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
3 types of infectious esophagitis
Candida: white pseudomembranes CMV: linear ulcers HSV: punched out lesions
26
Plummer Vinson Syndrome
Dysphagia, Iron Deficiency, Esophageal Webs
27
Cancers associated with H Pylori
``` MALT lymphoma (cured by H Pylori Treatment) Gastric ```
28
2 types of gastric cancer
Intestinal Type: H Pylori, smoked foods, tobacco, commonly on lesser curvature, ulcer w/ raised margins Diffuse Type: signet ring cells, thickened stomach wall
29
Genetics Associated w/ Celiac
HLA-DQ2 HLA-DQ8
30
Pneumonic for Zenker
``` Elderly MIKE Elderly Males Inferior Pharyngeal Constrictor Killian Triangle Esophageal Dysmotility ```
31
Rule of 2s for Meckel
``` 2x more likely in males 2 inches long 2 feet from ileocecal valve 2 years old 2 types of mucosa 2% of population ```
32
Causes of Intussusception
Meckel Divertuculum Rotavirus Vaccine Adenovirus
33
Peutz=Jeghers
Harmatomas, hyperpigmented skin
34
Lynch Syndrome Associated Cancer
GI, Ovarian, Endometrial, Skin
35
Strep Bovis Sepsis, what is the next step?
Colonoscopy
36
GGT tests
More specific than ALP for biliary disease (ALP can be elevated in bone disease)
37
Gilbert Syndrome
Reduced UDP-GT function, jaundice w/ stress, benign
38
Crigler Najjar Syndrome
Fatal, No UDP-GT function, high indirect bili
39
Dubin-Johnson Syndrome
Failure of bile transport into ducts, high conjugated bilirubin, black liver, benign
40
Rotor Syndrome
same as Dubin Johnson but no black liver
41
Hemochromatosis
HFE gene, Chr 6, HLA-A3 Prussian Blue distinguishes from Lipofuscin Cirrhosis, DM, pigmented skin, cardiomyopathy, hypogonadism, arthropathy
42
Primary Sclerosis Cholangitis
Associated w/ UC. Men. Increased pANCA
43
Primary Biliary Cholangitis
Autoimmune, Women. Increased AMAs
44
Gallstones
Stasis, Increased Cholesterol/Bilirubin, Reduced Bile Salts