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Step One > GI Random > Flashcards

GI Random Flashcards

1
Q

caudal fold closure

A

bladder extrophy

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2
Q

lateral fold closure

A

omphalocele, gastroschisis

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3
Q

rostral fold closure

A

sternal defects

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4
Q

macrolides

A

associated with hypertrophic pyloric stenosis

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5
Q

spleen

A

origin-mesoderm

foregut blood supply

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6
Q

retroperitoneal structure

A 
suprarenal glands
aorta and IVC
duodenum (2nd through 4th)
pancreas (except tail)
ureters
colon (descending and ascending)
kidneys
esophagus
rectum
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7
Q

falciform ligament

A

contains ligamentum teres hepatis (derivative of fetal umbilical vein)

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8
Q

hepatoduodenal ligament

A

portal triad (proper hepatic artery, portal vein, common bile duct)

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9
Q

omental foramen

A

connects greater and lesser sacs

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10
Q

gastrosplenic ligament

A

contains short gastrics and left gastroepiploic

separates greater and lesser sacs on left

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11
Q

submucosa

A

submucosal nerve plexus, secretes fluid

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12
Q

muscularis externa

A

myenteric plexus for motility

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13
Q

superior mesenteric artery syndrome

A

intermittent intestinal obstruction when transverse duodenum compressed between SMA and aorta

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14
Q

posterior duodenal ulcers

A

penetrate gastroduodenal artery causing hemorrhage

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15
Q

anterior duodenal ulcers

A

perforate into anterior abdominal cavity leading to pneumoperitoneum

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16
Q

esophagus anastomosis

A

left gastric to azygos

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17
Q

umbilicus anastomosis

A

paraumbilical and small epigastric veins of anterior abdominal wall

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18
Q

rectum anastomosis

A

superior rectal and middle and inferior rectal

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19
Q

treatment shunting

A

transjugular intrahepatic portosystemic shunt

can precipitate hepatic encephalopathy

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20
Q

location anal fissure

A

posterior (poorly perfused)

below pectinate line

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21
Q

zone 2 liver

A

yellow fever

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22
Q

femoral sheath

A

contains canal, vein, artery but not femoral nerve

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23
Q

spermatic cord

A

ICE tie
internal spermatic fascia (transversalis fascia)
cremasteric (internal oblique)
external spermatic fascia (external oblique)

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24
Q

indirect inguinal hernia

A

through internal (deep) inguinal ring and into scrotum
lateral to inferior epigastric
infants due to failure of processus vaginalis to close

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25
Q

direct inguinal hernie

A

through inguinal triangle through parietal peritoneum medial to rectus abdominis, through external inguinal ring only, old men from weakness in transversalis fascia

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26
Q

pancreatic secretions

A

isotonic
low-high Cl
high-high HCO3

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27
Q

rate limiting step bile acid synthesis

A

7alpha hydroxylase

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28
Q

pleomorphic adenoma

A

mixed tumor, chrondromyxoid stroma and epithelium

recurs

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29
Q

Warthin tumor

A

cystic with germinal centers

found in smokers

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30
Q

cancer plummer vinson

A

squamous cell carcinoma

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31
Q

Menetrier disease

A

hyperplasia of gastric mucosa

excess mucus production with protein loss and parietal cell atrophy, decreased acid production

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32
Q

sister mary jospeh nodule

A

subcutaneous periumbilical mets

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33
Q

perforated ulcer

A

free air under diaphragm

referred pain to shoulder due to irritation of phrenic nerve

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34
Q

histology Celiac

A

villous atrophy

crypt hyperplasia and intraepithelial lymphocytes

35
Q

D xylose test

A

blood and urine levels decrease with mucosal defects or bacterial overgrowth
normal in pancreatic insufficiency

36
Q

findings pancreatic insufficiency

A

decrease duodenal pH and fecal elastase

decrease KADE and B12

37
Q

Whipple disease

A

PAS positive

cardiac, arthralgias, neuro symptoms

38
Q

histology Crohn disease

A

transmural infalmmation
cobblestone, creeping fat, bowel wall thickening
noncaseating granulomas (T1 mediated)

39
Q

histology ulcerative colitis

A

mucosal and submucosal inflammation only

crypt abscesses and ulcers (T2 mediated)

40
Q

location of false diverticulum

A

vasa recta perforation of muscularis externa

41
Q

location Zenker diverticulum

A

Killian triangle

between thyropharyngeal and cricopharyngeal parts of inferior pharyngeal constrictors

42
Q

genetics Hirschsprung disease

A

RET

Down syndrome

43
Q

locations of volvulus

A

midgut in children

sigmoid in adults

44
Q

necrotizing enterocolitis

A

premature, formula fed infants with immature immune system

possible perforation-air in abdomen

45
Q

serrated polyps

A

CpG hypermethylation
microsatellite instability in BRAF
sawtooth pattern

46
Q

APC

A

tumor suppressor ch 5

47
Q

Gardner

A

FAP and osseous and soft tissue tumors, hypertrophy of retinal pigment epithelium, impacted/supernumerary teeth

48
Q

Turcot

A

FAP and malignant CNS tumor

49
Q

Peutz-Jeghers

A

AD hamartomas throughout GI
hyperpigmented mouth, lips, hands, genitalia
increased risk GI and breast cancer

50
Q

Lynch syndrome

A

AD DNA mismatch

proximal colon

51
Q

histology cirrhosis

A

diffuse bridging fibrosis and regenerative nodules

52
Q

spontaneous bacterial peritonitis

A

gram negative, aerobic
paracentesis with ascitic fluid
can worsen encephalopathy

53
Q

decreased platelets in liver disease

A

decrease thrombopoietin, liver sequestration

54
Q

mechanism Reye syndrome

A

decrease beta oxidation by reversible inhibition of mitochondrial enzymes

55
Q

histology alcoholic hepatitis

A 
swollen and necrotic hepatocytes with neutrophilic infiltation
mallory bodies (damaged keratin)
56
Q

triggers hepatic encephalopathy

A

increased production and absoprtion due to GI bleed, dietary, constipation, infection
decreased removal due to renal failure, diuretics
treat with lactulose, rifaximin, or neomycin

57
Q

cavernous hemangioma

A

biopsy contraindicated due to hemorrhage risk

58
Q

hepatic adenoma

A

OCP and anabolic steroid use

59
Q

angiosarcoma association

A

arsenic and vinyl chloride

60
Q

Budd Chiari

A

thombosis hepatic veins

associated with hypercoagulable states, polycythemia vera, postpartum, HCC

61
Q

alpha1AT liver

A

aggregation in hepatocellular ER

PAS+

62
Q

conjugated hyperbilirubinemia

A

biliary tract obstruction
bilary tract disease-sclerosing or biliary cholangitis
Dubin-Johnson and Rotor

63
Q

location kernicterus

A

basal ganglia

64
Q

treatment Crigler Najjar

A

phenobarbital-works in type II

65
Q

genetics Wilson disease

A

ATP7B on chromosome 13

66
Q

location Kayser-Fleischer rings

A

descemet membrane of cornea

67
Q

genetics hemochromotosis

A

HFE C282Y>H63D on ch 6, HLA-A3

68
Q

presentation hemochromatosis

A

restrictive or dilated cardiomyopathy (reversible)
hypogonadism
arthropathy-calcium pyrophosphate deposition at MCP

69
Q

histology primary sclerosing cholangitis

A

onion skin duct fibrosis

strictures and dilation-beading

70
Q

associations primary sclerosing cholangitis

A

UC, p-anca

risk of cholangiocarcinoma and gallbladder cancer

71
Q

histology primary biliary sholangitis

A

lymphocytic infiltrate and granulomas
destruction of intralobular bile ducts
anti-mitochondrial Ab

72
Q

histology secondary biliary cholangitis

A

extrahepatic bilary obstruction

increase pressure in intrahepatic ducts leading to fibrosis and bile stasis

73
Q

associations cholesterol stones

A

obesity, Crohn, estrogen, advanced age, multiparity, rapid weight loss, Native American

74
Q

associations pigment stones

A

crohn, hemolyis, alcoholic cirrhosis, advanced age, biliary infections, total parenteral nutrition

75
Q

findings choledocholithiasis

A

gallstone in common bile duct

elevated ALP, GGT, direct bilirubin, AST/ALT

76
Q

cause acalculous cholecystitis

A

CMV, stasis, hypoperfusion

77
Q

symptoms ascending cholangitis

A

jaundice, fever, RUQ pain

altered mental status, hypotension (shock)

78
Q

histology pseudocyst

A

granulation tissue, no epithelium

79
Q

histology pancreatic adenocarcinoma

A

tumor from pancreatic ducts (disorganized glands)

80
Q

H2 blockers and creatinine

A

cimetidine and ranitidine decrease excretion of creatinine

81
Q

rebound acid increase

A

calcium carbonate

82
Q

risk octreotide

A

increase risk of cholelithiasis due to CCK inhibition

83
Q

side effects sulfasalazine

A

reversible oligospermia

sulfa toxicitiy

Step One (19 decks)

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