkalosis (due to vomiting)

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20
Q

G cells are located in _______

A

Antrum, duodenum and jejunum

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21
Q

Chronic gastritis (autoimmune) is caused by ______ (pathophysiology)

A

Attack of CD4+ on the H+/K+ transporter in parietal cells

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22
Q

What type of anemia is present in chronic gastritis?

A

Megaloblastic anemia. Parietal cells are unable to secrete intrinsic factor which assists in B12 absorption. Without B12, RBC cannot fully mature, resulting in megaloblastic anemia.

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23
Q

Celiac’s disease is an intolerance to _______

A

Gluten

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24
Q

A late complication of celiac’s disease involves in ______ , a skin manifestation

A

Dermatitis Herpetiformis

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25
Q

On histology, celiac’s disease is characterized by ______.

A

Flattening of the villi

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26
Q

Gallbladder pain radiates to ______

A

The back shoulder

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27
Q

Choledocholithiasis is obstruction of ______. On presentation, the patient has ______ and labs show ______.

A

Common bile duct, jaundice, elevated direct bilirubin

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28
Q

Pain from the gall bladder radiates to ______

A

Right scapula

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29
Q

Charcot’s triad is seen in ______ and means _______.

A

Acute cholangitis; fever, jaundice and RUQ pain

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30
Q

Management for acute cholangitis is ______.

A

ERCP: endoscopic retrograde cholangiopancreatography

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31
Q

Meconium ileus is characterized by ______ and is seen in this disease.

A

Failure to pass first stool; cystic fibrosis

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32
Q

Necrotizing colitis presents ______ (age) and is associated with ______ (feeding)

A

2-3 weeks of life; formula-fed babies

33
Q

Gastrinomas most often occur in _____ and _____

A

duodenum and pancreas

34
Q

Meckel’s diverticulum results from ______ .

A

Persistence of vitellin duct which is a connection between ileum and yolk sac

35
Q

The Apoprotein molecule responsible for activating Lipoprotein Lipase is ______

A

Apo CII

36
Q

Pernicious anemia is caused by ______. Symptoms include ______

A

Lack of Vit B12 absorption (could be due to damaged parietal cells). Weakness, fatigue, glossitis (big tongue), neurological deficits

37
Q

Type I hyperlipidemia is characterized by increased ______ due to ______

A

chylomicrons; defective LPL or ApoCII

38
Q

Enteric fistula to the bladder results in _____ in urine and is suggestive of ______

A

fecal matter; Crohn’s disease

39
Q

Barium study will show a ______ for Crohn’s Disease

A

“string sign”

40
Q

The inflammation in Crohn’s disease is ______ vs in Ulcerative colitis is ______

A

transmural and has skipping; mucosa and submucosa and continuous

41
Q

Most common site of inflammation in Crohn’s is ______ and in Ulcerative Colitis is ______

A

ileum, rectum (goes proximal but never ileum)

42
Q

The post-ganglionic cells of autonomics are derived from ______

A

neural crest cells

43
Q

______ are cells of the adrenal gland that secrete epinephrine. They are derived from ______

A

chromaffin; neural crest cells

44
Q

Colonic diverticula are out-pouchings of the ______ layers of the colon; and hence are called ______ diverticulum

A

mucosal and submucosal; false

45
Q

Diverticulosis vs diverticulitis

A

diverticulosis is presence of diverticula without inflammation; diverticulitis is presence of diverticula with inflammation

46
Q

The most common cause of painless bleeding in the elderly is ______

A

diverticulosis

47
Q

Gastroschisis is caused by ______ and presents

A

incomplete fusions of lateral body folds; abdominal intestinal projections not covered by amnion adjacent to the midline

48
Q

Barium enema of Hirschsprung’s shows ______. The affected area is ______

A

Narrow rectum and dilated proximal colon; the narrow part that is aganglionic

49
Q

The short gastric artery is a branch off ______ and supplied the ______

A

splenic artery; fundus of the stomach

50
Q

In alcoholic hepatitis; LFTs reveal

A

Elevated AST and ALT with and AST:ALT ratio of >2

51
Q

Alcoholic hepatits on histology is characterized by _____

A

Swollen and necrotic hepatocytes and Mallory hyaline bodies

52
Q

An epigastric pain that is relieved by food indicates possible ______

A

ulcer in duodenum

53
Q

Reye’s Syndrome is damage to the ______ that causes ______

A

mitochondria, fatty liver and encephalopathy

54
Q

______ causes fatty liver and encephalopathy and typically occurs post-viral illness

A

Reye’s Syndrome

55
Q

_______ enzyme deficiency presents during infancy with intolerance to fruit products. Known as ______.

A

Fructose-1-phosphate aldolase B

56
Q

The problem in fructose 1 phosphate aldolase B deficiency is ______ which leads to (hyper/hypo) glycemia.

A

Trapping of inorganic phosphate. Leading to hypoglycemia (as glycogenolysis and gluconeogenesis require P)

57
Q

Essential fructosuria is a deficiency in ______ and presents ______

A

fructokinase; asymptomatically

58
Q

Classical galactosemia is caused by a _______ deficiency. Its inheritance pattern is ______. A prominent feature is ______

A

Galactose 1 phosphate uridylyl transferase; autosomal recessive; cataracts

59
Q

What leads to cataracts in deficiencies of galactose metabolism?

A

Galactose gets converted to galactitol via aldose reductase. Leads to build up in lens

60
Q

Dietary modification for deficiencies in galactose metabolism

A

Strict lactose restriction

61
Q

Regulation of PDH

A

There is a PDH kinase which phosphorylates and inactivates. The kinase is activated by acetyl-coa, NADH and ATP. The kinase inhibited by pyruvate and ADP. The phosphatase is activated by Ca2+.

62
Q

Lesch-Nyann Syndrome is a deficiency in ______ which is part of ______ pathway. This leads to ______ (metabolic). Features include ______ (various).

A

HGPRT, purine salvage; excessive de novo purine synthesis and uric acid (monosodium urate crystals). Self-mutilation, mental retardation

63
Q

What area is below the pectinate line and what is the blood supply?

A

Bottom part of anus; supplied by inferior rectal artery.

64
Q

Varicosities in the inferior rectal vein produce (internal/external) hemorrhoids that are (painful/painless)

A

External; painful

65
Q

Sliding hiatal hernias

A

Gastroesophageal junction found significantly above the hiatus

66
Q

Familial adenomatous polyposis typically occurs on the _____ side and arises from which pathogenesis pathway? Caused by what mutation?

A

Left; loss of APC, leading to KRAS mutation; 5q22

67
Q

Hyperthyroidism caused by Graves disease is caused by which hypersensitivity?

A

Type II - noncytotoxic

68
Q

What is Mallory-weiss tear?

A

Severe vomiting can result in a tear in the gastroesophageal junction which can lead to vomiting blood

69
Q

Areas of rich anastamoses in the gut

A

Lesser curvature (Left and right gastric); greater curvature (right and left gastroepiploic)

70
Q

MEN Type II is characterized by a mutation in ______

A

RET

71
Q

Infant with hypothyroidism only shows symptoms and failure to thrive after a few weeks, why?

A

Maternal-fetal- transfer of T4

72
Q

If you eat a ton of salt, what hormone maintains your plasma salt level?

A

ADH - thirst mechanism

73
Q

MMC and role in bacteria

A

Maintain low bacterial count

74
Q

Hemolytic anemia causes what kind of stones in the gallbladder

A

Bilirubinate stones (dark pigmented)

75
Q

Intestinal metaplasia of the esophagus in Barrett’s has what epithelium

A

Nonciliated columnar

76
Q

The splenic artery and vein travel within what ligament

A

Splenorenal ligament

77
Q

Pregnancy and its effects on thyroid hormone

A

Pregnancy increases estrogen which increases thyroid binding globulin. This results in increased Total T4 but TSH is normal because only free T4 can modulate TSH

78
Q

Gastrin’s role in mucosal barrier

A

Increases mucosa to thicken the barrier

Kaplan Step 1 (8 decks)

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