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GI Anderson Flashcards

1
Q

constrictor muscles for swallowing are innervated by

A

CN 10 mostly and CN 9

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2
Q

levator and tensor palati are innervation by

A

CN 5 and 10

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3
Q

palatophryngeus, palatoglossus,and salpingopharyngeus which are do deglutination and open the auditory tube are innervated by

A

CN 10

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4
Q

stylopharyngeus which elevated the larynx is innervated by

A

CN 9

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5
Q

gingivitis

A

calculus causes inflammation of gingival tissue

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6
Q

Vincent’s Angina/Trench Mouth/Necrotizing Gingivitis

A

mixed infection Borrelia Vincentii and Fusobacterium…young adults with poor oral hygiene

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7
Q

periodontitis

A

inflammation in periodontal ligament, alveolar bone, cementum of teeth

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8
Q

herpes stomatitis

A

cold sores, fever blisters, HSV I

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9
Q

leukoplakia

A

any hyperkeratotic lesion benign to malignant; strongly correlated to tobacco & alcohol

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10
Q

apthous stomatitis

A

canker sores, immune complex vasculitis, stress, hormonal changes, autoimmune, not herpes

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11
Q

Koplick’s spots

A

measles, precedes skin rash

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12
Q

thrush

A

candida albicans, babies, diabetics, antibiotics, KOH

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13
Q

Squamous Cell Carcinoma

A

tobacco, alcohol, Herpes Simplex I, syphilis,sunlight; lowerlip, tongue, floor of mouth; farther posterior=less well differentiated & more aggressive; poor prognosis, mestastasizes to lungs, liver, LN, bones

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14
Q

parotitis

A

mumps virus, can cause orchitis as sequelae

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15
Q

sjorgren’s syndrome

A

dry eyes, dry mouth, immune mediated destruction of lacrimal and salivary glands

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16
Q

what innervates the esophagus

A

CN 10

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17
Q

type of muscle in the upper esophagus

A

striated

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18
Q

type of muscle in the lower esophagus

A

inner circular, outer longitudinal

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19
Q

pharyngitis

A

Concomitant with viral upper resp. infection…Bacterial cause often beta hemolytic strep,
Post-strep Rheumatic fever & GN

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20
Q

Squamous Cell Carcinoma (Pharyngeal)

A

Smoking, Tend to grow silently until become unresectable, Spread to cervical LN or elsewhere

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21
Q

Hiatal Hernia

A

95% are sliding type, often from increased abdominal pressure, results in GERD

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22
Q

esophageal varices

A

Secondary to portal hypertension, alcoholic cirrhosis;

Distal esophagus & proximal stomach, asymptomatic until rupture

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23
Q

esophagitis

A

GERD, irritation, alcohol, smoking…sequelae is barret’s esophagus which converts squamous to columnar gastric cells=adenocarcinoma

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24
Q

adenocarcinoma

A

sequela of Barrett’s esophagus, male, smokers, distal esophagus

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25
Q

Squamous Cell Carcinoma of esophagus

A

Alcohol, smoking, fungal, nitrosamine containing foods, Zinc and other vitamin & mineral deficiencies may predispose, Mid to distal esophagus, dysphagia & obstruction

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26
Q

artery of the stomach

A

celiac artery is the main, also L and R gastric

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27
Q

gastric vein goes to

A

portal vein of liver

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28
Q

acute gastritis

A

NSAIDs, ETOH, smoking, stress, idiopathic,

Erosion of superficial epithelium, asymptomatic or ulcer-like pain

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29
Q

chronic gastritis

A

Often without erosions,
Autoimmune cause of lost parietal cells & IF, H. pylori, hypo or achlorhydria, B12 def.
most asymptomatic

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30
Q

hypochlorhydria

A

Chronic gastritis leading to atrophy of fundal mucosal cells …Immune mediated destruction of parietal cells…Hashimotos thyroiditis, Addisons; B 12 def, macrocytic anemia

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31
Q

Gastric Carcinoma

A

more common in asian countries, increased risk with type A blood

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32
Q

gastric ulcer

A

H Pylori in 75% of cases, less curvature, burning epigastric pain post-eating. Pain worse with food intake and better antacid/milk/fish

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33
Q

duodenal ulcer

A

75% of all PUD, H Pylori, burning epigastric pain 1-3 hours after eating, better eating

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34
Q

bile enters intestines through the

A

greater duodenal papilla…enzymes through greater and lesser

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35
Q

which part of the SI has the most lymphatics

A

ileum, called peyer’s patches

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36
Q

what is the sympathetic innervation to the jejunum

A

splanchnic…also has superior mesenteric artery/vein and vagus for parasympathetics

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37
Q

adynamic ileus

A

paralysis of bowel, often due to intestinal vascular obstruction

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38
Q

ischemic enteritis

A

Mucosal inflammation and ulceration caused by partial arterial occlusion, small vessel disease, venous obstruction, chronic vascular insufficiency…Most common in colon (i.e. ischemic colitis).

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39
Q

intestinal infarction

A

Incomplete or complete necrosis, gangrene and perforation due to any cause of vascular compromise (occlusive or non-occlusive)

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40
Q

intusseption

A

one segment of SI telescopes into immediate distal segment

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41
Q

nerve of the external sphincter

A

pudendal

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42
Q

vessel to the ascending colon

A

superior mesenteric

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43
Q

vessel to entire color other than ascending

A

inferior mesenteric

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44
Q

parasympathetic nerves of large intestine

A

pelvin splanchnics

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45
Q

sympathetic nerve to large intestine

A

hypogastric plexus

46
Q

diverticulosis

A

Herniation of colon mucosa through muscularis, submucosa & adventitia

47
Q

diverticulitis

A

Inflammation of diverticula, usu sigmoid colon, like appendicitis on left side

48
Q

Colorectal Carcinoma

A

60-70 yo males, low fiber diet, bacteria convert primary bile acids to secondary carcinogenic acids, CEA marker in later stages

49
Q

regional enteritis/Crohns

A

skip lesions, string sign, cobblestoning appearance, pain more than diarrhea

50
Q

chronic UC

A

rectum or whole colon, continuous, ulceration with pseudopolyps, bloody mucoid diarrhea, toxic megacolon

51
Q

acute pancreatitis

A

exocrine pancreas inflammation

52
Q

pancreatic cancer

A

duct cells of exocrine pancreas, heavy smoking triples risk, 60% in head of the pancreas, jaundice, mostly silent until late

53
Q

Trousseau’s syndrome

A

migratory thrombophlebitis/clots

54
Q

acute liver failure

A

fulminant hepatitis, toxic damage

55
Q

cholestasis

A

reduction of bile flow, elevated serum bilirubin and alk phos

56
Q

what two things comprise the enteric nervous system of the GI tract

A

submucosal plexus (Meissner’s) and myenteric plexus (Auerbach’s)

57
Q

Myenteric (Auerbach’s) Plexus does

A

motility

58
Q

Submucosal (Meissner’s) Plexus does

A

secretion and blood flow

59
Q

gastric H is stimulated by

A

histamine

60
Q

gastrin comes from

A

G cells

61
Q

CCK in the duodenum/jejunum comes from

A

I cells

62
Q

secretin in the duodenum/jejunum comes from

A

S cells

63
Q

paracrines

A

somatostatin, histamine

64
Q

somatostatin

A

inhibits GI hormone release and acid secretion

65
Q

histamine

A

stimulates gastric H secretion

66
Q

enkephalins

A

stimulate GI contraction at sphincters, stop fluid and electrolyte release

67
Q

pepsinogen is secreted by

A

chief cells

68
Q

parietal cells secrete

A

HCL and IF

69
Q

B12 is absorbed in the

A

terminal ileum

70
Q

iron is absorbed in the

A

duodenum

71
Q

carbs and amino acids are absorbed in the

A

duodenum and jejunum

72
Q

bile salts are absorbed in the

A

terminal ileum

73
Q

difference b/w the common hepatic duct and the common bile duct

A

common bile duct comes after the cystic duct from the gall bladder has joined with the common hepatic duct

74
Q

primary bile acids

A

synthesized from cholesterol…cholic and chenodeoxycholic acid

75
Q

secondary bile acids

A

converted from primary bile acids by bacteria in intestines…deoxycholic and lithocholic acids

76
Q

bile acids are conjugated w/ ___ to form

A

glycine or taurine to form bile salts

77
Q

bilirubin comes from

A

RBCs that have died

78
Q

bile acids are synthesized in the

A

liver

79
Q

the rate limiting step in bile acid synthesis is

A

the introduction of a hydroxyl group at Carbon 7 of the steroid ring by 7-alpha-hydroxylase which is inhibited by cholic acid

80
Q

function of bile acids

A

emulsifying agents in the intestine helping to prepare dietary triglycerides and other complex lipids for degradation by pancreatic enzymes

81
Q

function of bile salts

A

provide only significant mechanism for cholesterol excretion

82
Q

hepatitis A

A

children, fecal oral, no carrier or chronic state

83
Q

Hep B

A

blood born, maternal/fetal, acute and chronic hepatitis, cirrhosis which may lead to hepatic carcinoma

84
Q

Hep C

A

blood born, chronic, cirrhosis in 5-10 years, risk for hepatic cancer

85
Q

Wilson’s Dz (copper) can cause

A

cirrhosis

86
Q

cholelithiasis

A

female, fat, forty, fertile

87
Q

all amino acids are absorbed by

A

Na dependent cotransport

88
Q

describe right lymphatic drainage

A

upper right half of body only…right lymphatic duct drains to right subclavian

89
Q

describe left lymphatic drainage

A

drains most of the body. cysterna chyli drains lower half, joins thoracic duct and then drained to left subclavian

90
Q

deficiency of Vit A

A

night blindness

91
Q

deficiency of vit D

A

rickets/osteomalacia

92
Q

deficiency of vit E

A

ataxia

93
Q

deficiency of vit K

A

factor 2/7/9/10 bleeding disorders

94
Q

deficiency of B1

A

beriberi

95
Q

deficiency of B2

A

cheilosis/glossitis

96
Q

deficiency of B3

A

pellagra (dementia, diarrhea, dermaitits)

97
Q

deficiency of B5

A

bruning feet/HA/nausea

98
Q

deficiency of B6

A

microcytosis/neuropathy

99
Q

deficiency of B12

A

macrocytosis/pernicious anemia/neuropathy

100
Q

deficiency of vit C

A

scurvy

101
Q

deficiency of biotin

A

seborrheic dermatitis, nervous disorders, macrocytosis/glossitis/colitis

102
Q

a free radical turns ascorbate to

A

dehydroascorbic acid

103
Q

major storage site of Vit E is

A

fat

104
Q

most potent form of tocopherol (vit E)

A

alpha tocopherol

105
Q

storage of vitamin A

A

in the liver as retinyl palmitate

106
Q

vitamin D process in skin

A

uv light converts 7-hydroxycholesterol to cholecalciferol (D3)

107
Q

vitamin D process in liver

A

cholecalciferol (D3) from skin is turned to 25-hydryo-D3 by 25-hydrozylase enzyme

108
Q

vitamin D process in kidney

A

25-hydro-D3 has two potential pathways. To take more Ca into bone and lower serum Ca 24-hydroxylase with turn 25-hydro-D3to 24,25-Dihydro-D3…to take calcium out of bone and increase serum Ca 1-alpha-hydrozylase will turn 25-hydro-D3 to 1,25-Dihydro-D3

109
Q

what does PTH do to affect Ca

A

inactivates 24-hydroxylase enzyme in the kidney so that less calcium is taken from blood to bone

110
Q

what micromineral is needed to metabolize alchohol

A

zinc

111
Q

what micromineral is used in muscle contraction

A

magnesium

112
Q

glutathione is preserved by

A

ascorbate

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