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GI Review Flashcards

1
Q

50 year old woman with pruritus without jaundice, positive AMA

A

primary biliary cirrhosis

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2
Q

GI bleeding, buccal pigmentation

A

Peutz-Jeghers syndrome

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3
Q

60 year old woman, RA, no alcohol history, fatigue, and right abdominal pain; elevated ANA and ASMA, elevated serum IgG levels, no viral serologic markers

A

autoimmune hepatitis

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4
Q

23 year old woman, no alcohol history; elevated levels of LKM-1 antibodies, no viral serologic markers, liver biopsy with infiltration of the portal and periportal area with lymphocytes

A

autoimmune hepatitis

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5
Q

fatal disease of unconjugated bilirubin resulting from a complete lack of UDPGT activity

A

Criggler-Najjar type 1

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6
Q

What drugs and endogenous hormones regulate the secretion of gastric acid?

A

Hormones that promote gastric acid secretion:
- histamine, ACh, gastrin
Hormones that inhibit gastric acid secretion:
- prostaglandins, somatostatin, secretin, GIP
Drugs that regulate gastric acid secretion:
- PPIs, H2 blockers, antimuscarinic drugs

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7
Q

What is the difference between primary biliary cholangitis and primary sclerosing cholangitis?

A

primary biliary cholangitis - autoimmune, women, middle aged, + AMA

primary sclerosing cholangitis - men, middle-aged, + p-ANCA, associated with UC and cholangiocarcinoma; ERCP finding: alternating beading and stricturing

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8
Q

What is Reynold’s pentad for cholangitis?

A 
(Charcot triad):
1. fever
2. jaundice
3. RUQ pain
PLUS:
4. hypotension
5. altered mental status
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9
Q

What clinical features suggest congenital pyloric stenosis?

A
  • non-billious vomiting (projectile)
  • 2-6 weeks old
  • males > females
  • olive-shaped mass in abdomen
  • peristaltic waves before vomiting
  • hypochloremic hypokalemic metabolic alkalosis if vomiting >/= 5 days
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10
Q

What are the features of Plummer-Vinson syndrome?

A
  • glossitis
  • dysphagia d/t esophageal webs
  • iron deficiency
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11
Q

What histological findings of the distal duodenum are most likely seen in a patient with celiac sprue?

A
  • blunting of the villi
  • hyperplastic crypts
  • lymphocytes in the lamina propria
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12
Q

What is the most common benign salivary gland neoplasm? What is the most common malignant salivary gland neoplasm? What is the most common location for a salivary gland neoplasm?

A

pleomorphic adenoma
mucoepirdermoid carcinoma
parotid gland

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13
Q

What are the risk factors for adenocarcinoma of the esophagus?

A

obesity, GERD, smoking, Barrett esophagus, nitrosamines

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14
Q

What are the risk factors for squamous cell carcinoma of the esophagus?

A

smoking, alcohol, nitrosamines, achalasia, esophageal webs, strictures

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15
Q

What histological findings are seen in alcohol hepatitis?

A
  • fatty infiltration
  • Mallory bodies (intracytoplasmic eosinophilic inclusions)
  • necrosis and swelling of hepatocytes
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16
Q

Which hormones stimulate pancreatic secretions?

A

ACh (via vagus n)
CCK
Secretin (stimulates HCO3- secretion)

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17
Q

What are the retroperitoneal organs?

A

SAD PUCKER

  • suprarenal glands
  • aorta and IVC
  • duodenum (2nd, 3rd, and 4th parts)
  • pancreases (except tail)
  • ureters
  • colon (descending and ascending)
  • kidneys
  • esophagus (under diaphragm)
  • rectum
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18
Q

What are the possible etiologies of acute pancreatitis?

A 
PANCREATITIS
P - increased PTH -> hypercalcemia
A - Alcohol
N - Neoplasm
C - Cholelithiasis
R - Rx (drugs)
E - ERCP
A - abdominal surgery
T - hypertriglyceridemia
I - infection (mumps)
T - trauma
I - idiopathic
S - scorpion sting
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19
Q

What is the typical presentation of a patient with pancreatic insufficiency?

A
  • decreased uptake of fat soluble vitamins (DEAK)
  • malabsorption, weight loss
  • steatorrhea
  • diarrhea
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20
Q

What are the risk factors for development of hepatocellular carcinoma?

A 
cirrhosis
Hep B and C
hemochromatosis
alpha1-antitrypsin
hepatic ademona
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21
Q

What are the tumor markers for pancreatic cancer?

A

CEA, CA19-9 (more specific)

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22
Q

What are the two nervous tissue bundles that run through the GI tract and where are they located?

A

Meissner’s plexus - located in the submucosa

Auerbach’s plexus - between the layers of the muscularis propria

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23
Q

What is pulsus paradoxus and what are the causes?

A

> 10mmHg change in SBP with inspiration

-caused by anything that prolongs inspiration: COPD, asthma, cardiac tamponade

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24
Q

How is hnRNA processed before it leaves the nucleus?

A

5’ cap and poly-A tail; spice out introns

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25
What is the treatment for nephrogenic diabetes insipidus?
HCTZ - helps concentrate urine Amiloride - K+-sparing diuretic (Tx DI d/t Lithium toxicity) Indomethacin -> decrease RBF
26
What is schizotypal disorder?
personality disorder with interpersonal awkwardness, odd thoughts, and odd appearance
27
Which causes of vaginal discharge/vaginitis are associated with a high vaginal pH? Which are associated with a low vaginal pH?
high pH - garnerella, trichomonas | low pH - physiologic and candida
28
Which cell wall inhibitor is the next step in treatment of otitis media if amoxicillin resistant?
Amoxicillin/Clavulanic acid
29
Which cell wall inhibitor is prophylaxis against bacterial endocarditis?
penicillin V, aminopenicillins, 1st generation cephalosporin
30
Which cell wall inhibitor is sufficient for the treatment of syphilis?
penicillin G
31
Which cell wall inhibitor is used as a single-dose treatment for gonorrhea?
ceftriaxone
32
What are the kubler-ross stages of grief?
1. denial 2. anger 3. bargaining 4. depression/grief 5. acceptance
33
What are the common causes of restrictive cardiomyopathy?
``` sarcoidosis amyloidosis hemochromatosis Loeffler's Dz (endomyocardial fibrosis with eosinophilic infiltrate) endocardial fibroelastosis post-radiation fibrosis ```
34
Which type of antipsychotic is often the first line of treatment for psychosis? Which antipsychotic should be reserved for severe refractory psychosis because of the risk of agranulocytosis?
- atypical antipsychotics | - clozapine should be reserved
35
What is Budd-Chiari syndrome?
thrombosis of IVC or hepatic veins -> hepatic congestion
36
What substances are known for causing methemoglobinemia?
nitrates, antimalarials, dapsone, metochlopramide, sulfonamides, local anesthetics (lidocaine)
37
Which glomerular disease has IF: granular pattern of immune complex deposition and LM: diffuse capillary thickening?
membranous, diffuse proliferative
38
Which glomerular disease has IF: granular pattern of immune complex deposition and LM: hyper cellular glomeruli?
post-streptococcal glomerulonephritis
39
Which glomerular disease has IF: liner pattern of immune complex deposition?
Goodpasture
40
Which glomerular disease has EM: sub endothelial humps and "tram track" appearance?
membranoproliferative glomerulonephritis
41
Which glomerular disease has nephritis, deafness, and cataracts?
Alport syndrome
42
Which glomerular disease has LM: crescent formation in the glomeruli?
RPGN (rapidly progressive)
43
Which glomerular disease has LM: segmental sclerosis and hyalinosis?
FSGN (focal segmental)
44
Which glomerular disease has IF: Anti-GBM Abs?
Goodpasture
45
Which glomerular disease has LM: Kimmelstiel-Wilson lesions?
diabetic nephropathy
46
Which glomerular disease has purpura on backs of arms and legs, abdominal pain, IgA nephropathy?
Henoch-Schonlein purpura
47
Which glomerular disease has EM: spiking of the GBM due to electron dense subepithelial deposits?
membranous glomerulonephritis
48
Which genetic syndrome is caused by absence of HGPRTase?
Lesch Nyhan
49
Which genetic syndrome is caused by deficiency of aldolase B?
fructose intolerance
50
Which genetic syndrome is caused by deficiency of cystathione synthase?
homocystinuria
51
Which genetic syndrome is caused by galactose-1-phosphate uridyl transferase deficiency -> intellectual disability, hepatosplenomegaly, cataracts?
galactosemia
52
Which genetic syndrome is caused by deficiency of tyrosinase?
albinism
53
What medication inhibits alcohol dehydrogenase? What about acetaldehyde dehydrogenase?
alcohol dehydrogenase is inhibited by fomepizole | Acetaldehyde is inhibited by disulfiram
54
What is the rate-limiting enzyme of beta oxidation of fatty acids?
carnitine acyltransferase 1
55
Which cofactors are required for the function of pyruvate dehydrogenase? Which other enzyme requires the same cofactors?
``` TLC For Noone TPP Lipoic acid CoA FAD NAD ``` alpha-ketoglutarate dehydrogenase requires the same cofactors
56
What disorder is associated with hypertension, hypokalemia, and metabolic alkalosis?
Conn Syndrome/hyperaldosteronism
57
What disorder is associated with fever and night sweats and weight loss?
lymphoma or TB
58
What disorder is associated with adrenal hemorrhage due to meningococcemia?
Waterhouse-Friedrichson Syndrome
59
What disorder is associated with blue sclerae?
osteogenesis imperfecta
60
What disorder is associated with hyperplasia, hypersexuality, hyperoralitiy, and hyper docility?
bilateral amygdala lesions -> Kluver-Bucy Syndrome
61
What disorder is associated with nystagmus, intention tremor, and scanning speech?
Charcot triad of MS
62
What disorder is associated with lower extremity purpura, arthralgias, and renal disease?
Henoch-Scholein purpura

DIT Cards (16 decks)

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