GI High Yield Flashcards
1
Q
What organs are derived from the foregut?
A
Esophagus –> duodenum
2
Q
artery of the foregut?
A
celiac
3
Q
PNS innervation of midgut and foregut?
A
Vagus
4
Q
PNS innervation of hindgut?
A
Pelvic splanchnic nerves
5
Q
What organs are derived from the midgut?
A
Duodenum–> transverse colon
6
Q
What organs are derived from the hindgut?
A
Transverse colon–> anal canal
7
Q
Artery of the midgut?
A
SMA
8
Q
Artery of the hindgut?
A
IMA
9
Q
Opmaphalocele and gastrochisis result from a failure of what type of closure?
A
Lateral fold
10
Q
Bladder exstrophy results from a failure of what type of closure?
A
caudal fold closure
11
Q
“extrusion of abd contents through abdominal folds not covered by peritoneum”
A
gastroschisis
12
Q
“persistance of herniation of abd contents into umbilical cord, sealed by peritoneum”
A
omaphalocele
13
Q
What chromosomal abnormality is associated with duodenal atresia?
A
Trisomy 21
14
Q
What causes atresia of jejunum, ileum and colon?
A
vascular accident
15
Q
What presents with drooling, choking and vomiting with first feeding?
A
Tracheoesophageal anomalies
16
Q
What is a clinical test for tracheoseophageal fistulas?
A
passing nasogastric tube into the stomach
17
Q
“palpable ‘olive’ mass in epigastric region and nonbilous projectile vomiting at 2-6 weeks”
A
congeital pyloric stenosis
18
Q
What causes congeital pyloric stenosis?
A
hypertrophy!
19
Q
The liver is derived from what embryonic layer?
A
endoderm (of the foregut)
20
Q
What is the pancreas derived from?
A
foregut (endoderm)
21
Q
Which pancreatic duct contributes to teh pancreatic duct?
A
ventral bud
22
Q
BOTH pancreatic buds contribute to the ________ of the pancreas
A
Head of the pancreas
23
Q
Which pancreatic bud encircles the 2nd part of the duodenum?
A
ventral bud
24
Q
“ventral and dorsal parts of the pancreas fail to fuse at 8 weeks”
A
pancreas divism
25
What does the spleen arise from?
mesentery of the stomach (mesoderm)
26
Which organs are retroperitoneal?
DAD PUCKER
Suprarenal glands
Aorta and IVC
Duodenum
```
Pancreas
Ureter
Colon (ascending and descending)
Kidneys
Esophagus
Rectum
```
27
What ligament encloses the portal triad?
Hepatoduodenal ligament
28
Which ligament encloses the gastric arteries?
Gastrohepatic
29
Which ligament encloses the gastroepiploic arteries?
gastrocolic
30
Which nerve plexus (Meissner or auerbach) aids in secretion of fluid?
Meissner (submucosal)
31
Frequency of the basal electic rhythm of:
1- stomach
2- duodenum
3- ileum
1- stomach: 3/ min
2- duodenum: 12/ min
3- ileum: 8-9/min
32
Where are brunner glands found? What is their function?
Duodenum
Secretes HCO3-
33
Where are peyers patches found?
Ileum
34
Where are crypts of Lieberkuhn found?
duodenum, jejunum, ileum and colon
35
What section of the small intestine has the largets amount of goblet cells?
Ileum
36
What causes SMA syndrome?
Transferse portion (3rd portion) of te duodenum is entrapped between SMA and Aorta--> intestinal obstruction
37
Where is the "watershed" area between the SMA and IMA?
Splenic Flexure of colon
38
Which arteries lie on the lesser curvature of the stomach?
Left and right gastric
39
Which arteries lie on the greater curvature of the stomach?
Left and right gastroepiploic
40
What artery do the short gastric arteries come off of?
splenic
41
Which branch of the celiac tree can supply the seophagus?
Left gastric
42
Which 2 vessels compose esophageal varices?
Left gastric (portal) and esophageal (systemic)
43
Which 2 vessels compose umbilical varices?
Paraumbilical (portal) and small epigastric veins of the anterior sbd wall (systemic)
44
Which 2 vessels compose rectal varices?
Superior rectal (portal) and middle and inferior rectal (systemic)
45
What defines the pectate line?
formed where the endoderm (hindgut) meets to ectoderm
46
Internal hemorrhoids are caused by which artery?
Superior rectal artery (branch of the IMA)
47
External hemorrhoids are caused by which artery?
inferior rectal artery (branch of internal pudendal artery)
48
Do external or internal hemorrhoids normally drain into the portal system?
Internal
49
Which hemorrhoids are painful... internal or external?
External (somatic innervation)
50
"painless jaundice"
tumors at the head of the panceras that cause
51
"GE junction is displaced upward through the diaphragm"
Hourglass stomach
Sliding hiatal hernia
52
"GE junction is normal but the fundus of the stoach protrudes into the thorax"
diaphragmatic hernia
53
Which inguinal ring are indirect inguinal hernia associated with?
deep inguinal ring--> follows the path of the descent of the testes
54
Hernia common in older men?
direct inguinal hernia
55
Which hernia is common infemales?
femoral hernia
56
Cell source of gastrin?
G cells
57
Cell source of smatostatin?
D cells
58
Cell source of CCK?
I cells
59
What is the "inhibitory" hormone of the GI system?
Somatostatin
60
Cellular source of secretin?
S cells
61
Which hormone works to increase pancreatic HCO3- secretion, increase bile secretion, and decrease gastric acid secretion?
Secretin
62
Cellular source of GIP?
K cells
63
Cellular source of motilin?
small intested
64
What does motilin do?
produces migrating motor complexes
65
What does motilin do?
produces migrating motor complexes
66
Which cells produce intrinsic factor?
parietal cells
67
Which cells produce gastric acid?
parietal cells
68
What cells produce pepsin?
chief cells
69
Which pancreatic enzyme activates the others? (cleave proenzymes to enzyme)
Trypsinogen/ trypsin
70
How is trypsinogen activated
Converted by trypsin by enterokinase/ enteropeptidase (brush- border enzyme)
71
How are glucose and galactose taken up from the lumen of the intestine?
SGLT1 (Na dependent)
72
What enzyme catalyzes the RLS of bile synthesis?
Cholesterol 7alpha- hydroxylase
73
Bile salts are bile acids conjugated to either....
glycine or taurine (so they are water soluble)
74
What enzyme s responsible for metabolizing heme?
Heme oxygenase
75
Which type of salivary gland tumor is the most common and also recurrs after resection?
Pleomorphic adenoma
76
What is the most common malignant salivary tumor that has both mucinous and squamous components?
mucoepidermoid tumor
77
Which salivart gland usually involves the facial nerve?
mucoepidermoid tumor
78
"benign cystic salivary gland tumor with germinal centers"
Warthing tumor
79
"loss of auerbach plexus and failure of relaxation of LES"
achaasia
80
Which infectious disease is associated with chagas disease?
achalasia
81
"trachealization of the esophagus"
Eosinophilic esophagitis
82
Linear ulcers in the esophagus?
CMV esophagitis
83
Punched out ulcers inthe esophagus?
HSV1 ensophagitis
84
"dysphagie + Fe deficient anemia + esophageal webs"
Plummer vinson syndrome
85
Curling ulcers are due to...
burns!
86
Cushing ulcer is due to...
brain injury (increased vagal stimulation)
87
"gastric hyperplasia (hypertrophied rugae), excess mucus production with resultant protein loss and parietal cell atrophy"
Menetriers disease
88
Is intestinal adenocarcinoma of the stomach or diffuse adenocarcinoma of the stomach associated with H. pylori?
Intestinal type
89
"signet ring cells found int he stomach"
difuse type adenocarcinoma
90
Which ulcer type (gastric or duodenal) is assocated with decreased pain with feeding?
duodenal
91
Gastric ulcer perforation lead to referred shoulder pain through whch nerve?
phrenic nerve
92
HLA type associated with celiac disease?
HLA DQ2
| HLA DQ8
93
Immune cell types found in lamina propria of villi in celiac disease?
Lymphocytes--> Helper T cell mediated damage
94
Inheritance pattern of lactase deficiency?
AR
95
Test to differentiate pancreatic insufficiency from intestinal mucosal deficiencies?
D- xylose absorption test--> normal in pancreatic insufficiecny and decreased in intestinal mucosal defects
96
Difference between tropical sprue and celiac sprue?
tropical responds to Abx
97
"cobblestone mucosa, creeping fat, bowel wall thickening- string sign on barium swallow"
Crohn disease
98
Which is mediated by Th1...ulcerative colitis or crohn?
Crohns
99
Skin condition assocaited with CD and UC?
erythema nodosum
100
Does IBS pain improve or worsen with defecation?
Improve
101
"blind pouch protruding from the alimentary tract that communicates with the gut"
diverticulim
102
What factors can increase the risk of diverticulosis (caused by false diverticula)?
increased intraluminal pressure and focal weakness in the colon
103
What type of fistula can be seen in diverticulitis?
colovesical fistula...fistula with bladder
104
What part of the esophagus are zenker diverticulum found in?
upper (it is a false diverticulum)
105
"failure of the vitelline duct to involute"
Meckel diverticulum
106
2 complications of meckel diverticulum?
Intussusception and volvulus
107
Most common site of volvulus in infants and children?
Midgut
108
Most common location of volvulus in elderly?
Sigmoid colon
109
What is the most common site of intussuscpetion?
iliocecal junction
110
"currant jelly stools"
Intussusception or acute mesenteric ischemia
111
Hirschsprung disease is associated with what mutation?
RET gene mutation
112
"intestinal hypomotility without obstruction"
ileus
113
Where is APC gene located?
Chromosome 5
114
"FAP + osteoma/sarcoma + hypertrophy of retinal pigment + impacted teeth"
Gardner syndrome
115
"FAP + malignant CNS tumor"
Turcot syndrome
116
"Hamartomas throughout the GI tract and hyperpigmentation on mouth, lips, genitals and hands"
Peutx- Jeghers Syndrome
117
Which adenomatous polyps have higher malignant potentioal...tubular or villous?
Villous
118
Most common location of colon cancer?
Rectosigmoid > ascending > descending
119
Most common location of colon cancer?
Rectosigmoid > ascending > descending
120
Tumor marker for colorectal cancer?
CEA tumor marker
121
Adenoma- carcinoma sequence?
APC--> KRAS--> p53
122
ALP is a marker for...
Cholestatic and obstructive hepatobiliary disease, HCC, infiltrative disorders, bone disease
123
Cerulopasmin is decreased in....
Wilson disease
124
If you have an elevated ALP how can you differentiate liver / biliary disease from bone diseaes?
gamma glutamyl transpeptidase (GGT)
125
What organelle is targeted in Reye syndrome?
Mitochondria--> aspirin metabolites decrease beta oxidation by reversible inhibition of mitochondrial enzymes
126
Mallory bodies?
Alcoholic hepatitis
127
Which zone in the liver is effected most in alcoholic cirrhosis?
Zone III (central vein)
128
Common benign liver tumor?
Cavernous hemangioma
129
What exposure are angiosarcoma of the liver associated with?
arsenic and vinyl chloride
130
3 more common tumors to met to the liver?
GI, breast and lung
131
"misfolded gene product protein aggregates in hepatocelluar ER"
A1AT defciency
132
What is kernicterus?
Bilirubin deposition in brain (particulary the basal ganglia)
133
"mildly decreased UDPGT conjucation and impaired bilirubin uptake"
Gilbert syndrome
134
"grossly black liver due to defective liver excretion of CB"
Dubin- Johnson Syndrome
135
Mutation seen in Wilson disease?
AR inherited defect in Cu excretion into bile by hepatocyte Cu trasporting ATPase (ATP7B) gene
136
Treatment for Wilson disease?
Penicillamine or trientine
137
HLA type associated with Hemochromatosis?
HLA- A3
138
autoantibodies seen in primary biliary cirrhosis?
Anti-mitochondrial antbody (including IgM
139
"beading/ onion skinning of bile dict"
primary sclerosing cholangitis
140
"fistula between gallbladder and small intestine leading to air in biliary tree and allowing the passage of gallstones into the intestinal tract"
gallstone ileus
141
Which viris can cause cholecystitis?
CMV
142
"autodigestion of pancreas by pancreatic enzymes"
acute pancreatitis
143
Which viral infection is associated with acute pancreatitis?
mumps
144
Hypo or hypercalcemia associated with acute pancreatitis?
Hypocalcemia
145
Tumor marker of pancreatic adenoma?
CA 19-9
146
Trousseau syndrome?
Migratory thrombophlebitis associated with pancreatic adenocarcinoma
