Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Gastrointestinal > GI must knows > Flashcards

GI must knows Flashcards

1
Q

Risk factor pnemonic for Esophageal cancer

A

AABCDEFFGH

Alcohol- Squamous (upper and Middle Esophagus)
Achalasia
Barrett's- Adeno
Cigarretes- both
Diverticula- Squamous
Esophageal web- Squamous
Familial- 
Fat- 
GERD- Adeno
H- Hot liquids- Squamous
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Carcinoid Tumor is made up of what type of cell

A

neuroendocrine cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Chromogranin positive tumor…think what?

A

Carcinoid Tumor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Carcinoid tumors often secrete what?

A

Serotonin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How does Carcinoid syndrome develop?

A

Carcinoid tumors release serotonin. As long as the tumor is somewhere in the GI that is not the liver, this serotonin is secreted into the portal circulation which brings it to the liver where it is metabolized by MAO into 5-HIAA. If the tumor mets to the liver however, it can secrete serotonin into the hepatic vein which can bypass liver metabolism and cause serotonin to enter the systemic circulation causing bronchospasm, diarrhea, and skin flushing. May also cause Carcinoid heart disease which is right sided valvular fibrosis (not left side because there is MAO in the lungs).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Most common location of gastric ulcer

A

Antrum of the stomach (lesser curvature I think)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Black gallstones indicate

A

hemolysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What makes the black gallstones black?

A

High Billirubin content

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Acute Gastritis is or is not related to H. Pylori?

A 
NOT
Acute Gastritis risk factors include:
-Curling Ulcer (Burn- leads to hypovolemia which leads to decreased blood supply to the stomach. Normally the stomach is aided by blood supply which picks up leaked acid)
- Cushing ulcer- increased vagal nerve stimulation from increased intracranial pressure
- NSAIDS
- ALcohol
- Chemo
- Shock
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Chronic Gastritis causes

A
  • Autoimmune

- H Pylori

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What does a Urea breath test test for?

A

H Pylori…remember they give off urease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Chronic Autoimmune gastritis, whats the best way to test for it?

A
  • Test for antibodies against parietal cells and intrinsic factor.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Know Ulcerative Colitis vs Crohns

A

ok

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

The inflammation and hemorrhage of the pancreas during acute pancreatitis is due most generally to what?

A

autodigestion of the pancrease by inappropriately activated pancreatic enzymes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What enzyme is responsible for activating all other pancreatic enzymes?

A

Trypsin! MUST KNOW THAT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

two causes of acute pancreatitis

A

alcohol and gallstones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Which pancreatic enzyme is more specific for acute pancreatitis

A

serum lipase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What truly characterizes chronic pancreatitis?

A

Fibrosis of the pancreatic parenchyma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Clinical features of chronic pancreatitis

A

Pain that radiates to the back, steatorrhea, fat soluble vitamin deficiency, diabetes mellitus secondary to the destruction of islets, increased risk for pancreatic cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Peutz Jeghers Syndrome

A

Hamartomatous polyps throughout GI and freckle like spots on lips, oral mucosa.
Increased risk for colorectal, breast, and Gynecologic cancer

So, Polyps and Freckles…high cancer risk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Hyperplastic polyps most commonly found where

A

Left colon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What findings = bad prognosis with adenomatous polyp

A

Greater than 2cm, Sessile growth, villous histology

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

FAP?

A

Familial Adenomatous Polyposis Syndrome
This is an inherited APC (Adenomatous polyposis coli) mutation.
Colon and rectum removed prophylactically.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Gardner Syndrome

A

FAP + Fibromatosis + Osteomas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Turcot Syndrome?

A

FAP with CNS tumors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

2 pathways that lead to CRC?

A

1) Adenoma - Carcinoma pathway

2) Microsatellite Instability Pathway

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Tumor marker for pancreatic cancer

A

CA19-9

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Major signs/symptoms for pancreatic adenocarcinoma in the head of the pancreas?

A

Obstructive Jaundice, Pale stools. Palpable gallbladder,

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Major signs and symtpoms with pancreatic adenocarcinoma that arises in the tail or body?

A

Secondary diabetes Mellitus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Jaundice Bilirubin level?

A

Over 2.5 mg/dl

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

The fibrosis seen during liver cirrhosis is mediated by what?

A

Stellate cell ( relelase TGF- beta)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Periductal onion skin fibrosis

A

Primary sclerosing cholangitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Ulcerative colitis associated with what other diseases?

A

Primary sclerosing cholangitis and p-ANCA positivity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Crohns associated with?

A

Ankylosing spondylitis, sacroilitis, migratory polyarteritis, erythema nodosum, uveitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Achlorhydria seen when?

A

Chronic atrophic gastritis.

Not seen in PUD because you must have acid and pepsin present for ulceration to occur.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Oral contraceptives and the liver

A

Hepatic adenoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Angiosarcoma and the liver

A

vinyl chloride

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Corneal Kayser Fleischer rings

A

Wilson’s Disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What the F is Wilson’s disease?

A

Inadequate hepatic copper excretion and failure of copper to enter the circulation as ceruloplasmin.

40
Q

Where does copper accumulate>

A

Liver, Brain, Cornea, Kidneys, Joints

41
Q

Lab findings in Wilson’s disease?

A

Low Ceruloplasmin, high urinary copper

42
Q

Wilson’s disease follows what type of inheritance pattern and what gene is affected?

A

Auto Recessive. ATP7B gene (this gene codes for the ATP powered copper transporting ATPase which genenreally excretes copper into the bile where it can be incorporated into ceruloplasmin.
Without this copper ATPase, copper builds up in the liver, leaks into the serum, and deposits in tissues.

43
Q

Wilson’s disease generally presents when? How

A

Childhood.

Cirrhosis of the liver
Behavioral changes like parkinsonian symptoms due to basal ganglia degeneration
Asterixis- Tremor of the hand
Dementia, Dyskinesia, Dysarthria

44
Q

Bridging necrosis most commonly related to what?

A

Viral hepatitis (chronic)

45
Q

Pancreatic psuedocyst is a complication of what?

A

Chronic pancreatitis most often secondary to chronic alcoholism.

46
Q

In hemochromatosis, what organs are most commonly affected?

A

heart, pancreas , liver.

47
Q

Prussian blue stain turns what color with Hemochromatosis

A

Blue

48
Q

Hemochromatosis follows what inheritance pattern?

A

Autosomal recessive.

49
Q

Necrosis of hepatocytes at the interface between the portal tracts and liver lobule =

A

Chronic Hepatitis….this eventually leads to bridging necrosis and then cirrhosis with portal bridging fibrosis and nodular regeneration.

50
Q

Concentric bile duct fibrosis is associated with what?

A

Sclerosing cholangitis

51
Q

Microvesicular steatosis

A

acute fatty liver of pregnancy and Reye Syndrome in children

52
Q

Limiting plate inflammation, or inflammation around the portal triads?

A

Chronic viral hep…think HCV or potentially HBV

53
Q

Obesity and cholesterol

A

Obesity leads to high levels of HMG CoA reductase which means acetate is converted to free cholesterol

54
Q

Estrogen and cholesterol

A

Estrogen = increased cholesterol uptake pretty much…increased uptake of serum lipoproteins.

55
Q

Progesterone

A

Decreased cholesterol ester stores and increased free cholesterol

56
Q

Biliary Colic

A

Stone blocking the cystic duct

  • Pain for a short period of time then goes away. Nausea and vomitting present
  • NO fever, chills, jaundice
57
Q

After Biliary colic, what is the next in the line of severity

A

Cholecystitis- Stone blocking the cystic duct but it has been there for a longer period of time. Associated with inflammation of the gallbladder walls. Pain, fever, chills, nausea and vomitting.
NO Jaundice
Probably needs gallbladder removed

58
Q

After cholecystits, what is next most severe

A

Choledocholithiasis- stone has moved into common bile duct and bile backs up into both gallbladder and liver.
pt presents with pain, nausea, vomitting, JAUNDICE

59
Q

After choledocholithiasis

A

Cholangitis- Infloammation of the bile ducts in the liver…NOT GOOD NEWS AT ALL

60
Q

After choledocholithiasis with cholangitis?

A

Biliary Pancreatitis- stone is stuck in the common bile duct below where the pancreatic duct comes in. Pt will have symtoms of cholangitis and pancreatic enzymes will be high. Will develop pancreatitis, Persistent nausea and vomitting

61
Q

ADH2*1

A

genetic polymorphism in east asians that is associated with higher susceptibility to ALD

62
Q

TNF alpha 238

A

potential polymorphism in caucasians that is related to ALD

63
Q

Fatty change in alcoholic hepatitis and non-alcoholic macro or micro

A

Macro

64
Q

Take home for NAFLD and NASH:

A

Obesity = Inc in FFA synthesis and decrease in FFA oxidation

Insulin resistance = Increase in Peripheral lipolysis leading to higher FFA to the liver

These two mechanisms lead to increased FFA and increased oxidative stress

65
Q

Most common tumors in the liver are?

A

Metastatic tumors BY FAR!!!
Most common sites of origin =
Cancer sometimes penetrates benign liver
Colon, stomach, pancreas, breast, lung

66
Q

Most common benign tumor in the liver

A

Hemangioma…not hepatic adenoma

67
Q

Primary Billiary Cirrhosis associated with what antibodies

A

anti-mitochondrial

68
Q

Histology of PBC

A

Dense lymphocyticinfiltrate in and around interlobular bile ducts with granuloma and bile duct destruction

69
Q

PAS positive globules

A

alpha anti-trypsin

70
Q

Nutmeg liver=

A

kinda reddish looking. Its a result of Cor Pulmonale—-right sided heart failure that is caused by some sort of restrictive lung disease

71
Q

Gastrin tyrosyl residue in what position>

A

6 position

72
Q

Gastrin tyrosyl in 6 and sulfated

A

Gastrin II

73
Q

Gastrin Tyrosyl in 6 and desulfated

A

Gastrin !

74
Q

All of the GI tract is smooth muscle except for?

A

Upper 1/3 of esophagus and external anal sphincter

75
Q

Vagotomy will lead to lack of peristalsis in what section of the esophagus?

A

Upper 1/3….because this is skeletal striated muscle and skeletal striated muscle is innervated directly by vagal efferents whereas the myenteric plexus plays a large role in mediating lower 2/3.

76
Q

Salivary amylase is the same as pancreatic amylase

A

ok

77
Q

Glycerol does not need a micelle to be absporbed

A

ok

78
Q

Failure to reabsorb bile acids does cause osmotic diarrhea

A

ok

79
Q

Voluntary contraction of the external anal sphincter and the urge to defecate comes from

A

sacral region of spinal cordq

80
Q

Where is the H+ pump located in resting/unstimulated parietal cells

A

membranes of small tubulovesicles, oriented towards the inside.

81
Q

When parietal cells begin to secrete, where do the H+ pump containing tubulovesicles move?

A

Into the intracellular canaliculus of the secreting cell

82
Q

In the secreting stomach, the pH of venous blood is higher or lower than arterial

A

Higher, more basic

83
Q

During the stimulation of gastric acid secretion, what happens to the electrical potential difference across the gastric mucosa

A

Decreases

84
Q

Lymphocytes in myenteric plexus=

A

Achalasia

85
Q

Enteric nervous system =

A

Myenteric plexus- B/w inner circular and outer longitudinal layer. Motility

Meissner- INSIDE the submucosa…secretion

86
Q

Acute hemorrhagic gastritis =

A

alcohol, NSAIDS, trauma, sepsis, shock

87
Q

Chronic gastritis

A

H Pylori or autoimmune

88
Q

Esophageal cancer more common in what sex/ race

A

men
squamous= black
adeno= white

89
Q

adenomatous gastric polyps most common where

A

antrum

90
Q

injury, infxn, genetics —> gastritis —> atrophic gastritis —> Bacterial growth —> bacterial enzymes like nitrate reductase turn nitrates into nitrites and these lead to mutations

A

ok

91
Q

Signet ring cell in what type of gastric cancer

A

Diffuse

92
Q

Drugs associated with constipation, paralytic ileus, or acute megacolon

A

psychiatric drugs DON’t MISS

ALso…be careful to watch for C. Dif, IBD

93
Q

FAP

A

Autosomal dominant…
Over 100 adenomatous polyps starting in the 2nd and 3rd decade
All will develop CRC unless the colon is removed

In FAP, one allele of the mutated APC gene is inherited and another occurs somatically. This is when the problems arise

94
Q

HNPCC

A

Hereditary Non-polyposis colorectal carcinoma is associated with inherited mutations in DNA mismatch repatin enzymes….also associated with endometrial, ovaria, urinary, and gastric cancer

95
Q

Hyperplastic polyps most commonly arise where?

A

left colon

Gastrointestinal (58 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions