HOME STRETCH!

Question 1

What supplements are needed for exclusive breast fed

Answer 1

Vit D

Iron for preterm and low weight

Question 2

What are some tummy troubles people using opioids might have

Answer 2

sphincter of oddi spasm–> ↑ gallbladder pressure

Question 3

What does ezetimibe do

Answer 3

↓ intestinal cholesterol absorption

Question 4

What do fibrates do

Answer 4

activate PPAR-a and ↓ VLDL

Pretty much only drug that can lower triglycerides (fish oil does a little)

Question 5

What drug ↓ Apolipoprotein B

Answer 5

fish oil

Question 6

What does ↑ triglys do to pancreas

Answer 6

pancreas metabolizes it into free fatty acid –> toxic inflammatory effect–> pancreatitis

Question 7

What type of adenoma is most likely to transform into malignant in colon

Answer 7

Villous adenoma can transform to malig more than tubular adenoma

Question 8

What causes lynch syndrome

Answer 8

AD
nucleotide mismatch repair
MSH2, MLH1 genes –> MutS and MutL

Question 9

Esophageal varices are from HTN where

Answer 9

Left gastric

Question 10

Hemorrhoids are from HTN where

Answer 10

superior rectal

Question 11

CAPUT MEDUSAE ARE FROM htn WHERE

Answer 11

PARAUMBILICAL

Question 12

aldosterone producing adenoma

Answer 12

Conn syndrome

hypokalemia
HTN
metabolic alkalosis

Question 13

outermost layer of adrenal makes

Answer 13

aldosterone

Question 14

symptoms of conn’s syndrome

Answer 14

electrolyte problem –> paresthesia, muscle weakness

Question 15

is there fluid build up in conn

Answer 15

no because of aldosterone escape (↓ renin –> ↓ na, limits edema and na problem)

Question 16

gastric ulcers extend into

Answer 16

submucosa

Question 17

erosion penetrate to

Answer 17

muscularis mucosa

BUT they do not go through it

Question 18

Vertigo–> NV

Rx?

Answer 18

H1 and M1 receptor are on vestibular system, use blocker

Question 19

chemotherapy–> NV

Rx?

Answer 19

D2 receptor is in chemotrigger zone, use blocker

Question 20

gastroenteritis–> NV

Rx?

Answer 20

5HT receptor on stomach. use blocker

ONDASETRON

Question 21

name the non neoplastic polyps

Answer 21

hyperplastic polyp
inflammatory- UC and crohn’s
submucosal
mucosal

Question 22

what determines how bad a polyp is

Answer 22

degree of dysplasia

histologic pattern - villous is worse than tubular

size- bigger than 4 cm is especially bad

Question 23

blocks stomach acid secretion

relieves reflux

Answer 23

Ranitidine

Question 24

what is scopolamine

Answer 24

ach receptor antagonist

good for MOTION sickness (not all NV)

Question 25

How do you treat central nausea

Answer 25

seen in acute migraine d anatgs- metoclopramide, promethazine usually not first line

Question 26

These two diseases hurt after eating

Answer 26

Gastric ulcer- better w/ antacid Chronic mesenteric ischemia- not better w/ antacid

Question 27

How does leptin work

Answer 27

made by adipocytes goes to hypothalamus inhibits neuropeptide Y Makes alpha-MSH

Question 28

What does alpha-MSH do

Answer 28

increases satiety

Question 29

What does neuropeptide Y do

Answer 29

give you apatite

Question 30

What is a normal way to treat graves

Answer 30

radioiodine thyroid ablation

Question 31

What food bypasses phosphofructokinase

Answer 31

fructose this leads to the fact that fructose gets metabolized quicker key enzymes= fructokinase, Aldolase B

Question 32

How does the body excrete copper

Answer 32

secreted into bile--> stool

Question 33

why do you see hemochromatosis more in med

Answer 33

Auto phlebotomy once a month

Question 34

Whats a good stain for stool fat

Answer 34

sudan 3

Question 35

When does barrett's have symptoms

Answer 35

when its already malignant

Question 36

How does the Lac Operon turn on

Answer 36

↑ Lactose--> unbinds repressor/ operate site--> ↑ Transcription

Question 37

What happens to the lac operon when ↓ glucose

Answer 37

↑ cAMP (just cuz) --> activate CAP--> ↑ transcription

Question 38

If you compress that pit stalk why is there ↑ prolactin

Answer 38

D2 blocks upstream, but the block is compressed so there is no inhibition

Question 39

What normally increases sectrin

Answer 39

secretin is released in response to stomach acid secretin stimulates panc hco3 , and inhibits stomach gastrin

Question 40

What is a unique test for zollinger ellison syndrome

Answer 40

admin secretin (normally should ↓ acid) But in ZE--> secretin will ↑ Acid (gastrin)

Question 41

How does rapid urease test work

Answer 41

gastric sample added to urea. ih pH indicator turns pink (basic) H pylori infection is likely

Question 42

What is the portal triad

Answer 42

runs through the hepatoduodenal ligament Hepatic Artery Portal Vein Common bile duct

Question 43

What does vitamin e deficiency look like

Answer 43

ataxia Hemolytic anemia ↓ proprioception/ vibratory *results from oxidative stress

Question 44

What's the major reasons for SCC of esophagus in USA

Answer 44

tobacco | alcohol

Question 45

What is the biopsy finding in UC

Answer 45

inflammatory infiltrate involving mucosa and submucosa

Question 46

What is missing in hirschsprung

Answer 46

meisner autonomic in submucosal auerbach autonomic plexus in myenteric

Question 47

How do you treat congenital adrenal hyperplasia

Answer 47

low doses of steroids to suppress ACTH and reduce adrenal cortex production

Question 48

What does VIP do

Answer 48

stimulates intestinal water secretion Conteracts gastrin promotes bicarb from panc

Question 49

What stimulates somatostatin

Answer 49

↓ pH stimulates it (from lots of places) It inhibits pretty much everything

Question 50

what makes the gall bladder contract

Answer 50

cholecystokinin

Question 51

what does ricin inhibit

Answer 51

60 s

Question 52

what do poisonous mushrooms inhibit

Answer 52

mRNA synthesis s/s: NVD and liver damage

Question 53

what liver biopsy finding would you see with hepatitis

Answer 53

hepatocyte swelling from atp depletion hepatocyte apoptosis pmn infiltration

Question 54

What does cholestyramine do

Answer 54

bile acid sequestrant

Question 55

What is the best gallstone prevention rx?

Answer 55

ursodiol nontoxic bile acid ↑ bile acid, ↓ cholesterol secretion

Question 56

how many calories for protein

Answer 56

4 cal/gram

Question 57

how many calories for fat

Answer 57

9 cal/ gram

Question 58

What GI cancer has signet rings

Answer 58

diffuse gastric adenocarcinoma, loss of e-cadherin --> linitis plastica

Question 59

Define crigler najjar

Answer 59

AR genetic lack of uridine diphosphate glucuronyltransferase hyperbilirubinemia--> kernicterus--> death

Question 60

How does carcinoid syndrome present

Answer 60

facial flushing bronchospasm diarrhea hypotension

Question 61

what is chvostek sign

Answer 61

hypocalcemia facial twitch upon tapping

Question 62

where is the portal vein

Answer 62

anterior to vena cava