GU Weak Points

Question 1

What is achalasia?

Answer 1

-loss of intrinsic inhibitory innervation of the LES

Question 2

What causes achalasia?

Answer 2

• aperistalsis
• incomplete relaxation of LES
• inc resting tone of LES

Question 3

What does achalasia cause?

Answer 3

• dysphagia
• mucosal inflammation and ulceration
• squ cell carcinoma

Question 4

Why does GERD occur?

Answer 4

-incomplete closing of LES allowing acidic stomach contents to flow upward

Question 5

What are risks for GERD?

Answer 5

• obesity
• hiatal hernia
• vagal nerve abnormalities

Question 6

What happens in barrette esophagus?
Why?
What can it lead to?

Answer 6

• stratified squamous mucosa cells (esophagus) transform into columnar epithelium w/ goblet cells (GI) d/t longterm GERD
• can lead to adenocarcinoma

Question 7

What are the 2 types of esophageal ca?

Answer 7

1. squamous cell

2. adenocarcinoma

Question 8

Name the causes and locations of each type of esophageal ca.

Answer 8

1. squamous cell originates in esophagus and is higher caused by ETOH/smoking, ACHALASIA, hot tea
2. adenocarcinoma occurs near the distal esophagus (LES) caused by Barretts esophagus (caused by GERD)

Question 9

What is normal stomach ph?

Answer 9

1.5

Question 10

What is hemochromatosis?

Answer 10

iron overload (liver regulates iron)

Question 11

What are risk factors for hemochromatosis?

Answer 11

sx appear >50 y/o
male
small percent heterozygous carries and autosomal recessive

Question 12

What does hemochromatosis lead to?

Answer 12

cirrhosis, DM, skin pigmentation

Question 13

How do you treat hemochromatosis?

Answer 13

phlebotomy

Question 14

What are secondary causes of iron overload?

Answer 14

• transfusions
• sideroblastic anemia
• b thalassemia anemia

Question 15

What is another primary cause of iron overload?

Answer 15

bantu siderosis

Question 16

What are causes of hepatocarcinoma?

Answer 16

-hbv, hcv, alcohol, TYROSINEMIA, AFLOTXIN, cirrhosis

Question 17

What are the two types of cholelithiasis?

Answer 17

1. green/pigment GB stones

2. black/cholesterol GB stones

Question 18

What are the causes of green gallstones?

Answer 18

1. chronic hemolyic syndromes (SCA)
2. biliary infection
3. GI d/o (Crhon’s)

Question 19

Risk factors for black gallstones?

Answer 19

fair
forty (inc w/ age)
female
fertile/oral contraceptives
fat
hyperlipidemia
GB stasis

Question 20

What does chronic pyelonephritis cause?

Answer 20

obstruction/reflux leading to stasis > chronic inflammation > scarring

Question 21

What effect does obstruction have on the urinary tract?

Answer 21

urine stasis and proximal tract dilation