GI Final Details Flashcards
The crypts of keiberkuhn are found in what part of the intestine?
The Jejunum
What is a defining feature of the ilieum on histology?
Peyers patches in the lamina promria and submucosa
Crypts
Most number of goblet cells in small intestine
DOC for diverticulitis
Metronidazole and a Flurorquinolone
Meckel diverticulum associations
Rule of 2’s
- 2 inches long
- 2 feet from the iliocecal valve
- 2% of population
- 2 years of life
- 2 tissue types (gastric and pancreatic)
- 2x more common in males
Currant jelly stools- What is it and what is a major association?
Intussuception–> GI tumors (mostly idiopathic in children)
Layers of GI and location of nervous bundles
Mucosa
Submucosa–> contains meissners plexus
Muscularis Propria–> further divided into the inner circular and outer longitudinal. Between these two lies Auerbach’s (meyenteric) plexus
Serosa
Mutations involved in FAP
Mutation of APC gene (autosomal-dominant)
–>K-RAS mutation–> loss of P53–> tumors
FAP with osseus and soft tissue tumors
Gardener’s syndrome
FAP and a malignant CNS tumor (like mudulloblastoma)
Turcot Syndrome (turcot=turban=head tumor)
Apple core lesion on barium enema
colorectal cancer
Marker for Colorectal cancer? How about pancreatic cancer?
CEA
- CA-19-9 and CEA
Whic mutation allows progression from adenomas to carcinomas in CRC?
Loss of p53
Mechanism by which Aspirin causes Reye syndrome
aspirin metabolites inhibit B-oxidation by reversible inhibition of mitochondrial enzyme
–>fatty liver, hepatoencephalopathy
What is the only case in which you will use aspirin in a child?
Kawasaki Dz
Characteristic cell seen on biopsy of alcoholic hepatits
Mallory bodies
Increased risk with exposure to arsenic and PVC
Angiosarcoma of the liver
How do you differentiate Budd-chiari syndrome caused by Right heart failure from that caused by IVC occlusion?
JVD will be present in an individual with RHF
What gene is resposible for the excretion of copper in the bile?
ATP7B–> deficient in wilson disease as well as copper unable to enter circulation as ceruloplasmin
Serum iron findings in hemochromotosis?
Increased Ferritin
Increased Iron
Decreased TIBC (transporters are all bound)
Increased transferrin saturation (accounts for TIBC)
Type of cardiac issue in hemochromotosis?
Restrictive cardiomyopathy
(Restrictive like a dog on a LEASH–> Loeffler syndrome, Endocardial elastosis, Amyloidosis, sarcoidosis, hemochromotosis)
Difference in etiologies between primary and secondary biliary cirrhosis
Primary–> autoimmune (anti-mitochondiral ab)
Secondary–> due to some secondary obstriction (stone, tumor in pancreas head, etc)
Tx of 1’ biliary cirrhosis?
Ursadiol
Primary finding in primary sclerosing cholangitis?
Onion skin bile duct fibrosis
intra and extra-hepatic ducts
1’ sclerosing cholangitis is associated with what disease?
Ulcerative colitis
Classic presentation of a pt with 1’ sclerosin cholangitis?
Man (40)
+pANCA
Ulcerative colitis
cholangiocarcinoma
Common causes of acute pancreatitis
BAD HITS
Biliary stones
Alcohol
Drugs
Hypertriclycerides/Hypercalcemia
Idiopathic
Trauma
Scorpion sting
Calcifications in the LUQ with chronic fat malabsorbtion
Chroninc pancreatitis
Obstructive jaundice with a palpable non-tender gallbladder
Pancreatic adenocarcinoma (obstructing the bile duct)–> Courvoisier’s sign
H2 blockers commonly used in PUD
Cimetidine, ranitidine, famotidine, nazitidine
Problems associated with cimetidine?
Potent cyp-450 inhibitor and antiandrogenic effects
PGE-1 analogue used to increase gastric mucosal barrier
Other uses?
Misoprostol
Maintain PDA (close with indomethicin)
Major side effects associated with aluminum and Mg antacids?
Hypokalemia
Aluminum–> constipation (aluminimum feces)
Magnesium hydroxide–> diarrhea (must go to bathroom)
TNF-alpha inhibitor used in the Tx of crohn’s, UC, and RA
Infliximab
What test should always be performed before giving infliximab?
TB test
notocord becomes what adult structure
Nucleus pulposis of intervertebral disc
Marker for astrocytes
GFAP
Phagocytes of the CNS
Microglia
Colonic lesion with velvety coliflower like appearence
Villious adenocarcinoma
Young female with symetrically distributed tender points and morning stiffness with joint pain
Fibromyagia
What is the first part of the brain damaged with severe global ischemia?
Hippocampus
Weight gain, hair loss and dry skin in a patient on psychotropic meds. What is the medication?
Lithium
Causing hypothyroidism
What conversion is decreased in alkoptonuria
The conversion of Tyrosine to fumerate by homogentisic acid
What NT need BH4 for production
catecholamines, dopamine, serotinin, NO
Tx for borrelia bugdorferi
Doxycycline AND ceftriaxone
Cause of lambert-eaton syndrome?
Ab directed against presynaptic Ca2+ channels
Weakness while rising as well as autonomic instability also symptoms improve with use as more Ca is released from the SR
What two drugs are administered simultaneously in status epilepsis?
Lorazapam to stop the current seizure
Penytoin (cortical Na channel blockade) to prevent further seizing
What vitamin should be administered to a child from a asia, africa or europe presenting with measles?
Vitamin A
WHO recommends and it improves recovery d/t endemic vit. A deficiency in these areas
