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GI: 3/25-3/28 > GI- uworld > Flashcards

GI- uworld Flashcards

1
Q

spleen embryology

  • derived from which embryologic later
  • what is special embryologic features
A
  • mesoderm
  • derived from mesoderm, but receives blood supply from foregut derivates. splenic artery is coming out from celiac trunk
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2
Q

63-Q5. Greater omentum vs. lesser omentum: attachment site to stomach?

A

greater omentum: greater curvature -> travels inferiorly to cover whole surface

lesser omentum: lesser curvature -> to liver

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3
Q

63- Q14. Diphenoxylate

  • MOA
  • indication
  • another drug in same class?
A
  • u opioid receptor agonist
    => decrease motility: anti-diarrhea
  • diarrhea
  • loperamide
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4
Q

63- Q16. Buzzword for arsenic poisoning? what is treatment for arsenic poisoning?

A
  • buzzwords: insecticides, garlic odor, diarrhea

treatment: dimercarprol (also used for lead chelator)

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5
Q

63-Q19. Mast cell positive for KIT (CD177). What does this mean? possible GI complication?

A

KIT :tyrosine kinase -> excess histamine release from mast cell -> excess gastric acid

  • Even though I don’t know what KIT means, don’t panic. Go through answer choices, and think about it. In this question, I could derive an answer because I knew mast cell releases histamine, and parietal cells has H2 receptor for gastric acid release
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6
Q

Three functions of bile salts

A
  • anti-bacterial: membrane disruption
  • Fat soluble vitamin absorption
  • dissolve/excretion of cholesterol
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7
Q

Pertechneatate study: measuring what? for what abnormality?

A

ectopic gastric mucosa

For Mecekl diverticulum

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8
Q

Pathophysiology of dysphagia in CREST syndrome?

A

esophageal SMOOTH MUSCLE ATROPHY & FIBROSIS
-> loss of Ausrbach nerve plexus -> dismotility

  • this makes sense. autoimmune condition -> attacking esophageal smooth muscle
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9
Q

postprandial epigastric pain: three differential diagnosis? how to differentiate these?

A
  • biliary colic: pain comes and goes -> ultrasound for gall stones
  • gastric ulcer: abnormal GI endoscopy finding
  • chronic mesenteric ischemia: normal GI endoscopy, normally given with history of MI, stroke, DVT, or things like that.
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10
Q

63- Q35. long standing GERD. Two possible complications? How to differentiate them?

A
  • ulceration: pain with swelling

- malignancy: progressive dysphagia. First solid then liquid after

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11
Q

64- Q2 . Describe hepatic abscess in CT. Two infectious microrganisms for hepatic abscess?

A

fluid filled abscess

  • Staph aureus
  • Entamoeba Histolytica
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12
Q

64- Q 7. Compare pathophysiology: gastric ulcer vs. duodenal ulcer

A

gastric ulcer: decreased mucosal protection

duodenal ulcer: increased gastric acid or decreased mucosal protection

  • gastric ulcer is NOT NECESSARILY associated with gastric acid secretion. Which makes sense as gastric mucosa is designed to bear with gastric acid, while duodenal mucosa is not.
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13
Q

64- Q 12. macrocytic anemia, constipation, person work at construction. Diagnosis?

A

lead poisoning

  • ALWAYS pay attention to OCCUPATION.
    Construction environment is classic example of lead poisoning.
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14
Q

64- Q 13. site of bile reabsorption?

A

terminal ileum

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15
Q

64- Q 15. What is initial presentation of HepB acute infection?

A

serum sickness:

fever, arthralgia, rash

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16
Q

64-Q 39. What is silent GERD? clinical manifestation?

A

GERD with absence of heartburn

  • chronic esophagus irritation can lead to extraesophageal symptoms such as nocturnal cough or hoarseness
17
Q

65- Q8. Mechanism regarding how opioid exacerbates biliary colic

A

contraction of SMOOTH MUSCLE in SPHINCTER OF ODDI

18
Q

65- Q 13, Lower esophagus is associated with what type of esophagus cancer?

A

adenocarcinoma

upper esophagus -> squamous cell carcinoma

19
Q

65- Q 15. histologic finding of alcoholic hepatitis?

A

mallory bodies- intracytoplasmic eosinophilic inclusions of damaged keratin filaments

20
Q

65- Q 15. Necrotizing enerocolitis

  • affected population
  • pathophysiology
  • complication? How this complication is represented in abdominal x-ray?
A
  • premature, formula fed-kids
  • immature immune system -> bacteria invades into bowel mucosa -> inflammation
  • perforation. will be seen as pneumatosis intestinalis: radiolucent lumen of bowel
21
Q

66- Q 19. Past history of Crohn’s disease, multiple bruises and ecchymoses. What is going on?

A

damaged terminal ileum -> impaired bile reabsorption

  • > loss of vitamin K -> less coagulation factor
  • > bleeding
22
Q

66- Q27. Symptoms of fever, jaundice, abdominal pain. What should I suspect?

A

acute viral hepatitis

23
Q

67- Q4. What mediates increased gastric acid secretion in Zollinger-Ellison syndrome?

A

increased gastrin

24
Q

67-Q4. What is a diagnostic test for Zollinger-Ellison syndrome

A

secretin stimulation test

- gastrin levels remain high even after administration of secretin

25
Q

67- Q28. Frequency of colorectal cancer location among ascending colon, descending colon, rectosigmoid colon?

A

rectosigmoid colon > ascending colon > descending colon

26
Q

67- Q28. Describe different presentations of colorectal cancer in ascending colon vs. rectosigmoid colon

A
  • ascending colon: big mass, iron deficiency anemia (more like to bleed)
  • rectosigmoid colon: smaller mass (more like infiltrating mass), obstruction, hematochezia
  • this makes sense. ascending colon is big. so bigger one can grow well. while recosigmoid colon is close to anus, so bleeding poop
27
Q

68- Q1. Duodenal atresia vs. jejunal/ileal atresia

  • etiology
  • clinical finding
A

Duodenal atresia

  • failure of recanalization
  • Down syndrome, double bubble sign on x-ray

Jejunal/ileal atresia

  • ischemic necrosis
  • apple peel blood vessel (spiral shape of jejunum and ileum around blood vessel)
28
Q

68- Q4. Infectious esophagitis: morphology of each

  • HSV-1
  • CMV
  • Candida
A
  • HSV-1: punched out ulcer
  • CMV: linear ulcer
  • Candida: white pseudomembrane
29
Q

68- Q5. buzzword: mushroom

  • name of toxin
  • inhibition of what molecule?
A
  • Amatoxin (mushroom is called Amantia phalloides)

- RNA polymeraseII -> impaired mRNA synthesis

30
Q

68- Q8. End stage renal disease patient who received kidney transplant, complain progressive worsening dysphagia, chest pain. Esophageal endoscope reveals linear ulcer. What will be seen on esophageal biopsy?

A

Intranuclear inclusion
: owl-eye appearance of CMV

*This is fucking good question

  • buzzwords
    1. organ transplant -> immunocompromised
    2. linear esophageal ulcer -> CMV
31
Q

68- Q16. Patient with severe septic shock and respiratory failure showed blood in nasogastric suction. what is going on?

A

stressed induced acute gastiritis

  • buzzword
  • hypovolemic shock -> when shock and some GI manifestation is going on. Always think about stressed induced acute gastritis. Classic example is Curling’s ulcer (burn-> hypovolemia -> ischemia-> ulcer)
32
Q

Recent travel history to Mexico, with some liver thing going on. what should I suspect?

A

acute viral hepatitis

Mexico is endemic region for HepA

33
Q

68- Q 23. Anal fissure

  • what is it?
  • clinical presentation
  • location? why?
A
  • tear in anal mucosa
  • Painful Pooping, blood on Paper
  • Posterior below Pectneal line: due to less perfusion -> more susceptible for ischemia
  • notice all Ps
34
Q

68- Q 24. sign of obstructive jaundice? With obstructive jaundice + non-painful distended gallbladder: what should I think?

A
  • obstructive jaundice sign: pale stool, dark urine
  • bilirubin doesn’t get excreted fecally, but it can still get to urine via blood.
  • obstructive jaundice + nonpainful distended gallbladder -> should think about adenocarcinoma at HEAD of pancreas
35
Q

68- Q 26. hepatic vein vs. portal vein: to where does left gastric vein (esophageal varices) drain into? esophageal varices is sign of obstruction at what vein?

A
  • PVC
  • PVC
  • Thus, Budd-Chiarri (hepatic vein thrombosis) is not associated with esophageal varicies
36
Q

69- Q3. What is most common benign tumor of liver ? Histologic finding?

A

Cavernous hemangioma

  • multiple bloody spots: vasculcar malformation
  • check image FA p.368

GI: 3/25-3/28 (7 decks)

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