GI Formative

Question 1

Characteristic view of Barrets oesophagus?

Answer 1

Salmon pink mucosa

Metaplastic change in oesophagus

Question 2

Which area is most prone to ulceration in stomach?

Answer 2

Lesser curve

Question 3

Which area is most prone to peptic ulceration?

Answer 3

First part of duodenum

Question 4

Which major artery is at risk of haemorrhage if gastric ulcer erodes thru posterior aspect of the stomach?

Answer 4

Splenic

Question 5

Which blood test result when raised would most specifically indicate hepatocyte damage?

Answer 5

ALT (alanine transaminase)

Question 6

Which blood test result when raised would indicate gallstone is stuck in common bile duct?

Answer 6

conjugated bilirubin levels
> bile can’t flow into gut therefore bilirubin in the plasma increases
> its conjugated at this point

Question 7

when are ALP levels raised?

Answer 7

bone disease
biliary obstruction (but less specific indicator)

Question 8

when are AST levels raised?

Answer 8

liver damage

but not specific to liver as also present in cardiac and skeletal muscle

Question 9

what characteristic makes UC diagnosis more likely than crohns?

Answer 9

presence of disease in rectum
> continuous with disease in colon/ caecum
> backwash ileitis (inflamed terminal ileum)

Question 10

characteristics of Crohns disease

Answer 10

• presence of fistulas
• presence of perianal disease
• skip leisions

Question 11

role of GLUT2 transporter

Answer 11

move glucose out of the enterocyte across basolateral membrane

Question 12

role of GLUT 5 transporter

Answer 12

moves fructose across apical membrane of the enterocyte (from gut lumen into enterocyte)

Question 13

role of SGLT 1 transporter

Answer 13

Na glucose linked transporter

> co transports Na n glucose from the gut into the enterocyte

Question 14

mass movement is triggered by what reflex?

Answer 14

gastro-colic reflex

Question 15

which sympathetic splanchnic nerve supplies the stomach?

Answer 15

greater splanchnic

Question 16

through which site does an indirect inguinal hernia leave the abdomen?

Answer 16

deep inguinal ring

this type of hernia passes thru inguinal canal

Question 17

through which site does an femoral hernia leave the abdomen?

Answer 17

femoral ring

Question 18

through which site does an direct inguinal hernia leave the abdomen?

Answer 18

Hesselbach’s triangle

Question 19

relevance of the umbilical ring?

Answer 19

its where the midgut herniates through during embryological development

Question 20

where does an indirect hernia exit the inguinal canal

Answer 20

superficial inguinal ring

Question 21

what facilitates the movement of digested fats through the aq medium of gut lumen towards enterocyte?

Answer 21

micelle

Question 22

role of chylomicron

Answer 22

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

Question 23

pain associated with gallstones is called

Answer 23

biliary colic

Question 24

why does pain associated with gallstones typically come on an hr after food?

Answer 24

• 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

Question 25

complication of gallstones?

Answer 25

gall stone gets stuck in cystic duct > cholecystitis

• walls of gall bladder inflamed, thickened and oedematous
• secondary infection can occur due to bacterial proliferation

Question 26

complications of gallstone lodged in proximal common bile duct

Answer 26

• cholangitis (infection of biliary tree)

- post hepatic jaundice (occurs due to blockage of flow from liver to duodenum)

Question 27

complications of gallstone lodged in DISTAL common bile duct

Answer 27

• malnutrition
• pancreatitis (stone lodging near sphincter of odd can block major pancreatic duct)
• post hepatic jaundice

Question 28

what’s fatty liver called

Answer 28

steatosis

Question 29

how does excess alcohol intake cause hepatomegaly (enlarged liver)

Answer 29

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)

Question 30

how can chronic alcohol misuse lead to malnutrition?

Answer 30

• causes pancreatitis > impaired release of digestive enzymes
• causes chronic gastritis > impaired digestion

Question 31

features of crohns disease

Answer 31

• mouth to anus
• cobblestone appearane
• skip lesions
• adhesions
• mucosal oedema

Question 32

features of ulcerative colitis

Answer 32

• mucosal oedema
• discontinuous pattern of inflammation (skip lesions)
• opening of fistulae
• strictures (narrowing of bowel lumen)
• cobblestone appearance

Question 33

microscopic feature that’s pathognomonic of crohns?

Answer 33

granuloma

Question 34

perianal pathologies present in Crohns

Answer 34

• anal fissures
• haemorrhoids
• skin tags
• perianal abscess
• opening of fistula

Question 35

why do patients with crohns sometimes get right lower quadrant pain?

Answer 35

terminal ileum inflammation