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MET Flashcards

1
Q

Describe the changes epithelial structure at each of the following four junctions in the GI tract:
gastro-oesophageal
gastro-duodenal
ileo-ceacal
recto-anal

A

Gastro-esophageal: Simple columnar (Gastric) -> stratified squamous (oesophagus)

Gastro-duodenal: Epithelial glands in mucosa (Gastric) -> Epithelial glands in sub-mucosa (Duodenum)

Ileo-cecal: Epithelium in villi (ileum) -> no villi (large intestine)

Recto-anal: Simple columnar (rectum) -> stratified squamous (anal)

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2
Q

What do these GI cells secrete:
Goblet cell
Parietal cell
Chief cell
G-cell
ECL cell

A

Goblet cell - Mucous
Parietal cell - Intrinsic factor
Chief cell - Pepsinogen
G-cell - Gastrin
ECL cell - Histamine

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3
Q

What is the function of each part of the renal tubule:
Proximal tubule
Distal tubule
Loop of Henle
Collecting duct
Renal corpuscle

A

Proximal tubule - Most reabsorption happens here

Distal tubule - Cells form the juxtaglomerular apparatus

Loop of Henle - Generates counter-current gradient

Collecting duct - Sites of ADH

Renal corpuscle - filters plasma

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4
Q

How do the cells in the distal tubule detect low blood pressue

A

Osmoreceptors within the distal tubule detect low sodium concentration

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5
Q

What substances are produced in each part of the adrenal gland:
Adrenal Medulla
Zona Reticularis
Zona fasciculata
Zona Glomerulosa

A

Deep

Adrenal medulla = catecholamines (adrenaline)

Zona reticularis = glucocorticoids and androgens (DHEA - dehydroepiandrosterone)

Zona fasciculata = glucocorticoids (cortisol)

Zona glomerulosa = aldosterone

Superf​icial (Renal capsule)

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6
Q

Which adrenal gland region has a lot of lipid droplets (so would show up in lipid staining)

A

Zona fasciculata (cortisol)

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7
Q

What cells make up the parathyroid gland?

A

Chief cells

Oxyphil cells (less abundant clumps)

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8
Q

Label the lumbar plexus

A

Innocent Ian Gets Lunch On fridays:

  • Iliohypogastric (L1)
  • Ilioinguinal (L1)
  • Genitofemoral (L1, L2)
  • Lateral Cutaneous Nerve (L2, L3)
  • Obturator (L2, L3, L4)
  • femoral (L2, L3, L4)
  1. A: Subcostal nerve
  2. B: Iliohypogastric nerve
  3. C: Ilioinguinal nerve
  4. D: Genitofemoral nerve
  5. E: Lateral cutaneous nerve of the thigh
  6. F: Femoral nerve
  7. G: Obturator nerve
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9
Q

Above and below the dentate line, state the differences in the Upper and Lower anal canals in:

  • Embryological origin
  • Epithelium
  • Arterial supply
  • Venous drainage
  • Lymphatics
  • Innervation
A

Upper anal canal:

  • Embryological origin: Endoderm (from hindgut)
  • Epithelium: Simple columnar
  • Arterial supply: Superior rectal artery
  • Venous drainage: Superior rectal vein
  • Lymphatics Internal iliac lymph nodes
  • Innervation: Inferior hypogastric plexus (visceral)

Lower anal canal:

  • Embryological origin: Ectoderm (from cloaca)
  • Epithelium: Non-keratinised stratified squamous
  • Arterial supply: Middle and inferior rectal arteries
  • Venous drainage: Middle and inferior rectal veins
  • Lymphatics: Superficial inguinal lymph nodes
  • Innervation: Inferior rectal nerve (somatic)
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10
Q

What is Conn’s syndrome

A

Hyperaldosteronism (Zona Glomerulosa)

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11
Q

What part of the liver does congestive hepatopathy affect

A

Centrilobar

Chronic dilation of the interlobular veins in the centrilobular zone of the hepatic sinusoids.

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12
Q

What are the intraperitoneal structures

A
  • Liver
  • Stomach
  • Spleen
  • Duodenum (first part)
  • Ileum + jejunum
  • Transverse colon
  • Sigmoid colon
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13
Q

What are the retroperitoneal structures

A

‘SAD PUCKER’

  • Suprarenal (adrenal) glands
  • Abdominal aorta
  • Duodenum (2nd-4th parts)
  • Pancreas
  • Ureters
  • Colon (ascending + descending)
  • Kidneys
  • E(O)esophagus
  • Rectum
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14
Q

At what vertebrae level are the thyroid glands

A

C5-T1

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15
Q

What do Chief cells produce and what does it activate

A

PTH which stimulates 1-alpha hydroxylase

1 - alpha hydroxlase converts 25-hydroxy Vitamin D (Calcifediol) to 1,25-dehydroxy Vitamin D (Calcitriol)

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16
Q

What are the main secretions of the pancreas into the pancreatic duct

A

Bicarbonate

Digestive enzymes

17
Q

What are hiatal hernias, what are the types and what is the most common

A

Hiatal hernias are protusions of intra-abdominal structures through and enlarged oesophageal hiatus in the diaphragm

Types:

  • Sliding Hiatal Hernia (most common)
  • Paraoesophageal Hiatal Hernia
18
Q

What anatomical feature is used to locate the cystic artery and what forms it

A

Calot’s triangle

The borders consist of: Common hepatic duct, Cystic duct and the inferior surface of the liver

19
Q

What is the organisation of the renal arterioles?

A

Renal artery –> Segmental artery –> Lobar artery –> Interlobar artery –> Arcuate artery –> Interlobular artery –> Afferent arterioles

20
Q

What are the innervation of the eye muscles and what does each muscle do

A

Lateral rectus - VI: Turn eye laterally

Medual rectus - III: Turns eye medially

Superior rectus - III: Turns eye superiorly

Inferior rectus - III: Turns eye inferiorly

Superior Oblique - IV: Depresses, intorts and abducts (down and out)

Inferior Oblique - III: Elevatesm extorts and adducts (up and in)

21
Q

What hormone is produced in excess in cushings syndrome and where is it produced

A

Excess cortisol and it is produced in the zona fasciculata in the adrenal gland

22
Q

Name and describe the location of the suprahyoid muscles

A
23
Q

Signs and symptoms of minimal change disease in the kidneys

A

Peripheral oedema, weight gain, hypoalbuminaemia and proteinuria

Light microscopy shows no changes

24
Q

What cells make up the majority of the anterior pitruitary gland

A

Somatotrophic cells

25
Q

What are diagnostic features of alcoholic hepatits

A

Onset of jaundice within 60 days of heavy alcohol consumption (defined as 50 g/day) for a minimum of 6 months

Serum bilirubin increased (>3 mg/dL)

AST: ALT ratio of >1

26
Q

What is the psoas major innervated by

A

L1-L3

27
Q

What are X-ray findings in Hyperparathyroidism

A
  • Subperiosteal erosion
    • Occurs due to bone thinning as a result of increased bone resorption.
  • Terminal tuft erosion
    • Occurs due to bone thinning as a result of increased bone resorption.
  • Brown tumour
    • Reparative granulation tissue and fibrous tissue due to excess bone resorption.
  • Pepper-pot skull
    • Occurs due to resorption of trabecular bone within the skull.
28
Q

What is indapimide and where does it act

A

Indapimide is a thiazide-like diuretic and acts on the distal convoluted tubule

It inhibits the activity of the sodium-chloride symporter in the DCT preventing reabsorption.

This draws more water into the lumen, resulting in urine diuresis

Side Effects include:

Hyponatreamia, Hypokalaemia, Hypercalcaemia and Hypercholesterolemia

29
Q

What structures are lined by this epithelial structure

A

Transitional cell epithelium (urothelium)

Lines:

  • Renal calyces
  • Ureters
  • Bladder
  • Prostatic urethra
30
Q

What are the most abundant cells in the adrenal medulla

A

Chromaffin cells - produce catecholamines

31
Q

What are the 3 main portosystemic anastomoses and their corresponding pathologies

A

Oesophageal region

  • Portal circulation: Left gastric vein (oesophageal branch)
  • Systemic circulation: Azygos vein (oesophageal branch)
  • Pathology: Oesophageal varices

Periumbilical region

  • Portal circulation: Paraumbilical veins
  • Systemic circulation: Superficial epigastric veins
  • Pathology: Caput medusae

Rectal region

  • Portal circulation: Superior rectal vein
  • Systemic circulation: Inferior and middle rectal veins
  • Pathology: Rectal varices
32
Q
A
33
Q

What transporter does Liddle syndrome affect and where is it found

A

Epitheal Sodium Channel and it is found on the DCT and collecting tubule

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