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GI Stuffs Flashcards

1
Q

Embryology of GI tract: Sections

A

Foregut: Esophagus to upper duodenum
Midgut: Lower duodenum to 2/3 of transverse colon
Hindgut: Distal 1/3 transverse colon to rectum

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2
Q

When does herniation and rotation occur in development?

A

6th week Herniation

10th week rotation (270 degrees)

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3
Q

Gastrochesis vs Omphalocele

A

Gastrochesis: failure of folds, intestines herniate w/o covering
Omphalocele: persistent physiologic herniation, has peritoneal covering

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4
Q

Teratogen associated w/ pyloric stenosis

A

Macrolides

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5
Q

Retroperitoneal Structures:

A 
SADPUCKER:
Suprarenals (adrenals)
Aorta
Duodenum (2-4)
Pancreas (head and body)
Ureters
Colon (ascending and descending)
Kidneys
Esophagus
Rectum
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6
Q

What attaches liver to anterior body wall?

What does it contain?

A 
Falciform Ligament
Ligamentum Teres (remnant of umbilical vein)
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7
Q

What ligament has portal triad?

A

Hepatoduodenal, forms entry to lesser pouch

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8
Q

Splenorenal Ligament

A

Attaches spleen to posterior body wall, contains splenic artery/vein and tail of pancreas

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9
Q

Two nerve plexuses in gut tube

A

Meissner’s: submucosa, fluid secretion

Myenteric (Aurbachs): Muscularis Mucosa, Motility

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10
Q

Histologic Features Distinguishing Duodenum, Jejunum and Ileum

A

Duodenum: Brunner’s Glands (HCO3)
Jejunum: Plicae Circularis
Ileum: Peyer Patches

All have: crypts of Liberkuhn, and Goblet cells

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11
Q

Rough levels of major abdominal arteries

A

Celiac: T12
SMA: L1
IMA: L3
Bifurcation: L4-L5

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12
Q

Layers of the Inguinal Canal (Inner to Outer)

A 
Transversalis Fascia (Internal spermatic fascia)
Transversalis Muscle (cremasteric muscle)
External Oblique Fascia (external spermatic fascia)

Miss Internal Oblique

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13
Q

What causes indirect inguinal hernia?

A

Failure of processus vaginalis to close

Can cause hydrocele

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14
Q

Vessels that demarcate direct and indirect hernias

A

Epigastrics (indirect is lateral, direct is medial)

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15
Q

What hormone causes gastric hyperplasia?

A

Gastrin (increases w/ chronic PPIs)

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16
Q

What cells secrete Cholecystokinin?

A

I cells (duodenum and Jejunum)

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17
Q

Secretin

A

From S cells, increase pancreatic HCO3 and bile; REDUCES acid secretion!

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18
Q

GIP

A

From K cells, increases insulin and decreases acid

This is why enteral glucose increases insulin more than parenteral glucose

19
Q

When are motilin levels greatest?

A

In fasting state

20
Q

Carbohydrate Absorption

A

Glucose and Galactose by SGLT1
Fructose by GLUT5
All across basolateral membrane via GLUT2

21
Q

Rate limiting step of bile acid synthesis?

A

Cholesterol 7-alpha-hydroxylase

22
Q

What enzyme deficiency causes jaundice in infants?

A

UDP-Glycuronosyl Transferase

23
Q

What gives urine its yellow color?

A

Urobilin (from urobilinogen in enterohepatic circulation)

24
Q

Salivary Tumors

A

Pleomorphic: benign, mixed tumor
Mucoepidermal: malignant
Warthin: lymphoid, benign

25
Q

3 types of infectious esophagitis

A

Candida: white pseudomembranes
CMV: linear ulcers
HSV: punched out lesions

26
Q

Plummer Vinson Syndrome

A

Dysphagia, Iron Deficiency, Esophageal Webs

27
Q

Cancers associated with H Pylori

A 
MALT lymphoma (cured by H Pylori Treatment)
Gastric
28
Q

2 types of gastric cancer

A

Intestinal Type: H Pylori, smoked foods, tobacco, commonly on lesser curvature, ulcer w/ raised margins
Diffuse Type: signet ring cells, thickened stomach wall

29
Q

Genetics Associated w/ Celiac

A

HLA-DQ2 HLA-DQ8

30
Q

Pneumonic for Zenker

A 
Elderly MIKE
Elderly
Males
Inferior Pharyngeal Constrictor
Killian Triangle 
Esophageal Dysmotility
31
Q

Rule of 2s for Meckel

A 
2x more likely in males
2 inches long
2 feet from ileocecal valve
2 years old
2 types of mucosa
2% of population
32
Q

Causes of Intussusception

A

Meckel Divertuculum
Rotavirus Vaccine
Adenovirus

33
Q

Peutz=Jeghers

A

Harmatomas, hyperpigmented skin

34
Q

Lynch Syndrome Associated Cancer

A

GI, Ovarian, Endometrial, Skin

35
Q

Strep Bovis Sepsis, what is the next step?

A

Colonoscopy

36
Q

GGT tests

A

More specific than ALP for biliary disease (ALP can be elevated in bone disease)

37
Q

Gilbert Syndrome

A

Reduced UDP-GT function, jaundice w/ stress, benign

38
Q

Crigler Najjar Syndrome

A

Fatal, No UDP-GT function, high indirect bili

39
Q

Dubin-Johnson Syndrome

A

Failure of bile transport into ducts, high conjugated bilirubin, black liver, benign

40
Q

Rotor Syndrome

A

same as Dubin Johnson but no black liver

41
Q

Hemochromatosis

A

HFE gene, Chr 6, HLA-A3
Prussian Blue distinguishes from Lipofuscin
Cirrhosis, DM, pigmented skin, cardiomyopathy, hypogonadism, arthropathy

42
Q

Primary Sclerosis Cholangitis

A

Associated w/ UC. Men. Increased pANCA

43
Q

Primary Biliary Cholangitis

A

Autoimmune, Women. Increased AMAs

44
Q

Gallstones

A

Stasis, Increased Cholesterol/Bilirubin, Reduced Bile Salts

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