GI Formative Flashcards
Characteristic view of Barrets oesophagus?
Salmon pink mucosa
Metaplastic change in oesophagus
Which area is most prone to ulceration in stomach?
Lesser curve
Which area is most prone to peptic ulceration?
First part of duodenum
Which major artery is at risk of haemorrhage if gastric ulcer erodes thru posterior aspect of the stomach?
Splenic
Which blood test result when raised would most specifically indicate hepatocyte damage?
ALT (alanine transaminase)
Which blood test result when raised would indicate gallstone is stuck in common bile duct?
conjugated bilirubin levels
> bile can’t flow into gut therefore bilirubin in the plasma increases
> its conjugated at this point
when are ALP levels raised?
bone disease biliary obstruction (but less specific indicator)
when are AST levels raised?
liver damage
but not specific to liver as also present in cardiac and skeletal muscle
what characteristic makes UC diagnosis more likely than crohns?
presence of disease in rectum
> continuous with disease in colon/ caecum
> backwash ileitis (inflamed terminal ileum)
characteristics of Crohns disease
- presence of fistulas
- presence of perianal disease
- skip leisions
role of GLUT2 transporter
move glucose out of the enterocyte across basolateral membrane
role of GLUT 5 transporter
moves fructose across apical membrane of the enterocyte (from gut lumen into enterocyte)
role of SGLT 1 transporter
Na glucose linked transporter
> co transports Na n glucose from the gut into the enterocyte
mass movement is triggered by what reflex?
gastro-colic reflex
which sympathetic splanchnic nerve supplies the stomach?
greater splanchnic
through which site does an indirect inguinal hernia leave the abdomen?
deep inguinal ring
this type of hernia passes thru inguinal canal
through which site does an femoral hernia leave the abdomen?
femoral ring
through which site does an direct inguinal hernia leave the abdomen?
Hesselbach’s triangle
relevance of the umbilical ring?
its where the midgut herniates through during embryological development
where does an indirect hernia exit the inguinal canal
superficial inguinal ring
what facilitates the movement of digested fats through the aq medium of gut lumen towards enterocyte?
micelle
role of chylomicron
part of fat digestion
micelle diffuses into enterocyte and then the fatty products are recycled into chylomicrons
> which exocytose across the basolateral wall of the enterocyte and move into lacteals
pain associated with gallstones is called
biliary colic
why does pain associated with gallstones typically come on an hr after food?
- time it takes for material to go from stomach to duodenum
- presence of acid, aa, fa stimulates the release of CCK
- causes gall bladder contraction which causes pain (as contracting against a blockage
complication of gallstones?
gall stone gets stuck in cystic duct > cholecystitis
- walls of gall bladder inflamed, thickened and oedematous
- secondary infection can occur due to bacterial proliferation
complications of gallstone lodged in proximal common bile duct
- cholangitis (infection of biliary tree)
- post hepatic jaundice (occurs due to blockage of flow from liver to duodenum)
complications of gallstone lodged in DISTAL common bile duct
- malnutrition
- pancreatitis (stone lodging near sphincter of odd can block major pancreatic duct)
- post hepatic jaundice
what’s fatty liver called
steatosis
how does excess alcohol intake cause hepatomegaly (enlarged liver)
NADH is a by product of alcohol metabolism
> inhibits lipid breakdown
> promotes lipid synthesis
> ethanol inhibits formation and secretion of lipoproteins (lipids accumulate in liver)
how can chronic alcohol misuse lead to malnutrition?
- causes pancreatitis > impaired release of digestive enzymes
- causes chronic gastritis > impaired digestion
features of crohns disease
- mouth to anus
- cobblestone appearane
- skip lesions
- adhesions
- mucosal oedema
features of ulcerative colitis
- mucosal oedema
- discontinuous pattern of inflammation (skip lesions)
- opening of fistulae
- strictures (narrowing of bowel lumen)
- cobblestone appearance
microscopic feature that’s pathognomonic of crohns?
granuloma
perianal pathologies present in Crohns
- anal fissures
- haemorrhoids
- skin tags
- perianal abscess
- opening of fistula
why do patients with crohns sometimes get right lower quadrant pain?
terminal ileum inflammation
