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GI - random shit Flashcards

1
Q

Hemochromatosis HLA?

what does body stop making?

A

3

Hepcidin

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2
Q

What gene is mutated in hemochromatosis?

A

HFE on 6p chr

C282Y - cysteine replaced with tyrosine

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3
Q

What is mutated in Wilsons dz?

A

ATP7B

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4
Q

Other name for Wilsons

A

Hepatolenticular degeneration

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5
Q

Other name for Crohns

A

Regional enteritis

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6
Q

Which dz has anti-mitochondrial abs?

A

Primary biliary cirrhosis

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7
Q

Plummer Vinson

A 
Plumber digs for iron pipe
D - dysphagia - eso webs
I - iron def anemia
G - glossitis
S - SCC
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8
Q

UC high yield and HLA?

A

HLA-B27
ulcers try to heal - pseudo polyps
lose haustra - lead pipe
MPO - p-anca

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9
Q

Crohns high yield and gene mut?

A 
NOD 2 mut
creeping fat, cobblestones
AKA regional enteritis
Granulomas and transmural
Complications: stricture, obstruction, fistula, sinus tract
Ab: anti sacromyces serivacia ASCA
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10
Q

Two other names for acid fast stain

A

Kinyoun

Ziehl Neelson

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11
Q

Stain for iron?

A

Prussian blue

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12
Q

Reye syndrome what is damaged?

A

Mito

Get acute micro vesicular steatosis

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13
Q

MC cause of Budd Chiari syn?

A

Polycythemia vera
can be anything that causes hypercoag –> hepatic v thrombosis
Nutmeg liver from RHF into centrilobular zone

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14
Q

Hepatocellular carcinoma toxin? Marker?

A

Aflatoxin B1 from moldy grain

AFP

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15
Q

Alcoholic liver dz

Ammonium levels high tx?

A

Acidification of intestinal contents with lactulose

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16
Q

Ruptured spleen, ligate?

A

Splenorenal lig

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17
Q

H pylori tx

A

amoxicillin
clarithromycin
omeprazole

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18
Q

Alcoholic Cirrhosis initial tx

A

Furosemide and spironolactone

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19
Q

Peutz Jeghers syn

A

AD benign harartomatous polyps
Hyperpigment macules on lips, buccal, eyes and nostrils
Increased risk GI and BCA

Like Mic Jagger with black lips - likes breasts

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20
Q

Gardners syn

A

Suppression of APC gene
CRC and osteomas, retinal hyperplasia, epidermoid cysts
think of gardeners kneeling and can’t see to prune

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21
Q

Turcots syn

A

Turban

FAP and malignant CNS

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22
Q

Phenobarbitol to Gilbert syn

A

Bilirubin back to normal

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23
Q

Anastamoses eso varices

A

L gastric vein - azygous v

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24
Q

Anastamoses caput medusa

A

Paraumbilical v - inf epigastric v

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25
Anastamoses hemorrhoids
Sup rectal v - inf rectal v
26
Hep B complete recovery
HbcAb IgG | HbsAg
27
Hep B acute infection
HbcAb IgM HbsAg HbeAg
28
Hep B chronic carrier
HbcAb IgG HbsAg HbeAb
29
Villous atrophy in duodenum and jejunum
Celiacs
30
Painless hematemesis
Eso varices
31
Boerhave syn
Rare complication of Mallory Weiss Rupture eso subQ emphysemsa - crunchy on ausculatation
32
Esophageal carcinome 2 types and location
1 squamous - MC worldwide - hot tea, drano, achlasia | 2 Adenocarcinoma - assoc with Barretts, MC US - distal
33
Menetrier disease
Men, enlarged rugal folds crowd out the parietal cells = dec acid secretion. G cells sense no acid to INCREASE gastrin Protein loss b/c increased mucous cells = no tight junctions
34
Zollinger Ellison
enlarged rural folds and increased acid
35
Pain better with eating? Tend to gain wt
duodenal ulcer - wake up in middle of noc and eat because of pain
36
Pain worse with eating?
stomach ulcer, food increases acid = wt loss
37
Stomach ulcer going posterior can penetrate?
Pancreas and gastroduodenal a
38
Ulcer penetrating ant wall stomach?
perforation = free air under diaphragm
39
Currant jelly stool?
``` Intussusception prox into distal Kids: rotavirus Adults: tumor Tx: air contrast enema - apply pressure ```
40
Indirect hernia
IN inguinal canal - deep --> superficial
41
Direct hernia
directly through the wall
42
Hirschsprung Dz
Aganglionic megacolon Failure of neural crest migration Mut: RET
43
Sounds like celiacs but pt doesn't get better on gluten free?
Tropical sprue - travel hx - tx: abx
44
Whipple Disease
Organism? Tropheryma whipplei PAS+ G+ rids in Macrophages = foamy like a can of whipped cream Male white Joint pain, watery D, skin lesions
45
Osler Weber Rendu Syn
AKA hereditary hemorrhagic telangiectasia - telangiectasias of skin and mucous membranes - iron def anemia
46
Tx C diff
1. metronidazole | 2. oral vanco
47
Lynch Syn
``` Hereditary nonpolyposis colorectal CA DNA mismatch repair in MLH1, MSH2 Lynch has a CEO C - colon CA E - endometrial O - ovarian ```
48
R sided colon CA
Polypoid mass - big, no obstructions | Occult blood, iron def
49
L sided colon CA
Narrow! so dx early Napkin rink configuration, apple core Pencil shaped stool
50
How does CRC spread?
Hematogenously - mesenteric LN - Liver
51
Stabbing pain that radiates to back?
Acute pancreatitis
52
Black pigmented gallstones?
Think Hemoglobin | -sickle cell, HS
53
Brown pigmented stones?
Bacterial infection
54
Pain that radiates to shoulder?
Gallstones | from release of CCK = contraction of GB = pain
55
Gallstone in cystic duct?
Acute cholecystitis
56
Gallstone ileus
When have gallstone in cystic duct, can make a fistula into duodenum, if large enough will get ileum Xray: air in biliary system
57
Porcelain GB and + Courvosier sign?
Think CA in head of pancreas FIRST | then: GB or bile ducts
58
Sucralfate
Physical barrier to ulcer
59
Misoprostol
PGE-1 analog Stimulates production and secretion of gastric mucosa and decreases acid production ABORTION
60
H2 Blockers
End in DINE ie. Ranitidine Reversibly bind H2 = Dec H+ from parietal cells
61
Ocreotide
Somatostatin analog | Use: variceal bleed, acromegaly, VIPoma, carcinoid tumors
62
Sulfasalazine
Combo of Sulfapyridine - antibacterial and 5-ASA - anti inflame Use: Crohns and UC
63
Metoclopramide
MOA: D2 R antagonist --> increased gastric motility SE: parkinsonian effects, interacts with DM and digoxin meds
64
Niacin
MOA: inhibits lipolysis in adipose and decreases VLDL secretion in liver SE: flushing, hyperglycemia/hyperuricemia
65
Bile acid resins
Have Chole or Cole in name | ie. cholestyramine, colestipol
66
Fibrates
Have FIBR in name MOA: upregulate LPL and increases TG clearance ie. gemfibrozil, fenofibrate
67
Double bubble on XR?
Duodenal atresia
68
Lacerated liver pinch where?
Free edge of lesser omentum - Portal triad there
69
Portal triad?
Proper hepatic a Common bile duct Portal v
70
Good surgical area to cut through?
Epiploic foramen of Winslow - omental foramen
71
Anterior rupture of stomach, pain?
Hypogastric | the greater sac is big
72
Posterior rupture of stomach, pain?
Epigastric | the lesser sac is small
73
Rupture the spleen, ligate?
Splenorenal lig | -splenic a and v
74
Layers of gut wall?
Mucosa Submucosa Muscularis Serosa
75
Where are Peyers Patches?
Ileum
76
Above pectinate line?
Internal hemorrhoids - visceral innervation so not painful | --Blood: sup rectal a off IMA
77
Below pectinate line?
External hem - somatic inn from inf rectal branch of pudendal n = painful Blood: inferior rectal a and v
78
If anal fissure?
Posterior tear because poorly perfused
79
Ito cells
In liver AKA stellate cells Store Vit A, when activated produce extracellular matrix
80
Femoral triangle
NAVeL | Venous near the penis
81
Inguinal canal mnemonic
ICE - TIE I - internal spermatic fascia - T - transversalis fascia C - cremasteric m and fascia - I - internal oblique E - External spermatic fascia - E - external oblique
82
HLA assoc with Celiacs?
HLA-DQ2 and DQ8
83
Bronze Diabetes?
``` Hemochromatosis Dec hepcidin - too much iron gets in, door stays open Cirrhoisis DM Skin pigment ```
84
PPIs MOA
Irreversibly inhibit the H/K ATPase in stomach parietal cells
85
Carcinoid tumor marker?
5 HIAA

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