GI Random Flashcards
caudal fold closure
bladder extrophy
lateral fold closure
omphalocele, gastroschisis
rostral fold closure
sternal defects
macrolides
associated with hypertrophic pyloric stenosis
spleen
origin-mesoderm
foregut blood supply
retroperitoneal structure
suprarenal glands aorta and IVC duodenum (2nd through 4th) pancreas (except tail) ureters colon (descending and ascending) kidneys esophagus rectum
falciform ligament
contains ligamentum teres hepatis (derivative of fetal umbilical vein)
hepatoduodenal ligament
portal triad (proper hepatic artery, portal vein, common bile duct)
omental foramen
connects greater and lesser sacs
gastrosplenic ligament
contains short gastrics and left gastroepiploic
separates greater and lesser sacs on left
submucosa
submucosal nerve plexus, secretes fluid
muscularis externa
myenteric plexus for motility
superior mesenteric artery syndrome
intermittent intestinal obstruction when transverse duodenum compressed between SMA and aorta
posterior duodenal ulcers
penetrate gastroduodenal artery causing hemorrhage
anterior duodenal ulcers
perforate into anterior abdominal cavity leading to pneumoperitoneum
esophagus anastomosis
left gastric to azygos
umbilicus anastomosis
paraumbilical and small epigastric veins of anterior abdominal wall
rectum anastomosis
superior rectal and middle and inferior rectal
treatment shunting
transjugular intrahepatic portosystemic shunt
can precipitate hepatic encephalopathy
location anal fissure
posterior (poorly perfused)
below pectinate line
zone 2 liver
yellow fever
femoral sheath
contains canal, vein, artery but not femoral nerve
spermatic cord
ICE tie
internal spermatic fascia (transversalis fascia)
cremasteric (internal oblique)
external spermatic fascia (external oblique)
indirect inguinal hernia
through internal (deep) inguinal ring and into scrotum
lateral to inferior epigastric
infants due to failure of processus vaginalis to close
direct inguinal hernie
through inguinal triangle through parietal peritoneum medial to rectus abdominis, through external inguinal ring only, old men from weakness in transversalis fascia
pancreatic secretions
isotonic
low-high Cl
high-high HCO3
rate limiting step bile acid synthesis
7alpha hydroxylase
pleomorphic adenoma
mixed tumor, chrondromyxoid stroma and epithelium
recurs
Warthin tumor
cystic with germinal centers
found in smokers
cancer plummer vinson
squamous cell carcinoma
Menetrier disease
hyperplasia of gastric mucosa
excess mucus production with protein loss and parietal cell atrophy, decreased acid production
sister mary jospeh nodule
subcutaneous periumbilical mets
perforated ulcer
free air under diaphragm
referred pain to shoulder due to irritation of phrenic nerve
histology Celiac
villous atrophy
crypt hyperplasia and intraepithelial lymphocytes
D xylose test
blood and urine levels decrease with mucosal defects or bacterial overgrowth
normal in pancreatic insufficiency
findings pancreatic insufficiency
decrease duodenal pH and fecal elastase
decrease KADE and B12
Whipple disease
PAS positive
cardiac, arthralgias, neuro symptoms
histology Crohn disease
transmural infalmmation
cobblestone, creeping fat, bowel wall thickening
noncaseating granulomas (T1 mediated)
histology ulcerative colitis
mucosal and submucosal inflammation only
crypt abscesses and ulcers (T2 mediated)
location of false diverticulum
vasa recta perforation of muscularis externa
location Zenker diverticulum
Killian triangle
between thyropharyngeal and cricopharyngeal parts of inferior pharyngeal constrictors
genetics Hirschsprung disease
RET
Down syndrome
locations of volvulus
midgut in children
sigmoid in adults
necrotizing enterocolitis
premature, formula fed infants with immature immune system
possible perforation-air in abdomen
serrated polyps
CpG hypermethylation
microsatellite instability in BRAF
sawtooth pattern
APC
tumor suppressor ch 5
Gardner
FAP and osseous and soft tissue tumors, hypertrophy of retinal pigment epithelium, impacted/supernumerary teeth
Turcot
FAP and malignant CNS tumor
Peutz-Jeghers
AD hamartomas throughout GI
hyperpigmented mouth, lips, hands, genitalia
increased risk GI and breast cancer
Lynch syndrome
AD DNA mismatch
proximal colon
histology cirrhosis
diffuse bridging fibrosis and regenerative nodules
spontaneous bacterial peritonitis
gram negative, aerobic
paracentesis with ascitic fluid
can worsen encephalopathy
decreased platelets in liver disease
decrease thrombopoietin, liver sequestration
mechanism Reye syndrome
decrease beta oxidation by reversible inhibition of mitochondrial enzymes
histology alcoholic hepatitis
swollen and necrotic hepatocytes with neutrophilic infiltation mallory bodies (damaged keratin)
triggers hepatic encephalopathy
increased production and absoprtion due to GI bleed, dietary, constipation, infection
decreased removal due to renal failure, diuretics
treat with lactulose, rifaximin, or neomycin
cavernous hemangioma
biopsy contraindicated due to hemorrhage risk
hepatic adenoma
OCP and anabolic steroid use
angiosarcoma association
arsenic and vinyl chloride
Budd Chiari
thombosis hepatic veins
associated with hypercoagulable states, polycythemia vera, postpartum, HCC
alpha1AT liver
aggregation in hepatocellular ER
PAS+
conjugated hyperbilirubinemia
biliary tract obstruction
bilary tract disease-sclerosing or biliary cholangitis
Dubin-Johnson and Rotor
location kernicterus
basal ganglia
treatment Crigler Najjar
phenobarbital-works in type II
genetics Wilson disease
ATP7B on chromosome 13
location Kayser-Fleischer rings
descemet membrane of cornea
genetics hemochromotosis
HFE C282Y>H63D on ch 6, HLA-A3
presentation hemochromatosis
restrictive or dilated cardiomyopathy (reversible)
hypogonadism
arthropathy-calcium pyrophosphate deposition at MCP
histology primary sclerosing cholangitis
onion skin duct fibrosis
strictures and dilation-beading
associations primary sclerosing cholangitis
UC, p-anca
risk of cholangiocarcinoma and gallbladder cancer
histology primary biliary sholangitis
lymphocytic infiltrate and granulomas
destruction of intralobular bile ducts
anti-mitochondrial Ab
histology secondary biliary cholangitis
extrahepatic bilary obstruction
increase pressure in intrahepatic ducts leading to fibrosis and bile stasis
associations cholesterol stones
obesity, Crohn, estrogen, advanced age, multiparity, rapid weight loss, Native American
associations pigment stones
crohn, hemolyis, alcoholic cirrhosis, advanced age, biliary infections, total parenteral nutrition
findings choledocholithiasis
gallstone in common bile duct
elevated ALP, GGT, direct bilirubin, AST/ALT
cause acalculous cholecystitis
CMV, stasis, hypoperfusion
symptoms ascending cholangitis
jaundice, fever, RUQ pain
altered mental status, hypotension (shock)
histology pseudocyst
granulation tissue, no epithelium
histology pancreatic adenocarcinoma
tumor from pancreatic ducts (disorganized glands)
H2 blockers and creatinine
cimetidine and ranitidine decrease excretion of creatinine
rebound acid increase
calcium carbonate
risk octreotide
increase risk of cholelithiasis due to CCK inhibition
side effects sulfasalazine
reversible oligospermia
sulfa toxicitiy
