GI uworld Flashcards
volvulus
midgut malrotation
- twisting around SMA
amylase
starch digestion
increased waist circumference and insulin
increased insulin resistance
celiac disease
-villous atrophy
-malabsorption of fat soluble vitamins ADEK
-positive tissue transglutaminase IgA antibodies
-decreased serum calcium
-decreased serum phosphorus
-increased parathyroid hormone (phosphate trashing hormone)
-dermatitis herpetiformis
gastric adenocarcinoma
- chronic inflammation induces intestinal metaplasia
Arises from glandular cells in stomach - most commonly found on lesser curvature
- diffuse type has signet ring cells - round cells filled with mucin
duodenal ulcer
- pain improves with meals
gastrochisis
congenital malformation of abdominal wall that exposes the intenstines
omphalocele
failure of intestines to return to the body cavity, failure of lateral walls to migrate at umbilical ring
-persistent hernaniation of bowel into umbilical cord
-associated with trisomy 13 and 18
pyloric stenosis
-causes hypokalemic hypochloremic metabolic alkalosis secondary to vomiting
- non bilious vomiting
- more common in males
- hypertrophy of sphincter of smooth muscles
-present 2 weeks after birth
-palpable olive shaped mass, visible peristaltic waves
acute gastritis
-burning of stomach by acid
- increased acid production or decreased protective mucosa
things that cause acute gastritis
-nsaids, heavy alcohol use, chemotherapy, increased intracranial pressure, shock - stress ulcers (give PPIs),
-severe burn leads to curling ulcer
chronic gastritis
- chronic autoimmune
-chronic h pylori
pernicious anemia
- type IV hypersensitivity reaction against parietal cells (acid secreting cells)
- leads to achlorhydria
-megaloblastic anemia due to decreased B12 and Intrinsic factor absorption
hormone responsible for gallbladder contraction
cholecystokinin - when fat enters the duodenum
secretin
promotes bicarb secretion from pancreatic ductal epithelium
Pseudogout
Usually in the knee where as gout is in the toe
Calcium pyrophosphate whereas gout is monosodium urate
Most common site for hydronephrosis in newborn
Uretopelvic junction (last to form from metanephric blastema)
constipation in pregnancy
common due to inhibitory effect of progesterone
recombinant parathyroid hormone
promotes bone formation by stimulating osteoblasts into osteoclasts
serum alkaline phosphate levels correlate with
osteoblast activity
Crohns disease
- fistula
- transmural inflammation (that can cause the fistula)
- non caseating granulomas
- cobblestoning
- creeping fat
- usually in terminal ileum
koplik spots
-bright red maccules with blueish white center on buccal mucosa
- sign of active measles infection
leukoplakia
development of white plaques in the mouth which cannot be scraped off
- could be due to Epstein Barr
- common in HIV or malignancy
GERD can cause
barrets esophagus - intestinal metaplasia of squamous epithelium due to exposure of acidic environment
most common diverticula formation
sigmoid colon due to increased pressure
asciites
can cause spontaneous bacterial peritonitis
skin flushing, telangiectasis, cyanosis, watery diarrhea, bronchospasm, wheezing
carcinoid tumor
B2 effect on insulin
stimulates insulin
a2 effect on insulin
blocks insulin release
ethanol reduces acetaminophen toxicity by
competitive inhibition of hepatic cytochrome p450
peutz jeghers syndrome
autosomal dominant, mutation in STK11, hamartomatous polyps in GI tract especially stomach and intestine- could lead to intussusception, hyperpigmented spots on mouth/lips, hands, genitalia
- associated with breast and GI cancer
intussuception
red currant jelly stools, telescoping of the bowel
whipples disease
gram positive microbe, reveals PAS positive foamy macrophages in the intestines, caused by tropheryma wipplei, impairs fat absorption in GI tract - steattorhea. weight loss, can also have neurologic symptoms and cardiac symptoms, joint involvement
gilbert syndrome
- mildy decreased activity of UDP glucuronosyltransferase compared to crigler nagar which is absent UDP glucuronosyltransferase
- mildly asymptomatic but triggered with stress
-recurrent scleral icterus and jaundice
(build up of unconjugated bilirubin)
black liver
Dubin johnson, decreased excretion of hepatic bilirubin
sevelamer
- decreased intestinal absorption of phosphorus
- nonabsorbable anion-exchange resin that binds intestinal PO43-
stones in crohns disease
calcium oxalate
hep B must ___ hep D to be infective
coat (viral coating)
tumor stage marks
degree of spread (high stage means lymph node involvement)
Anti mitochondrial antibodies
Primary biliary cholangitis,
Also granulomas and increased direct bilirubin and alk phos, fatigue, itching, cholestasis
Rb protein
Associated with human papilloma virus, can cause head and neck squamous cell carcinoma
spider angiomas in patients with cirrhosis
due to estrogen increase
copper accumulation in liver, brain, and cornea
wilson’s disease
-abnormal LFTs, neuropsychiatric symptoms
secretes bicarb in response to duodenal H+ to neutralize gastric contents
s cells - secretin
inhibit HMG Co-A reductase
statins
side effects of statins
hepatotoxicity, muscle toxicity
decreases intestinal cholesterol absorption
ezetimibe
increases hepatotoxicity if given with statins
ezetimibe
activate PPAR alpha, decreases VLDL synthesis
fibrates
action of fibrates
decreases triglycerides, increases HDL
phenofibrate, gemfibrozil
fibrates
PPAR alpha
increases synthesis of lipoprotein lipase, used for severe hypertriglyceridemia. Increase HDL. Decrease VLDL
anatomic connection between the ileum and umbilicus resulting from incomplete obliteration of the vitelline duct
meckel diverticulum
pancreatic inflammation can cause a blood clot in the
splenic vein
bisacodyl
stimulates enteric nerves to stimulate peristalsis for constipation
reduces the surface tension of stool
docusate
Ecchinococcus granulosus
causes hydatid cysts and leads to anaphylaxis during surgery
hepatitis B
systemic skin (urticaria) and joint symptoms; hepatomegaly; elevated AST and ALT
regulator of iron homeostasis
hepatic parenchymal cells - releases hepcidin
transmembrane protein responsible for transferring intracellular iron into the circulation
ferroportin - decreases intestinal iron absorption
dilation of the ____ leads to hematemesis
left gastric
binds to mu opined receptors in the colonic myenteric plexus, slowing peristalsis
loperamide - inhibits acetylcholine release
somatostatin analog that reduces the secretion of pancreatic and GI hormones
octreotide
Paramycin
Given in entamoeba histolytica to kill intenatial cysts (metronidazole kills trophozoites)
Beta 3 agonists
Cause detrusor smooth muscle relaxation allowing increase during storage and decreases in continent episodes
cholestryamine
-upregulated hepatic LDL receptors
-prevents reabsorption of bile in the intestinal lumen
bile is conjugated with
glycine and taurine
cholesterol gallstones
due to decreased bile
watershed area
splenic flexure
CA19-9
Pancreatic cancer
Alpha fetoprotein cancer marker
Hepatocellular carcinoma, germ cell tumor
CA 125 marker
Ovarian cancer
Cholesterol stones
White or yellow in appearance due to increased cholesterol synthesis, gallbladder hypomotility, or decreased bile acid synthesis
Colchicine
Inhibits microtubule polymerization, treats gout, disrupts chemotaxis, phagocytosis and degranulation
Lithium can cause ___thyroidism
Hypothyroidism
Iron is absorbed in the
Duodenum and jejum
Patent urachus
Remnant if the allantois that extends from the bladder to the umbilical. Results in urinary drainage from the bladder through umbilicus
alcoholic hepatitis
neutrophil infiltration
acetaminophen overdose
- depletion of intrahepatic glutathione
- over accumulation of NAPQI
- mitochondria dysfunction
- treat with N acetylcysteine
CCK
Stimulates gall bladder contraction after a meal
Impaired relaxation of the LES
Achalasia
diverticulosis
weakness in areas near the vasa recta (area that lacks structural integrity)
Zenker diverticulum
develops when the muscle between the throat and esophagus, known as the cricopharyngeus muscle, over-tightens, causing the throat above it to pouch out. Overtime, the pouch can enlarge as the muscles below it tighten excessively. Food can catch in this pouch or it can cause an obstruction.
primary biliary cholangitis
granulomatous autoimmune destruction of the intrahepatic bile ducts and cholestasis, elevated alk phos, itching especially at night, increased direct bilirubin, common in middle aged women
risk of hep C transmissino
very low
