HOME STRETCH! Flashcards
What supplements are needed for exclusive breast fed
Vit D
Iron for preterm and low weight
What are some tummy troubles people using opioids might have
sphincter of oddi spasm–> ↑ gallbladder pressure
What does ezetimibe do
↓ intestinal cholesterol absorption
What do fibrates do
activate PPAR-a and ↓ VLDL
Pretty much only drug that can lower triglycerides (fish oil does a little)
What drug ↓ Apolipoprotein B
fish oil
What does ↑ triglys do to pancreas
pancreas metabolizes it into free fatty acid –> toxic inflammatory effect–> pancreatitis
What type of adenoma is most likely to transform into malignant in colon
Villous adenoma can transform to malig more than tubular adenoma
What causes lynch syndrome
AD
nucleotide mismatch repair
MSH2, MLH1 genes –> MutS and MutL
Esophageal varices are from HTN where
Left gastric
Hemorrhoids are from HTN where
superior rectal
CAPUT MEDUSAE ARE FROM htn WHERE
PARAUMBILICAL
aldosterone producing adenoma
Conn syndrome
hypokalemia
HTN
metabolic alkalosis
outermost layer of adrenal makes
aldosterone
symptoms of conn’s syndrome
electrolyte problem –> paresthesia, muscle weakness
is there fluid build up in conn
no because of aldosterone escape (↓ renin –> ↓ na, limits edema and na problem)
gastric ulcers extend into
submucosa
erosion penetrate to
muscularis mucosa
BUT they do not go through it
Vertigo–> NV
Rx?
H1 and M1 receptor are on vestibular system, use blocker
chemotherapy–> NV
Rx?
D2 receptor is in chemotrigger zone, use blocker
gastroenteritis–> NV
Rx?
5HT receptor on stomach. use blocker
ONDASETRON
name the non neoplastic polyps
hyperplastic polyp
inflammatory- UC and crohn’s
submucosal
mucosal
what determines how bad a polyp is
degree of dysplasia
histologic pattern - villous is worse than tubular
size- bigger than 4 cm is especially bad
blocks stomach acid secretion
relieves reflux
Ranitidine
what is scopolamine
ach receptor antagonist
good for MOTION sickness (not all NV)
How do you treat central nausea
seen in acute migraine
d anatgs- metoclopramide, promethazine
usually not first line
These two diseases hurt after eating
Gastric ulcer- better w/ antacid
Chronic mesenteric ischemia- not better w/ antacid
How does leptin work
made by adipocytes
goes to hypothalamus
inhibits neuropeptide Y
Makes alpha-MSH
What does alpha-MSH do
increases satiety
What does neuropeptide Y do
give you apatite
What is a normal way to treat graves
radioiodine thyroid ablation
What food bypasses phosphofructokinase
fructose
this leads to the fact that fructose gets metabolized quicker
key enzymes= fructokinase, Aldolase B
How does the body excrete copper
secreted into bile–> stool
why do you see hemochromatosis more in med
Auto phlebotomy once a month
Whats a good stain for stool fat
sudan 3
When does barrett’s have symptoms
when its already malignant
How does the Lac Operon turn on
↑ Lactose–> unbinds repressor/ operate site–> ↑ Transcription
What happens to the lac operon when ↓ glucose
↑ cAMP (just cuz) –> activate CAP–> ↑ transcription
If you compress that pit stalk why is there ↑ prolactin
D2 blocks upstream, but the block is compressed so there is no inhibition
What normally increases sectrin
secretin is released in response to stomach acid
secretin stimulates panc hco3 , and inhibits stomach gastrin
What is a unique test for zollinger ellison syndrome
admin secretin (normally should ↓ acid)
But in ZE–> secretin will ↑ Acid (gastrin)
How does rapid urease test work
gastric sample added to urea. ih pH indicator turns pink (basic) H pylori infection is likely
What is the portal triad
runs through the hepatoduodenal ligament
Hepatic Artery
Portal Vein
Common bile duct
What does vitamin e deficiency look like
ataxia
Hemolytic anemia
↓ proprioception/ vibratory
*results from oxidative stress
What’s the major reasons for SCC of esophagus in USA
tobacco
alcohol
What is the biopsy finding in UC
inflammatory infiltrate involving mucosa and submucosa
What is missing in hirschsprung
meisner autonomic in submucosal
auerbach autonomic plexus in myenteric
How do you treat congenital adrenal hyperplasia
low doses of steroids to suppress ACTH and reduce adrenal cortex production
What does VIP do
stimulates intestinal water secretion
Conteracts gastrin
promotes bicarb from panc
What stimulates somatostatin
↓ pH stimulates it (from lots of places)
It inhibits pretty much everything
what makes the gall bladder contract
cholecystokinin
what does ricin inhibit
60 s
what do poisonous mushrooms inhibit
mRNA synthesis
s/s: NVD and liver damage
what liver biopsy finding would you see with hepatitis
hepatocyte swelling from atp depletion
hepatocyte apoptosis
pmn infiltration
What does cholestyramine do
bile acid sequestrant
What is the best gallstone prevention rx?
ursodiol
nontoxic bile acid
↑ bile acid, ↓ cholesterol secretion
how many calories for protein
4 cal/gram
how many calories for fat
9 cal/ gram
What GI cancer has signet rings
diffuse gastric adenocarcinoma, loss of e-cadherin
–> linitis plastica
Define crigler najjar
AR
genetic lack of uridine diphosphate glucuronyltransferase
hyperbilirubinemia–> kernicterus–> death
How does carcinoid syndrome present
facial flushing
bronchospasm
diarrhea
hypotension
what is chvostek sign
hypocalcemia
facial twitch upon tapping
where is the portal vein
anterior to vena cava
