git Flashcards
perioral melanosis + hamartoumtous polyps
peutz jegherz syndrome
iron def + esophageal web + pharyngitis
plummer- vinson
5 days fever red eyes/lips/tongue + edema + palm desquamation
kawasaki
HSV characteristic
dna env linear
scarlet fever caused by which group strept
A
hand-foot-mouth dis caused by
picornaviridea
benign salivary gland tumor has variability in cell size and shape
pleomorphic adenoma
salivary gland tumor invades / has symptoms of B cells
mucoepidermoid carcinoma
salivary gland tumor resembles the lymphatic tissue
warthin tumor
herniation of stomach upward through the diaphragm
hiatal hernia
abnormal relation of cardia to lower end of esophageal hiatus
hiatal hernia
protrusion of fundus into chest above which level
t10
irrit of esophageal mucosa by gastric acid
gerd
gerd presents with
nocturnal cough
recurrent pneumonia
burning after eating a meal
the most important risk factor for gerd
obesity
high energy or forceful coughing vomiting
pyloric stenosis
not billous vomiting
duodenal atresia - annular pancreas
spitting up during the first feed
tracheoesophageal atresia
barret eso
metaplasia of distal eso, conversion of squamous to columnar
barret can progress to
adenocarcioma
new onset of dysphagia to solids
dysphagia to solids that progress to solids and liquids
gerd -> adenocarcinoma
how to diagnose the adenocarcioma
biopsy
what affects the upper 2/3 of esophagus
what r the risk factors
squamous cell carcinoma
heavy smoker/alcohol consumption
outpouching of eso above the cricopharyngeous muscle
zenker div
what is the diff between true and false diverticulum’s
true has musclaries layer
high tone due to loss of NO-secreting neurons
achalasia
enteric ganglia is the site of the prob
achalaia
dysphagia to both solids and liquids from the start
achalsia
which microbial dis causes achalsia
chagas dis by trypanosomiasis s
how to diagnose achalsia
esophageal manometry
esophageal perforation/boerhavaave syndrome
high pressure due to vomiting or straining
use water soluble contrast
mallory weiss tear
tearing of gastroesohageal junction leading to small amounts of blood
( no volume hematemsis )
causes of torturous esophageal veins
portal hypertension - cirrhosis - spelnic vein thrombosis
which vein is most affected in cirrhosis, causing tortuous eso veins
left gastric vein
idiopathic spasm of eso that mimic angina and has corkscrew appearance
eso spasm
trachealization of esophagus is indication of
eosinophilia esophagitis
cck functions
gallbladder contraction
sphincter of oodi relaxation
high exocrine pancreas secretion
macronutrients causing high or low cck secretion
high
hormone responsible for pain in biliary colic
cck
RUQ pain after fatty meal, which hormone is responsible
cck
secretin is produced by
s cells in duodenum
what causes high bicarbonate sec
secretin
histamine produced by
ECL cells
EC cells produces
serotonin
why ECL hyperplasia is associated with chronic gastritis
atrophy of parietal cells means high ecl production (histamine) to compensate
how gastrin increases production of hcl
by agonizing the gastrin receptors / stimulate ecl production
gastrin levels increases in
chronic gastrits and h pylori + ZE
ze syndrome associated with
MEN1
VIP causes what?
high water content/ volume from pancreas
WDHA syndrome
watery diarrhea - hypokalemia - achlorhydria
motilin
increases the peristalsis
responsible for gi sounds
glucose dependent insulin tropic peptide
causes high insulin sec in response to oral micronutrient
responsible for oral glucose being utilized faster than iv glucose
amylase is sec by
salivary glands and pancreas
pancreatic amylase increases in
acute panc
lipase function
responsible for break down the fat
chief cells secrets
pepsinogen
intrinsic factor secreted by
parietal cells
intrinsic factor function
helps in b12 abs
trypsin in converted to .. in brush border
enterokinase
serotonin inc or sec the gi peristalsis
inc
serotonin is produced by
EC cells 90%
carcinoid syndrome
carcinoid syndrome diagnosis
flushing and tachy, diarrhea and sometimes tricuspid regurg, 5-HIAA
DPP-4 inh
causes high insulin sec ( secretagogue)
insulin is prod by
beta cells in the tail
how the body dec the blood glucose levels
1- via glut 4 on skeletal muscles and adipose
2- glucokinase in the liver
high insulin and lows c peptide means !
exogenous insulin
whipppe triad
insluinoma ( hypoglycemia + it’s symptoms + improves with meals )
hyperinsluinemia causes what?
anovulation
acanthois nigricans
associated with insulin resets and stomach cancer
necrolytic erythema
associated with glucagonoma
what is counter-regulatory glucagon
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
gastric ulcer charactaristic
pain with meals
duodenal ulcer characteristic
pain after meals
h pylori outcomes
duodenal ulcers - it inc the gastric acid/proteinaceous fluid
what causing gastric outlet obs
h pylori
h pylori inc the risk of
malt lymphoma
nsaid-induced ulcer
misoprostol
other cause of gastrits
burns and head trauma , smoking and alcohol
low mucosal thickening and low hcl and high gastrin
chronic gastrits
type A gastrits
affects fundus,body of stomach (autoimmune)
causes b12 def
associated with other autoimmune dis
gastric cancer types
intestinal and diffuse
gastric metastasis can spread into which organ
ovaries / hematogenosly
why high incidence of gastric cancer in japan
high nitrosamines and smoked food
gastric cancer histo
has signet ring cells contains mucin
virchaow node
palpable supraclavicular lymph nodes, associated with gastric cancer
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.
indirect
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.
indirect
- 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
up
if we have a bile duct obstruction, we get indirect/direct bilirubin.
direct
Highest yield cause of direct bilirubin on USMLE is.. in neonates
biliary atresia
Highest yield cause of direct bilirubin on USMLE is,,.. in neonates
biliary atresia
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..
bile duct obs
Partial deficiency of bilirubin uptake enzyme at the liver (UDP glucuronosyltransferase).
gilbert
Presents as isolated indirect bilirubin with yellow eyes in young adult with stress factor, such as studying for exams, or recent surgery/trauma.
gilbert
Near-absence of UDP-glucuronosyltransferase causing indirect/ direct bilirubin in neonate.
indirect
. Answer on USMLE for direct bilirubin in a kid under the age of 6 weeks
biliary atresia
caused by lack of development of the intrahepatic bile ductules and biliary tree.
biliary atresia
Ultrasound will be done first, but USMLE wants liver biopsy to confirm which diagnosis.
biliary atresia
Inflammation of bile ducts within the liver, leading to their destruction.
primary biliary cirrhosis
Answer in a woman 20s-50s who has generalized pruritis, high serum cholesterol, high ALP, high direct bilirubin.
primary biliary cirrhosis
theory, would be due to biliary obstruction, where ̄ bile entering small bowel merely means ̄ fat absorption., associated with
biliary cirrhosis
Cholangiocarcinoma is
Bile duct cancer
. Answer on USMLE if the vignette sounds like pancreatic cancer but they tell you in the last line CT is negative.
Bile duct cancer
Stones in the gallbladder.
cholelithiasis
- Presents with biliary colic, which is acute-onset waxing/waning spasm- like pain in the epigastrium or RUQ.
cholelithiasis
what upregulates HMG-CoA reductase
estrogen
high … causing high cholesterol synthesis and secretion into bile.
estrogen
what lithogenic bile means
promoting the formation of stones
USMLE wants you to know that splenectomy is Tx for hereditary spherocytosis to ̄ incidence of ..
cholelithiasis
Ursodeoxycholic acid (ursodiol) ̄ …secretion of cholesterol into bile.
dec