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GI Final Details Flashcards

1
Q

The crypts of keiberkuhn are found in what part of the intestine?

A

The Jejunum

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2
Q

What is a defining feature of the ilieum on histology?

A

Peyers patches in the lamina promria and submucosa

Crypts

Most number of goblet cells in small intestine

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3
Q

DOC for diverticulitis

A

Metronidazole and a Flurorquinolone

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4
Q

Meckel diverticulum associations

A

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
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5
Q

Currant jelly stools- What is it and what is a major association?

A

Intussuception–> GI tumors (mostly idiopathic in children)

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6
Q

Layers of GI and location of nervous bundles

A

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

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7
Q

Mutations involved in FAP

A

Mutation of APC gene (autosomal-dominant)

–>K-RAS mutation–> loss of P53–> tumors

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8
Q

FAP with osseus and soft tissue tumors

A

Gardener’s syndrome

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9
Q

FAP and a malignant CNS tumor (like mudulloblastoma)

A

Turcot Syndrome (turcot=turban=head tumor)

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10
Q

Apple core lesion on barium enema

A

colorectal cancer

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11
Q

Marker for Colorectal cancer? How about pancreatic cancer?

A

CEA

  • CA-19-9 and CEA
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12
Q

Whic mutation allows progression from adenomas to carcinomas in CRC?

A

Loss of p53

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13
Q

Mechanism by which Aspirin causes Reye syndrome

A

aspirin metabolites inhibit B-oxidation by reversible inhibition of mitochondrial enzyme

–>fatty liver, hepatoencephalopathy

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14
Q

What is the only case in which you will use aspirin in a child?

A

Kawasaki Dz

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15
Q

Characteristic cell seen on biopsy of alcoholic hepatits

A

Mallory bodies

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16
Q

Increased risk with exposure to arsenic and PVC

A

Angiosarcoma of the liver

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17
Q

How do you differentiate Budd-chiari syndrome caused by Right heart failure from that caused by IVC occlusion?

A

JVD will be present in an individual with RHF

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18
Q

What gene is resposible for the excretion of copper in the bile?

A

ATP7B–> deficient in wilson disease as well as copper unable to enter circulation as ceruloplasmin

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19
Q

Serum iron findings in hemochromotosis?

A

Increased Ferritin

Increased Iron

Decreased TIBC (transporters are all bound)

Increased transferrin saturation (accounts for TIBC)

20
Q

Type of cardiac issue in hemochromotosis?

A

Restrictive cardiomyopathy

(Restrictive like a dog on a LEASH–> Loeffler syndrome, Endocardial elastosis, Amyloidosis, sarcoidosis, hemochromotosis)

21
Q

Difference in etiologies between primary and secondary biliary cirrhosis

A

Primary–> autoimmune (anti-mitochondiral ab)

Secondary–> due to some secondary obstriction (stone, tumor in pancreas head, etc)

22
Q

Tx of 1’ biliary cirrhosis?

A

Ursadiol

23
Q

Primary finding in primary sclerosing cholangitis?

A

Onion skin bile duct fibrosis

intra and extra-hepatic ducts

24
Q

1’ sclerosing cholangitis is associated with what disease?

A

Ulcerative colitis

25
Q

Classic presentation of a pt with 1’ sclerosin cholangitis?

A

Man (40)

+pANCA

Ulcerative colitis

cholangiocarcinoma

26
Q

Common causes of acute pancreatitis

A

BAD HITS

Biliary stones

Alcohol

Drugs

Hypertriclycerides/Hypercalcemia

Idiopathic

Trauma

Scorpion sting

27
Q

Calcifications in the LUQ with chronic fat malabsorbtion

A

Chroninc pancreatitis

28
Q

Obstructive jaundice with a palpable non-tender gallbladder

A

Pancreatic adenocarcinoma (obstructing the bile duct)–> Courvoisier’s sign

29
Q

H2 blockers commonly used in PUD

A

Cimetidine, ranitidine, famotidine, nazitidine

30
Q

Problems associated with cimetidine?

A

Potent cyp-450 inhibitor and antiandrogenic effects

31
Q

PGE-1 analogue used to increase gastric mucosal barrier

Other uses?

A

Misoprostol

Maintain PDA (close with indomethicin)

32
Q

Major side effects associated with aluminum and Mg antacids?

A

Hypokalemia

Aluminum–> constipation (aluminimum feces)

Magnesium hydroxide–> diarrhea (must go to bathroom)

33
Q

TNF-alpha inhibitor used in the Tx of crohn’s, UC, and RA

A

Infliximab

34
Q

What test should always be performed before giving infliximab?

A

TB test

35
Q

notocord becomes what adult structure

A

Nucleus pulposis of intervertebral disc

36
Q

Marker for astrocytes

A

GFAP

37
Q

Phagocytes of the CNS

A

Microglia

38
Q

Colonic lesion with velvety coliflower like appearence

A

Villious adenocarcinoma

39
Q

Young female with symetrically distributed tender points and morning stiffness with joint pain

A

Fibromyagia

40
Q

What is the first part of the brain damaged with severe global ischemia?

A

Hippocampus

41
Q

Weight gain, hair loss and dry skin in a patient on psychotropic meds. What is the medication?

A

Lithium

Causing hypothyroidism

42
Q

What conversion is decreased in alkoptonuria

A

The conversion of Tyrosine to fumerate by homogentisic acid

43
Q

What NT need BH4 for production

A

catecholamines, dopamine, serotinin, NO

44
Q

Tx for borrelia bugdorferi

A

Doxycycline AND ceftriaxone

45
Q

Cause of lambert-eaton syndrome?

A

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

46
Q

What two drugs are administered simultaneously in status epilepsis?

A

Lorazapam to stop the current seizure

Penytoin (cortical Na channel blockade) to prevent further seizing

47
Q

What vitamin should be administered to a child from a asia, africa or europe presenting with measles?

A

Vitamin A

WHO recommends and it improves recovery d/t endemic vit. A deficiency in these areas

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