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COMLEX Level 1 > GI > Flashcards

GI Flashcards

1
Q

Gastrin

A

↑ gastric acid secretion
↑ growth of gastric mucosa
↑ gastric motility
secreted by G cells in the stomach

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2
Q

Somatostatin

A 
↓ gastric acid and pepsinogen secretion
↓ pancreatic and SI secretions
↓ gallbladder contraction
↓ insulin and glucagon release
released by D cells in pancreas and GI
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3
Q

CCK

A

↑ pancreatic secretions
↑ gallbaldder contraction
↑ sphincter of Oddi relaxation
secreted by I cells in duodenum and jejunum

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4
Q

Secretin

A

↑ Pancreatic HCO3- secretion
↓ gastric acid secretion
↑ bile secretion
released from S cells in the duodenum

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5
Q

Glucose-dependent Insulinotropc peptide

A

↓ gastric acid secretion
↑ insulin release
secreted from K cells in the duodenum and jejunum

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6
Q

Vasoactive inestinal polypeptide (VIP)

A

↑ intenstinal water and electrolyte secretion
↑ relaxation of intenstinal smooth muscle and sphincters
↑ in VIPoma

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7
Q

VIPoma

A

pancreatic islet cell tumor
↑↑ VIP secretion
causes watery diarrhea, hypokalemia, and achlorhydria (no gastric acid secretion?)

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8
Q

Ghrelin

A

↑ appetite

released from stomach

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9
Q

Intrinsic factor

A

binds with Vit B12 to allow absorption in terminal ileum

released from parietal cells in stomach

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10
Q

Primary sclerosing cholangitis

A

onion skin bile duct
beading of bile ducts
p-ANCA
assx with ulcerative colitis

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11
Q

Primary biliary cholangitis

A

autoimmune destruction of lobular bile ducts

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12
Q

secondary biliary cholangitis

A

Extrahepatic biliary obstruction

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13
Q

Portosystemic anastomoses

A

Left gastric → Azygos
Paraumbilical → Epigastric
Superior rectal → Middle, inferior rectal

Portal → systemic

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14
Q

Retroperitoneal structures

A 
SAD PUCKER
Suprarenal glands
Aorta/IVC
Pancreas
Duodenum
Pancreas
Ureters
Colon (Ascending and descending)
Kidneys
Esophagus
Rectum
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15
Q

Vessels inside hepatoduodenal ligament

A

Portal triad
proper hepatic a.
portal v.
bile ducts

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16
Q

Indirect inguinal hernia

A

Herniates through internal ring, external ring, and into scrotum
lateral to inf epigastric vessels

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17
Q

Direct inguinal hernia

A

Herniates through external ring only

medial to inf epigastric vessels

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18
Q

Femoral hernia

A

inferior to inguinal ligament and medial to femoral vessels

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19
Q

cholesterol 7α-hydroxylase

A

rate limiting step of bile acid synthesis

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20
Q

diffuse esophageal spasm

A

corkscrew appearance

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21
Q

Boerhaave syndrome

A

distal esophageal rupture from vomitting

22
Q

Mallory-Weiss syndrome

A

Partial thickness longitudinal laceration of distal esophagus
from violent vomiting
alcoholics

23
Q

Plummer-Vinson syndrome

A 
Plummers DIE
DYsphagia
Iron def anemia
Esophageal webs
↑ risk of SCC
koilonychia → spoon shaped nails
24
Q

Schatzki rings

A

rings at gastroesophageal junction from acid reflux

25
Q

Menetrier disease

A

hyperplasia of gastric mucosa
↓ acid production
↑ mucous
Protein loss → edema

26
Q

Virchow node

A

left supraclavicular node indicating gastric cancer

27
Q

Krukenberg tumor

A

Mucin-secreting, signet ring cells

bilateral ovary metastases from gastric cancer

28
Q

Sister-mary Joseph nodule

A

subQ periumbilical metastasis from gastric cancer

29
Q

Celiac disease

A 
Gliadin allergy
HLA-DQ2 and HLA-DQ8
IgA tTG (anti-tissue transglutaminase)
Villous atrophy
crypt hyperplasia
intraepithelial lymphocytosis
30
Q

Whipple disease

A 
Tropheryma whipplei
PAS +
gram +
foamy macrophages
Heart, brain, joint
diarrhea
31
Q

Crohn’s

A 
transmural inflammation
cobblestone mucosa
noncaseating granulomas
Kidney stones
ASCA antibodies
Th1
32
Q

Ulcerative colitis

A

mucosal and submucoal inflammating
Lead pipe
Th2
p-ANCA

33
Q

diverticulosis

A

many false diverticuli in the colon
diet high in fat and red meat
hematochezia

34
Q

Necrotizing enterocolitis

A

Preamature babies fed only with formula

35
Q

Lynch syndrome

A

colon cancer with no polyps

endometrial and ovarian cancers also

36
Q

Anal SCC

A

HPV 16 and 18

37
Q

Reye syndrome

A

Aspirin in children with viral infection
coma, encephalopathy
hepatomegaly with fatty change
hypoglycemia

38
Q

Hepatic encephalopathy

A

↑ NH3 production and absoprtion
↓ NH3 removal
tx: ↑ NH4 generation

39
Q

Hepatic angiosarcoma

A

arsenic or vinyl chloride exposure

40
Q

Ascending cholangitis

A

Charcot triad: Fever, jaundice, RUQ pain

Reynolds pentad: triad + altered mental status and shock

41
Q

Acute pancreatitis

A

2 of 3:
epigastric pain
CT changes
↑ Lipase or amylase 3x UNL

Cullen’s sign → periumbilical ecchymosis
Grey Turner’s sign → flank ecchymosis

42
Q

H2 blockers

A

-tidine
↓ gastric acid secretion
potent CYP450 inhibitor
anti-androgenic effects

43
Q

Antacids

A

Aluminum hydroxide → causes constipation
Magnesium hydroxide → causes diarrhea
calcium carbonate

44
Q

Misoprostol

A

PGE1 analog
↑ gastric mucous production
prevents NSAID induced ulcers

45
Q

Octreotide

A

somatostatin analog

used in variceal bleeds, VIPoma

46
Q

Loperamide

A

µ-opioid agonist

treats diarrhea

47
Q

Methyl-naltrexone

A

µ-opioid antagonist

treats constipation effects of opioids

48
Q

Ondansetron

A

5-HT3 antagonist
↓vagal stimulation
powerful central acting anti-emetic

49
Q

Metoclopramide

A

D2 receptor agonist
↑ gastric motility (post-op)
↑ LES tone (GERD)

50
Q

Orlistat

A

Inhibits gastric and pancreatic lipase
↓ fat breakdown
↑ weight loss

51
Q

Aprepitant

A

Substance P antagonist

anti-emetic for chemotherapy induced nausea

COMLEX Level 1 (13 decks)

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