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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
Q

Anastamoses hemorrhoids

A

Sup rectal v - inf rectal v

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26
Q

Hep B complete recovery

A

HbcAb IgG

HbsAg

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27
Q

Hep B acute infection

A

HbcAb IgM
HbsAg
HbeAg

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28
Q

Hep B chronic carrier

A

HbcAb IgG
HbsAg
HbeAb

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29
Q

Villous atrophy in duodenum and jejunum

A

Celiacs

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30
Q

Painless hematemesis

A

Eso varices

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31
Q

Boerhave syn

A

Rare complication of Mallory Weiss
Rupture eso
subQ emphysemsa - crunchy on ausculatation

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32
Q

Esophageal carcinome 2 types and location

A

1 squamous - MC worldwide - hot tea, drano, achlasia

2 Adenocarcinoma - assoc with Barretts, MC US - distal

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33
Q

Menetrier disease

A

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

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34
Q

Zollinger Ellison

A

enlarged rural folds and increased acid

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35
Q

Pain better with eating? Tend to gain wt

A

duodenal ulcer - wake up in middle of noc and eat because of pain

36
Q

Pain worse with eating?

A

stomach ulcer, food increases acid = wt loss

37
Q

Stomach ulcer going posterior can penetrate?

A

Pancreas and gastroduodenal a

38
Q

Ulcer penetrating ant wall stomach?

A

perforation = free air under diaphragm

39
Q

Currant jelly stool?

A 
Intussusception
prox into distal
Kids: rotavirus
Adults: tumor
Tx: air contrast enema - apply pressure
40
Q

Indirect hernia

A

IN inguinal canal - deep –> superficial

41
Q

Direct hernia

A

directly through the wall

42
Q

Hirschsprung Dz

A

Aganglionic megacolon
Failure of neural crest migration
Mut: RET

43
Q

Sounds like celiacs but pt doesn’t get better on gluten free?

A

Tropical sprue

  • travel hx
  • tx: abx
44
Q

Whipple Disease

A

Organism? Tropheryma whipplei
PAS+ G+ rids in Macrophages = foamy like a can of whipped cream
Male white
Joint pain, watery D, skin lesions

45
Q

Osler Weber Rendu Syn

A

AKA hereditary hemorrhagic telangiectasia

  • telangiectasias of skin and mucous membranes
  • iron def anemia
46
Q

Tx C diff

A
  1. metronidazole

2. oral vanco

47
Q

Lynch Syn

A 
Hereditary nonpolyposis colorectal CA
DNA mismatch repair in MLH1, MSH2
Lynch has a CEO
C - colon CA
E - endometrial
O - ovarian
48
Q

R sided colon CA

A

Polypoid mass - big, no obstructions

Occult blood, iron def

49
Q

L sided colon CA

A

Narrow! so dx early
Napkin rink configuration, apple core
Pencil shaped stool

50
Q

How does CRC spread?

A

Hematogenously

  • mesenteric LN
  • Liver
51
Q

Stabbing pain that radiates to back?

A

Acute pancreatitis

52
Q

Black pigmented gallstones?

A

Think Hemoglobin

-sickle cell, HS

53
Q

Brown pigmented stones?

A

Bacterial infection

54
Q

Pain that radiates to shoulder?

A

Gallstones

from release of CCK = contraction of GB = pain

55
Q

Gallstone in cystic duct?

A

Acute cholecystitis

56
Q

Gallstone ileus

A

When have gallstone in cystic duct, can make a fistula into duodenum, if large enough will get ileum
Xray: air in biliary system

57
Q

Porcelain GB and + Courvosier sign?

A

Think CA in head of pancreas FIRST

then: GB or bile ducts

58
Q

Sucralfate

A

Physical barrier to ulcer

59
Q

Misoprostol

A

PGE-1 analog
Stimulates production and secretion of gastric mucosa and decreases acid production
ABORTION

60
Q

H2 Blockers

A

End in DINE
ie. Ranitidine
Reversibly bind H2 = Dec H+ from parietal cells

61
Q

Ocreotide

A

Somatostatin analog

Use: variceal bleed, acromegaly, VIPoma, carcinoid tumors

62
Q

Sulfasalazine

A

Combo of Sulfapyridine - antibacterial and 5-ASA - anti inflame
Use: Crohns and UC

63
Q

Metoclopramide

A

MOA: D2 R antagonist –> increased gastric motility
SE: parkinsonian effects, interacts with DM and digoxin meds

64
Q

Niacin

A

MOA: inhibits lipolysis in adipose and decreases VLDL secretion in liver
SE: flushing, hyperglycemia/hyperuricemia

65
Q

Bile acid resins

A

Have Chole or Cole in name

ie. cholestyramine, colestipol

66
Q

Fibrates

A

Have FIBR in name
MOA: upregulate LPL and increases TG clearance
ie. gemfibrozil, fenofibrate

67
Q

Double bubble on XR?

A

Duodenal atresia

68
Q

Lacerated liver pinch where?

A

Free edge of lesser omentum - Portal triad there

69
Q

Portal triad?

A

Proper hepatic a
Common bile duct
Portal v

70
Q

Good surgical area to cut through?

A

Epiploic foramen of Winslow - omental foramen

71
Q

Anterior rupture of stomach, pain?

A

Hypogastric

the greater sac is big

72
Q

Posterior rupture of stomach, pain?

A

Epigastric

the lesser sac is small

73
Q

Rupture the spleen, ligate?

A

Splenorenal lig

-splenic a and v

74
Q

Layers of gut wall?

A

Mucosa
Submucosa
Muscularis
Serosa

75
Q

Where are Peyers Patches?

A

Ileum

76
Q

Above pectinate line?

A

Internal hemorrhoids - visceral innervation so not painful

–Blood: sup rectal a off IMA

77
Q

Below pectinate line?

A

External hem - somatic inn from inf rectal branch of pudendal n = painful
Blood: inferior rectal a and v

78
Q

If anal fissure?

A

Posterior tear because poorly perfused

79
Q

Ito cells

A

In liver
AKA stellate cells
Store Vit A, when activated produce extracellular matrix

80
Q

Femoral triangle

A

NAVeL

Venous near the penis

81
Q

Inguinal canal mnemonic

A

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
Q

HLA assoc with Celiacs?

A

HLA-DQ2 and DQ8

83
Q

Bronze Diabetes?

A 
Hemochromatosis
Dec hepcidin - too much iron gets in, door stays open
Cirrhoisis
DM
Skin pigment
84
Q

PPIs MOA

A

Irreversibly inhibit the H/K ATPase in stomach parietal cells

85
Q

Carcinoid tumor marker?

A

5 HIAA

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