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Board Review - C - Gastrointestinal > GI III > Flashcards

GI III Flashcards

1
Q

gastric acid secretion from parietal cells

A

stimulus - ACh, gastrin, histamine

  • M3 - ACh / gastrin - CCK-B / histamine - H2
  • most important - ECL histamine release
  • mechanism - cAMP and IP3/Ca stimulate H/K ATPase

inhibit - prostaglandin and somatostatin
decreased cAMP

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2
Q

alkaline tide

A

with gastric acid secretion

  • carbonic anhydrase - convert CO2 and H2O
  • to H and HCO3

H - secreted to gastric lumen
HCO3 - bicarb - secreted to blood - alkaline tide

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3
Q

pancreas secretion

A

a-amylase - starch digestion
lipase - fat digestion
proteases - secreted as proenzymes
trypsinongen - converted to active trypsin

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4
Q

trypsinogen activation

A

from pancreas
-converted to trypsin by enterokinase - brush border of duodenum/jejunum

active form - trypsin - activates other pancreas proteases

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5
Q

carb absorption

A

monosacchaides - absorbed enterocytes

glucose and galactose - SGLT1

fructose - facilitated diffusion - GLUT 5

all transported GLUT-2

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6
Q

iron absorption

A

duodenum

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7
Q

folate absorption

A

small bowel

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8
Q

B12 absorption

A

terminal ileum - with IF

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9
Q

peyer patches

A

M cell - APC

B cells to IgA plasma cell in germinal centers

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10
Q

rate limiting step bile acid synthesis

A

7a hydroxylase

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11
Q

bilirubin metabolism

A

heme to biliverdin - by heme oxygenase
biliverdin to bilirubin

unconjugated - not soluble - indirect
-in blood complexed albumin

conjugated with glucuronate - soluble - direct

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12
Q

UDP glucuronosyl transferase

A

unconjugated to conjugated bilirubin

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13
Q

warthin tumor

A

papillary cystadenoma lymphomatosum

B9 cystic tumor with germinal center

salivary gland - often parotid

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14
Q

MC salivary gland tumor

A

pleomorphic adenoma

chrondromyxoid stroma

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15
Q

achalasia

A

failure LES - loss of myenteric (auerbach) plexus

dysphagia - solid and liquid

bird beak - barium swallow

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16
Q

obstruction dysphagia

A

solid only

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17
Q

secondary achalasia

A

with chagas disease - t. cruzii

or malignancy

18
Q

boerhaave syndrome

A

wretching - transmural tear distal esophagus

get pneumomediastinum - air

19
Q

esophageal stricture

A

lye and acid reflux

20
Q

punched out lesion HIV esophagitis

A

HSV-1

21
Q

linear ulcer HIV esohpagitis

A

CMV

22
Q

plummer vinson syndrome

A

dysphagia, iron deficiency, esophagus webs

risk of esophageal SCC

23
Q

barret esophagus

A

stratified squamous to intestinal

nonciliated columnar with goblet cells

24
Q

esophageal cancer

A

worldwide - SCC more common
-upper 2/3

adenocarcinoma - in US
-lower 1/3

25
Q

SCC of esophagus risk fx

A 
zenker diverticula
alcohol
esophageal web
hot liquid
cigarette
26
Q

adenocarcinoma of esophagus risk fx

A

barret
obesity
GERD

27
Q

parts of stomach

A

cardiac - GE junction
fundus - top
body - main
antrum - pyloric sphincter - near duodenum

28
Q

acute gastaritis

A

loss mucosa barrier - inflammation

NSAID - low PGE2
burns - curling ulcer
brain injury - cushing ulcer - increased vagal - more ACh

29
Q

cushing ulcer

A

with brain injury

increased vagal stimulation - more ACh - more H+

30
Q

chronic gastritis

A

non-erosive

type A - fundus/body - autoimmune
type B - antrum - h. pylori

31
Q

h. pylori

A

infect antrum of stomach
-get chronic gastritis

risk of MALToma

32
Q

menetrier disease

A

gastric hyperplasia of mucosa

precancerous

hypertrophic rugae - look like brain gyri

33
Q

virchow node

A

left supraclavicular

with mets from stomach

34
Q

krukenberg tumor

A

B/L stomach ca mets to ovaries

mucin secreting, signet ring cells

35
Q

sister mary joseph nodule

A

subQ periumbilical mets

from stomach ca

36
Q

intestinal stomach cancer

A 
h. pylori
smoked foods -nitrosamine
tobacco
smoking
achlorhydria
chronic gastritiis

commonly - lesser curve

37
Q

diffuse stomach cancer

A

signet ring cell - stomach wall grossly thick and leathery

-linitis plastica

38
Q

gastric ulcer

A

worse with meals
weight loss

NSAIDs

39
Q

duodenal ulcer

A

better with meals
weight gain

ZES

40
Q

posterior wall duodenum ulcer

A

gastroduodenal a

41
Q

gastric ulcer lesser curve stomach

A

left gastric a

Board Review - C - Gastrointestinal (6 decks)

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