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Designated study period: daily cards > March 29 - GI > Flashcards

March 29 - GI Flashcards

1
Q

Pathogenesis of gallbladder cholesterol stones (3 causes)

A
  1. Bile supersaturation
  2. Decreased bile acids/decreased phospholipids to bind the insoluble cholesterol
  3. Gallbladder stasis
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2
Q

Pathogenesis of bilirubin stones

A

Unconj bili + Ca++ precipitate out to form radiopaque stones.

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3
Q

Gastric varices: portal HTN vs splenic vein thrombosis

A

Portal HTN: seen in cirrhosis, increased pressure in L gastric veins results in both gastric and esophageal varices

Splenic thrombosis: incresaes pressure in short gastrics causing varices in fundus only. Complication of chronic pancreatitis

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4
Q

Layers of stomach and ulcers vs erosions

A

Layers: mucosa, muscularis mucosa, submucosa, muscularis propria, serosa

Ulcers extend down into submucosa
Erosions do not fully extend through muscularis mucosa

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5
Q

C diff toxin

A

Inactivates Rho resulting in disruption of the actin cytoskeleton and disruption of tight junctions, increasing paracellular fluid secretion

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6
Q

Abetalipoproteinemia: pathology, pathophysiology

A

Pathology: Normal mucosal architecture with clear/foamy enterocytes due to accumulation of lipids in sm intestine villi. Red cells with abnormal membranes and thorny projections

Pathophysiology: AR mutation in MTP gene results in impaired formation of apoB-containing lipoproteins (VLDL and chylomicrons)

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7
Q

Watershed regions of colon

A

splenic flexure

rectosigmoid junction

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8
Q

Garlic odor

A

Seen in arsenic poisoning

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9
Q

Mallory weiss tear pathophys

A

Increased intrabdominal pressure during vomiting. Hiatal hernias a risk factor

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10
Q

Toxic megacolon

A

Inflammation causes release of inflammatory mediators and NO. This leads to colonic sm muscle paralysis and colonic distension

Diagnosis: x-ray showing multiple air fluid leels

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11
Q

Fidaxomicin

A

Macrocyclic antibiotic with poor oral absorption. Used for c diff

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12
Q

Blood supply: celiac trunk, SMA, and IMA

A

Celiac trunk: abdominal esophagus through upper duodenum, pancreas, liver, gallbladder, spleen

SMA: mid duodenum through 2/3 down transverse colon

IMA: distal 1/3 transferse colon to upper anus

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13
Q

Delta508 mutation

A

3 base deletion that results in abnormal folding of CFTR, preventing trafficking to right location

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14
Q

Infertility in CF

A

Due to absent vas deferens and decreased sperm transport despite normal production

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15
Q

Diphenoxylate

A

Opioid anti-diarrhea, decreases motility. Similar to loperamide

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16
Q

Imperforate anus

A

50% of time associated with GU abnormalities, esp urorectal, urovesical, and urovaginal fistulas

17
Q

Hep B liver pathology

A

Hep B surface antigen accumulates in infected hepatocytes, appearing as finely granular, homegenous, dull eosinophilic inclusions

18
Q

Acute liver injury: liver proteins

A

Elevated PT due to short half life of factor VII. Normal albumin due to its long half life

19
Q

Polyethylene glycol

A

Osmotic laxative along with mag citrate

20
Q

Systemic mastocytosis

A

Cloncal mast cell proliferation in bone marrow and skin. Caused by mutations in KIT. Increased histamine results in syncope, hypotension, flushing, and hives as well as increased gastrcic acid secretion and ulcers.

21
Q

Retroperitoneal organs

A

SAD PUCKER:

  • suprarenal (adrenal) glands
  • aorta and IVC
  • duodenum, except first part
  • pancreas - head and body
  • ureters and bladder
  • colon- asc and desc
  • kidneys
  • esophagus
  • rectum - mid to distal
22
Q

Rifaximin

A

Non-absorbable antibiotic. Alters GI flora to decrease production of ammonia. Used to treat hepatic encephalopathy

23
Q

Sudan stain

A

Looks for fat in the stool

24
Q

Vibrio cholera vs C jejuni

A

Cholera grows on alkaline media

C jejuni grows at high temps

25
Q

Cavernous hemangioma

A

Most common benign liver tumor

26
Q

Hepatic adenoma

A

Associated with OCPs

27
Q

Secrin

A

Released in response to acid in the duodenum. Increases bicarb release from submucosal glands and pancreas

28
Q

CMV esophagitis

A

Seen in immunocompromised. Causes odynophagia, dysphagia. On endoscopty see linear shallow ulcerations. On biopsy, enlarged cells with intranuclear inclusion bodies

29
Q

Metoclopramide

A

D2 antagonist used to treat gastroparesis. Increases resting tone, contractility, and LES tone. Increases motility

30
Q

Cimetidine

A

H2 antagonist. ADRs: thrombocytopenia, CYP inhibition, gynecomastia

Designated study period: daily cards (32 decks)

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