GI Flashcards

1
Q

Stomach acid is involved in…

  • Breaking fat into smaller units
  • Activating protease enzymes
  • Denaturing proteins
  • Promoting epithelial cell turnover
  • Sterilising luminal contents
A

Breaking fat into smaller units

Activating protease enzymes

Denaturing proteins

Promoting epithelial cell turnover

Sterilising luminal contents

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2
Q

stomach acid and enzyme activation

A

HCL converts pepsinogen

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3
Q

HCL and proteins

A

denatures to give a greater surface are for digestion

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4
Q

Which of these viscera are fully retroperitoneal structures?

Transverse colon

Ascending colon

Duodenum

Kidneys

Stomach

A

Transverse colon

Ascending colon

Duodenum

Kidneys

Stomach

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5
Q

retroperitoneal structures

A
  • The ascending and descending colon are both retroperitoneal
  • The first part of the duodenum is intraperitoneal but the 2nd , 3rd and 4th parts are retroperitoneal
  • The kidneys are retroperitoneal
  • The stomach is intraperitoneal (connected to the liver and spleen via peritoneal ligaments)
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6
Q

During embryological development, which of these structures develops within the dorsal mesentery?

Left kidney

Greater omentum

Spleen

Liver

Stomach

A

Left kidney

Greater omentum

Spleen

Liver

Stomach

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7
Q

which organ develops in the ventral mesentry

A

liver

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8
Q

Which of the following are true concerning an Omphalocoele?

  • Not associated with other developmental defects
  • Herniated contents covered in peritoneal layer
  • Herniation occurs through Para-umbilical defect in anterior abdominal wall
  • Herniation occurs through umbilical ring
  • Herniated bowel is often significantly under-developed
A
  • Not associated with other developmental defects
  • Herniated contents covered in peritoneal layer
  • Herniation occurs through Para-umbilical defect in anterior abdominal wall
  • Herniation occurs through umbilical ring
  • Herniated bowel is often significantly under-developed
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9
Q

compare omphalocele to gastroschisis

A
  • Omphalocoele is often associated with other congenital problems and as a result has a high mortality rate
  • The problem is not with the initial herniation (which is physiological) but due to the fact the contents do not return to the abdomen. Contents are contained within the umbilical cord
  • Gastroschisis herniated through paraumbilical defect
  • As the herniated contents including bowel are covered in peritoneum, they are not exposed to amniotic fluid so develop relatively normally.
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10
Q

Which region in the stomach has the greatest concentration of G cells?

A
  • The greatest concentration of G cells is the Pyloric region
  • The greatest concentration of the Parietal cells is in the body of the stomach
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11
Q

What is the function of bile salts?

A

Form micelles

Emulsify fat

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12
Q

how are micelles formed

A

Micelles form when bile salts combine with the products of fat digestion (eg fatty acids and monoglycerides). The amphipathic nature of bile salts mean that they can surround fat digestion products in a hydrophilic shell to transport them through the aqueous environment of the gut lumen.

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13
Q

Which of the following blood results would you expect with a gallstone stuck in this location?

  • Elevated AST
  • Elevated Amylase
  • Elevated ALP
  • Elevated Bilirubin
  • Elevated Albumin
A
  • Elevated ALP
  • Elevated Bilirubin
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14
Q

What other features would corelate with an inflammatory bowel disease with this pattern of inflammation?

A

Presence of granulomas

Inflammation restricted to mucosa

Presence of fistulae

Perianal disease

Continuous pattern of inflammation

This pattern of inflammatory bowel disease would indicate Crohn’s disease

  • Granulomas, if present, strongly corelate with Crohn’s
  • In Crohn’s, the inflammation is transmural (UC is restricted to mucosa)= Fistulas can therefore occur
  • Perianal disease (skin tags, fistulae, abscesses, scarring or sinuses) are present in 20-3-% of patients with Crohn’s disease
  • UC has a continuous pattern of inflammation while Crohn’s has skip lesions (patchy inflammation).
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15
Q

On this CT scan, indicate the location of the pancreas

A

It lies behind the stomach

In the curve of the duodenum

Its tail reaches towards the spleen

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16
Q

function of the mesentry

A
  • decreases the friction between the adjacent visceral surfaces
  • allows some movement of the organs that occur during digestion, whilst holding them in place
  • Storing fat, vessels and nerves; attaching the intestines to the abdominal wall
17
Q

There are three mesenteries, all named after their organ attachments in the abdominal cavity, as follows:

A
  • the mesentery of the small intestine or mesentery proper,
  • transverse mesocolon
  • sigmoid mesocolon