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USMLE STEP1 📚👩🏻‍⚕️ > GI & liver > Flashcards

GI & liver Flashcards

1
Q

Intussussception

A

1.Meckel Diverticulum
Rule of 2
2.Infection
3.HSP

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2
Q

HLA B27

A

IBD , Ankylosing Spondylitis , RA ,1 Scelrosing Cholangitis, Pyoderma Gran

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3
Q

Recto-Sigmoid Junction + BPR + Abd Pain + Arthropathy +Fam Hx

A

IBD ( UC type) - Mucosa only / continuous lesions

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4
Q

Drugs inducing Kernictus

A

HEPATIC ENCEPHALOPATHY
Aspirin /sulfa drugs/antibiotics

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5
Q

If Phototherapy fails ?

A

Albumin Transfusion + Plasma Exchange

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6
Q

Charcot Triad

A

Chonlangitis ( fever + Jaundice + RUQ pain)

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7
Q

Raynold’s Pentad

A

Charcot triad+ hypotension + mental alternation ( confusion )

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8
Q

Murphy Sign

A

Pain on palpation of RUQ costal area
1.Cholecystitis
2.Gallstone (Choledocholelithiasis) in CBD + GB distension

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9
Q

Mc Burney Point

A

Appendicitis
Peritoneal irritation ( Guarding +Rebound )

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10
Q

HCV test

A

HCV RNA (PCR) (+ after 1 month approx)
HCV antibody ( + after 3 months )

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11
Q

Thiamine B1 function

A

aerobic cellular respiration
Oxidative Decarboxylation ( BCAA)
PPP( NADPH production)

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12
Q

Thirst + Elevated RBG + bronze skin + elevated Fe+ transferrin

A

Bronze DM
Hemochromatosis

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13
Q

Fe deposit organs ?

A

Liver (COL&raquo_space; HCC)
Joint
Cardio

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14
Q

Copper deposit organ ( Ceruloplasmin )

A

Wilson DS
CNS Dominant

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15
Q

NE Tumors

A

1.Gastrinoma (most common) ( pancreas and duodenum )
2.Insulinoma ( B cells )

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16
Q

Gastrinoma asso syndromes

A

1.ZES ( PU + diarrhea + increase gastrin)
2.MEN-1 (3Ps)&raquo_space; pancreatitis , parathyroid , pituitary Adenomas

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17
Q

Alcoholic Hepatitis (COL)

A

AST> ALT

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18
Q

Congenital anomalies of Mesoderm

A

VACTERL
Vertebrae anomalies
Anal atresia
Cardiac defects
Tracheo-Esophageal fistula
Renal anomalies
Limb anomalies

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19
Q

Transudate or Exudate in Ascites

A

SAAG
> 1.1 ~transudate(Portal HTN)
<1.1 ~ exudate (HRS , Ca)

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20
Q

GI related SE of Clindamycin

A

Pseudomembranous Colitis
-C.Difficle
-Hospitalized patient
-fulminant colitis ( asso with Toxic Megacolon)
Rex- Metronidazole

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21
Q

Posprandial non-bilious projectile vomiting+ lethargy + dehydration + M.alkalosis +olive mass on palpation

A

Pyloric stenosis

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22
Q

Child ,
Recent Viral infection + Vomit + altered mental status
Hx of Aspirin Rx

A

Reye Syndrome
-fetal if not treated promptedly
-Mitochodrial dysfunction
-cerebral Edema
-severe transaminitis
Biopsy : Liver steatosis

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23
Q

Ileum absorbs

A

Bile salt + B12
Short bowel syndrome ( if ileum resection )

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24
Q

Impact on PT/aPTT from bile salt malabsorption

A

Increase ( Bile - Fat vitamin ADEK )
K important co-factor for CF 2/7/9/10

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25
Q

What risk if Pernicious Anemia + Type A blood +Gastritis

A

Gastric Cancer

26
Q

Most common gastric Ca

A

Adenocarcinoma
Signet ring cell + leather bottle stomach
Diffuse infiltration

27
Q

Krukenberg tumor

A

Ovary tumor from gastric cancer

28
Q

Virchow node

A

Left supraclavicular LN

29
Q

Sister Mary Joseph node / Irish node

A

Periumblical /axillary nodes (lymphatic spread)

30
Q

Ligament of triez

A

Differentiate between UGIB / LGIB

31
Q

Subacute combined degeneration of SC + Chron’s + beefy tongue

A

B12 deficiency ( pernicious Anemia )
Parasthesia + Ataxia

32
Q

Which hormone inhibit gastric Acid secretion ?

A

Secretin
Somatostatin analogs ( Eg : Octreptides ) inhibits gastrin ,VIP,insulin ,glucagon

33
Q

Gastric parietal cell receptors

A
  1. Histamine ( Raniditine)
    2.PP( omeprazole)
    3.Acetylcholine (vagal Input)
    4.PGs ( misoprostol )
    5.Gastrin
34
Q

Xanthelesma
Pruritis
Scelra icterus
Female
Abd pain

A

PBC
Associate with autoimmune d/o
Anti-mitochondrial Ab
Intrahepatic BD obstruction + inflammation

35
Q

Peyer patches location and importance ?

A

Ileum ( mucosa - laminate propria)
M cells -APC , plasma cell of ileum produce IgA
Fight/ Deal w Intraluminal Antigens

36
Q

Peyer patches location and importance ?

A

Ileum ( mucosa - laminate propria)
M cells -APC , plasma cell of ileum produce IgA
Fight/ Deal w Intraluminal Antigens

37
Q

How to differentiate ?Internal and external hemorrhoids
What happen w Portal HTN?

A

Int: painless ( visceral n) , dilated vein
(Sup rectal v» IMV»Portal)
Ext: painful ( somatic n) ,no dilated vein (Inf rectal&raquo_space; I iliac > IVC)

38
Q

Watershed areas
Why importance ?

A
  1. Splenic flexture
  2. Rectosigmoid junction

Vulnerable to Ischemia / obstruction / necrosis

39
Q

Dual blood supply area ?
Importance ?

A

SMA- IMA
IMA- Int iliac a
Rare for ischemia

40
Q

Intermittent int obstruction ( after eating )
Underweight / malnourished
Compression of duodenum.
Which artery compress?

A

SMA / Aorta
Superior mesenteric $

41
Q

Compress left renal vein between aorta and SMA
Flank pain
Hematuria
Risk of what urogenital anomalies ?
Name of $

A

Varicocele
Nutcracker $

42
Q

Histology of stomach / esophagus

A

ESO- stratified squamous ep
Stomach - simple columnar

43
Q

Enteric nervous supply to which part of intestinal layer ?

A

Auerbach plexus ( Muscularis)

44
Q

2 type of omentum

A

Lesser - liver and stomach / faliciform ligaments
Greater - greater curvature of stomach below

45
Q

Ligation of which ligament to stop bleeding or identifying source of bleeding?
Why ?

A

Hepatoduodenal ligament
Enclosed portal traid( Hepatic a/ Portal V/ Common bile duct )

46
Q

Stomach content out surround by amnion and peritoneum
Congenital abn
Failure of lateral wall to migrate at umbilical ring

A

Omphalocele

47
Q

Abd production increase wirhh breathing /crying
Newborn.
Congenital disorder

A

Umbilical hernia

48
Q

Double bubble sign on X ray
Cong defect

A

Duodenal atresia

49
Q

Olive mass
Projectile non-bilious vomiting
First born male

A

Pyloric stenosis

50
Q

Acute mesenteric Ischemia most common cause

A

Embolus from thrombus , heart disease

51
Q

CCK

A

produce hormones ( FA/ protein digestion )
Pancreas secretion / jejunum /duodenum I cells)

52
Q

Somatostatin

A

Inhibitory gastrointestinal hormones
Decrease acid/ pancreas secretion / decrease gall bladder contraction
Decrease glucagons and insulin

53
Q

Secretin

A

Bicarbonates secretion
Neutralize acid
Duodenum

54
Q

GIP

A

Increase insulin
Fed state
Decrease H+

55
Q

VIP

A

Parasympathetic
Increase water /E secretion
Relax smooth m/s

VIP Noma- pancreatic tumor

56
Q

WDHA $

A

Watery diarrhea
Hypokalemia
Achlorhydria

57
Q

Hunger hormone /fast state /increase appetite

A

Ghrelin
Increase in Prada Willi
Decrease after gastric bypass Sx

58
Q

Motilin

A

Increase in Fast state
Stimulate peristalsis

59
Q

Warrior from Germany love smoking

A

Warthin Tumor (salivary glands tumor)
Germinal Centre
Smokers

60
Q

Barium swallow -Dilated esophagus
Distal stenosis
Bird beak
Associated ds- Chagus Infection
Dx?

A

Achalasia (fail to relax LES -increase LEX pressure )
Dysphasia of solid /liquid
Loss of inhibitory neurons in myentric plexus of eso wall

61
Q

Budesonide ?
MOA ?

A

Glucocorticoids used in Chron disease
Attach to cytosolic receptors bind to heat shock protein ,enter nucleus alter RNA (translocation) - genes modification

USMLE STEP1 📚👩🏻‍⚕️ (13 decks)

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