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mehlman > git > Flashcards

git Flashcards

1
Q

perioral melanosis + hamartoumtous polyps

A

peutz jegherz syndrome

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2
Q

iron def + esophageal web + pharyngitis

A

plummer- vinson

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3
Q

5 days fever red eyes/lips/tongue + edema + palm desquamation

A

kawasaki

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4
Q

HSV characteristic

A

dna env linear

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5
Q

scarlet fever caused by which group strept

A

A

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6
Q

hand-foot-mouth dis caused by

A

picornaviridea

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7
Q

benign salivary gland tumor has variability in cell size and shape

A

pleomorphic adenoma

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8
Q

salivary gland tumor invades / has symptoms of B cells

A

mucoepidermoid carcinoma

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9
Q

salivary gland tumor resembles the lymphatic tissue

A

warthin tumor

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10
Q

herniation of stomach upward through the diaphragm

A

hiatal hernia

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11
Q

abnormal relation of cardia to lower end of esophageal hiatus

A

hiatal hernia

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12
Q

protrusion of fundus into chest above which level

A

t10

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13
Q

irrit of esophageal mucosa by gastric acid

A

gerd

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14
Q

gerd presents with

A

nocturnal cough
recurrent pneumonia
burning after eating a meal

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15
Q

the most important risk factor for gerd

A

obesity

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16
Q

high energy or forceful coughing vomiting

A

pyloric stenosis

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17
Q

not billous vomiting

A

duodenal atresia - annular pancreas

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18
Q

spitting up during the first feed

A

tracheoesophageal atresia

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19
Q

barret eso

A

metaplasia of distal eso, conversion of squamous to columnar

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20
Q

barret can progress to

A

adenocarcioma

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21
Q

new onset of dysphagia to solids
dysphagia to solids that progress to solids and liquids

A

gerd -> adenocarcinoma

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22
Q

how to diagnose the adenocarcioma

A

biopsy

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23
Q

what affects the upper 2/3 of esophagus
what r the risk factors

A

squamous cell carcinoma
heavy smoker/alcohol consumption

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24
Q

outpouching of eso above the cricopharyngeous muscle

A

zenker div

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25
Q

what is the diff between true and false diverticulum’s

A

true has musclaries layer

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26
Q

high tone due to loss of NO-secreting neurons

A

achalasia

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27
Q

enteric ganglia is the site of the prob

A

achalaia

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28
Q

dysphagia to both solids and liquids from the start

A

achalsia

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29
Q

which microbial dis causes achalsia

A

chagas dis by trypanosomiasis s

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30
Q

how to diagnose achalsia

A

esophageal manometry

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31
Q

esophageal perforation/boerhavaave syndrome

A

high pressure due to vomiting or straining
use water soluble contrast

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32
Q

mallory weiss tear

A

tearing of gastroesohageal junction leading to small amounts of blood
( no volume hematemsis )

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33
Q

causes of torturous esophageal veins

A

portal hypertension - cirrhosis - spelnic vein thrombosis

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34
Q

which vein is most affected in cirrhosis, causing tortuous eso veins

A

left gastric vein

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35
Q

idiopathic spasm of eso that mimic angina and has corkscrew appearance

A

eso spasm

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36
Q

trachealization of esophagus is indication of

A

eosinophilia esophagitis

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37
Q

cck functions

A

gallbladder contraction
sphincter of oodi relaxation
high exocrine pancreas secretion

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38
Q

macronutrients causing high or low cck secretion

A

high

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39
Q

hormone responsible for pain in biliary colic

A

cck

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40
Q

RUQ pain after fatty meal, which hormone is responsible

A

cck

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41
Q

secretin is produced by

A

s cells in duodenum

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42
Q

what causes high bicarbonate sec

A

secretin

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43
Q

histamine produced by

A

ECL cells

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44
Q

EC cells produces

A

serotonin

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45
Q

why ECL hyperplasia is associated with chronic gastritis

A

atrophy of parietal cells means high ecl production (histamine) to compensate

46
Q

how gastrin increases production of hcl

A

by agonizing the gastrin receptors / stimulate ecl production

47
Q

gastrin levels increases in

A

chronic gastrits and h pylori + ZE

48
Q

ze syndrome associated with

A

MEN1

49
Q

VIP causes what?

A

high water content/ volume from pancreas

50
Q

WDHA syndrome

A

watery diarrhea - hypokalemia - achlorhydria

51
Q

motilin

A

increases the peristalsis
responsible for gi sounds

52
Q

glucose dependent insulin tropic peptide

A

causes high insulin sec in response to oral micronutrient
responsible for oral glucose being utilized faster than iv glucose

53
Q

amylase is sec by

A

salivary glands and pancreas

54
Q

pancreatic amylase increases in

A

acute panc

55
Q

lipase function

A

responsible for break down the fat

56
Q

chief cells secrets

A

pepsinogen

57
Q

intrinsic factor secreted by

A

parietal cells

58
Q

intrinsic factor function

A

helps in b12 abs

59
Q

trypsin in converted to .. in brush border

A

enterokinase

60
Q

serotonin inc or sec the gi peristalsis

A

inc

61
Q

serotonin is produced by

A

EC cells 90%
carcinoid syndrome

62
Q

carcinoid syndrome diagnosis

A

flushing and tachy, diarrhea and sometimes tricuspid regurg, 5-HIAA

63
Q

DPP-4 inh

A

causes high insulin sec ( secretagogue)

64
Q

insulin is prod by

A

beta cells in the tail

65
Q

how the body dec the blood glucose levels

A

1- via glut 4 on skeletal muscles and adipose
2- glucokinase in the liver

66
Q

high insulin and lows c peptide means !

A

exogenous insulin

67
Q

whipppe triad

A

insluinoma ( hypoglycemia + it’s symptoms + improves with meals )

68
Q

hyperinsluinemia causes what?

A

anovulation

69
Q

acanthois nigricans

A

associated with insulin resets and stomach cancer

70
Q

necrolytic erythema

A

associated with glucagonoma

71
Q

what is counter-regulatory glucagon

A

in type 2, glucagon must inc when the glucose levels r low, once the pancreas is fibrosed, it won’t be able to prod glucagon, thus hypoglycemia

72
Q

gastric ulcer charactaristic

A

pain with meals

73
Q

duodenal ulcer characteristic

A

pain after meals

74
Q

h pylori outcomes

A

duodenal ulcers - it inc the gastric acid/proteinaceous fluid

75
Q

what causing gastric outlet obs

A

h pylori

76
Q

h pylori inc the risk of

A

malt lymphoma

77
Q

nsaid-induced ulcer

A

misoprostol

78
Q

other cause of gastrits

A

burns and head trauma , smoking and alcohol

79
Q

low mucosal thickening and low hcl and high gastrin

A

chronic gastrits

80
Q

type A gastrits

A

affects fundus,body of stomach (autoimmune)
causes b12 def
associated with other autoimmune dis

81
Q

gastric cancer types

A

intestinal and diffuse

82
Q

gastric metastasis can spread into which organ

A

ovaries / hematogenosly

83
Q

why high incidence of gastric cancer in japan

A

high nitrosamines and smoked food

84
Q

gastric cancer histo

A

has signet ring cells contains mucin

85
Q

virchaow node

A

palpable supraclavicular lymph nodes, associated with gastric cancer

86
Q

In the setting of hemolysis or ­ RBC turnover (i.e., sickle cell, hereditary spherocytosis, blood given during surgery), where we have ­ RBC breakdown, we get ­ direct/indirect bilirubin.

A

indirect

87
Q

In the setting of hemolysis or ­ RBC turnover (i.e., sickle cell, hereditary spherocytosis, blood given during surgery), where we have ­ RBC breakdown, we get ­ direct/indirect bilirubin.

A

indirect

88
Q
  • If the there’s a problem with uptake at the liver (i.e., acute hepatitis), or there is deficient conjugation enzyme (Gilbert syndrome, Crigler-Najjar), indirect bilirubin also goes ­
A

up

89
Q

if we have a bile duct obstruction, we get ­ indirect/direct bilirubin.

A

direct

90
Q

Highest yield cause of ­­ direct bilirubin on USMLE is.. in neonates

A

biliary atresia

91
Q

Highest yield cause of ­­ direct bilirubin on USMLE is,,.. in neonates

A

biliary atresia

92
Q

Cholangitis (inflammation of bile ducts), choledocholithiasis (stone in biliary tree), choledochal cyst, head of pancreas cancer (impingement on common bile duct), and cholangiocarcinoma (bile duct cancer) are all HY causes of..

A

bile duct obs

93
Q

Partial deficiency of bilirubin uptake enzyme at the liver (UDP glucuronosyltransferase).

A

gilbert

94
Q

Presents as isolated ­ indirect bilirubin with yellow eyes in young adult with stress factor, such as studying for exams, or recent surgery/trauma.

A

gilbert

95
Q

Near-absence of UDP-glucuronosyltransferase causing ­­ indirect/ direct bilirubin in neonate.

A

indirect

96
Q

. Answer on USMLE for ­­ direct bilirubin in a kid under the age of 6 weeks

A

biliary atresia

97
Q

caused by lack of development of the intrahepatic bile ductules and biliary tree.

A

biliary atresia

98
Q

Ultrasound will be done first, but USMLE wants liver biopsy to confirm which diagnosis.

A

biliary atresia

99
Q

Inflammation of bile ducts within the liver, leading to their destruction.

A

primary biliary cirrhosis

100
Q

Answer in a woman 20s-50s who has generalized pruritis, high­ serum cholesterol, ­ high ALP, ­ high direct bilirubin.

A

primary biliary cirrhosis

101
Q

theory, would be due to biliary obstruction, where ̄ bile entering small bowel merely means ̄ fat absorption., associated with

A

biliary cirrhosis

102
Q

Cholangiocarcinoma is

A

Bile duct cancer

103
Q

. Answer on USMLE if the vignette sounds like pancreatic cancer but they tell you in the last line CT is negative.

A

Bile duct cancer

104
Q

Stones in the gallbladder.

A

cholelithiasis

105
Q
  • Presents with biliary colic, which is acute-onset waxing/waning spasm- like pain in the epigastrium or RUQ.
A

cholelithiasis

106
Q

what upregulates HMG-CoA reductase

A

estrogen

107
Q

high … causing ­ high cholesterol synthesis and secretion into bile.

A

estrogen

108
Q

what lithogenic bile means

A

promoting the formation of stones

109
Q

USMLE wants you to know that splenectomy is Tx for hereditary spherocytosis to ̄ incidence of ..

A

cholelithiasis

110
Q

Ursodeoxycholic acid (ursodiol) ̄ …secretion of cholesterol into bile.

A

dec

mehlman (2 decks)

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