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PBL 2.2.4 > Path 17-18 GI and Liver > Flashcards

Path 17-18 GI and Liver Flashcards

1
Q

Duodenal atresia cause

A

Failure to recanalize

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2
Q

Duodenal atresia sx

A

Bilious vomit and abd distension

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3
Q

Pyloric stenosis presentation

A

Palapable mass, nonbilious vomit at 2-6 weeks

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4
Q

Eosiniphilic esophagitis cause

A

Food allergens

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5
Q

Plummer vinson syndrome

A

DIES

Dysphagia, iron deficiency, esophageal webs, squamous cell carcinoma

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6
Q

Barret esophagus caused by

A

GERG

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7
Q

Barret esophagus pathology

A

Intestinal metaplasia replaces squamous epithelium

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8
Q

Esophageal cancer: portions affected

A

Squamous: Top 2/3
Adenocarcinoma: Bottom 1/3

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9
Q

NSAID gastritis how

A

decreased PGE2 means leads to lower gastric mucosa protection

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10
Q

Cushing ulcer pathogenesis

A

Vagal stim —> ACh increases —> H+ increases

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11
Q

Autoimmune gastritis caused by

A

Autoantibodies to H+/K+ ATPase on parietal cells

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12
Q

H pylori vs autoimmune gastritis location

A

H pylori antrum

Autoimmune body and fundus

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13
Q

Menetier disease pathology

A

Hyperplasia of gastric mucosa make rugae

Decreased acid production

Edema and other GI sx

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14
Q

Gastric adenocarcinoma outward signs

A

Virchow node, sister mary joseph node

Acanthosis nigricans

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15
Q

Celiac disease findings

A

IgA antitissue transglutaminase

Crypt hyperplasia

Gliadin peptide antibodies

Villious atrophy

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16
Q

Tropical sprue caused by

A

Infection. Infectious celiac. Pathogen unk

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17
Q

Whipple disease cause

A

Tropheryma whilpplei cause

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18
Q

Whipple disease histo and sx

A

PAS+ foamy macrophages

Cardiac, Arthralgia, Neuro sx

PAS FOAMY WHIPPED CAN

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19
Q

Chrons location

A

Ususally colon, spares rectum

Skip lesions

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20
Q

Ulcerative colitis location

A

Whole colon, continous

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21
Q

Chrons morphology

A

Fistulas, cobblestone mucosa, string sign on barium swallow, linear fissures

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22
Q

Chron disease histo

A

Non caseating granulomas and lymphoid aggregates

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23
Q

Ulcerative colitis location

A

Only affects mucosa and submucosa

LEAD PIPE appearance (no haustra)

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24
Q

Ulcerative colitis histo

A

Crypt absecess and bleeding

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25
Q

Chrons vs UC disease mediated by

A

Chrons Th1
UC Th2

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26
Q

UC vs Chrons: bloody diahreah?

A

UC: bloody
Chrons: sometimes bloody

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27
Q

Ulcerative colitis associated antibodies

A

p-ANCA

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28
Q

Toxic megacolon seen with (chrons/UC)

A

Ulcerative colitis

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29
Q

McBurney point location

A

1/3 distance from ASIS to ubilicus

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30
Q

Diverticulosis pathology

A

MAny false diverticula in colon

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31
Q

Diverticulitis presentation

A

LLQ pain, fever, leukocytosis

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32
Q

Meckel vs false diverticulum

A

Meckel: all layers

False: only mucosa and submucosa

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33
Q

Zenker diverticulum pathology

A

False diverticulum at Killian triangle

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34
Q

Hirshprung dx pathogenesis

A

Congenital lack of nervous plexus in distal colon leads to toxic megacolon

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35
Q

Hirschprung disease embryo cause

A

Failure of neural crest cell migration

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36
Q

Hirschprung disease gene abnormality

A

RET

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37
Q

Volvulus xray appreance

A

Coffee been sign

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38
Q

Intussuseption sx

A

PAin, bloody red jelly stool

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39
Q

Most common small bowel obstruction

A

Adhesion s/p surgery

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40
Q

Hamartoma polyps associated with

A

Peutz-Jeghers syndrome

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41
Q

Adenomatous polyp histo

A

Tubular or Villous

Villous more cancerous

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42
Q

Adenomatous polyps gene

A

APC KRAS

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43
Q

Familial denomaptous polyposis gene

A

Autosomal domminant APC tumor suppression gene

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44
Q

Gardner syndrome

A

FAP (familial polyposis) + soft tissue or bone tumor

45
Q

Turcot syndrome

A

FAP (famililal polyposis) + neural tumors

46
Q

Colon cancer presentation

A

Iron deficiency anemia in elderly, IBD, apple core xray, weight loss

47
Q

Colorectal cancer tumor marker

48
Q

Smoking protective for

A

Ulcerative colitis

49
Q

Colon cancer gene mutation

A

APC —> KRAS —>TP53

AK 53

50
Q

Cirrhosis cell type

A

Stellate cells

51
Q

Cirrhosis histo

A

Difuse fibrosing by stellate cells, regenerative nodules

52
Q

Primary bacterial peritonitis sx

A

ASCITES Sepsis, ileus, diagnosed by high neutrophils in ascitic fluid

53
Q

In alcoholic live which transferase is elevated more

54
Q

Alk phos goes up in _____

A

Bone disease and cholestasis

55
Q

Reye syndrome MOA

A

Aspirin metabolites decrease β oxidation by inhibiting mitochondria. Fucks up liver

56
Q

Reye syndrome sx

A

SHINE

Steatosis of liver
Hypoglycemia
Infection
Not alert
Encephalopathy

57
Q

Hepatic steatosis

A

Macrovesicular fatty change

reversible

58
Q

Alcoholic hepatitis histo

A

Swollen and necrotic hepatocytes with neutrophil inflammation

Mallory bodies

59
Q

Nonalcaholic fatty liver dx moa

A

Insulin resistance leads fatty infiltration of hepatocytes

60
Q

Most common primary malignancy of liver

A

Hepatocellular carcinoma

61
Q

Virus that causes hepatocellular cancer

62
Q

Hepatocellular carcinoma clinical features

A

Jaundice, ascites, hepatomegaly polycethemia

63
Q

Hepatocellular carcinoma labs

A

elevated α-fetoprotein

64
Q

Angiosarcoma of liver is from what exposure

A

Arsenic, vinyl chlorida

65
Q

Most common benign liver tumor

A

Cavernous hemangioma

66
Q

Budd chiari syndrome pathology

A

Thrombosis/compression of hepatic vein causes congestive liver sx.

67
Q

Causes of jaundice

A

HOT Liver

Hemolysis
Obstruction
Tumor
Liver dx

68
Q

α1- anti trypsin pathogenesis liver

A

Misfolder gene product with protein aggregates in hepatocellular ER

69
Q

α1- antitrypsin liver progression

A

Causes PAS+ cirrhosis

70
Q

Conjugated hyperbillirubinemia causes

A

Biliary obstruction

Dubin Johnson

Rotor syndrom

71
Q

Unconjugated hyperbilirubiemia caused by

A

Hemolytic anemia , gilbert syndrome, Crigler-najjar

72
Q

Pysiologic neonatal jaundice caused by

A

immature UDP-glucuronosyltransferase

73
Q

Billiary atresia presentation

A

Jaundice 2 weeks after birth, dark urine, acholic stool

Elevated direct bilirubin and GGT

74
Q

Biliary atresia pathogenesis

A

Fibro-obliterative destruction of extra hepatic bile ducts

75
Q

Heriditary hyperbilirubenimias genetics

A

autosomal recessive

76
Q

Gilber syndrome pathogenesis

A

decreased UPD-glucoronosyltransferase activity

77
Q

Gilbert syndrome presentations

A

Assymptomatic jaundice after stress

78
Q

Crigler Najjar syndrome pathogenesis

A

UPD-glucoronosyltransferase leads to no conjugation

79
Q

Crigler-Najjar findings

A

Jaundice, kernicters, increased indirect bilirubin

80
Q

Dubin johnson pathogenesis and findings

A

Conjugated hyperbili from defective liver excretion

Black liver

81
Q

Wilson disease gene mutation and chromosome

A

13

ATP7B gene

82
Q

Wilson disease pathogenesis

A

Copper transport ATPase means copper cant be excreted into bile. Copper accumulates and is found in urine

83
Q

Wilson disease findings

A

Low ceruloplasmin

Eye rings, neuropsych issues, renal dx (fanconi)

84
Q

Wilson dx treatment

A

Copper chelation with penicillamine and oral zinc

85
Q

Hemochromatosis genetics

A

autosomal recessive

HFE gene

chromosome 6

86
Q

Hemochromatosis pathogenesis

A

Abnormal iron sensing leads to increased intestinal absorption

Iron overload

87
Q

Hemochromatosis labs

A

Elevated: ferritin, iron, transferin

Decreased: TIBC

88
Q

Hemocrhomatosis presentation

A

Cirrhosis, diabetes, bronze skin

89
Q

Hemochromatosis cardiac complication

A

Restrictive cardiomyopathy

90
Q

Biliary tract disease presentation

A

Pruritus, jaundice, dark urine, light colored stool

91
Q

Cholestatic pattern (lab values)

A

Increased: Conjugated bilirubin, cholesterol, AlkPhos, GGT

92
Q

Primary sclerosing cholangitis pathology

A

Onion skin bile duct fibrosis

93
Q

Primary sclerosin cholangitis patient population

A

Middle aged men w/ UC

94
Q

Primary sclerosing colangitis associated conditions and labs

A

Ulcerative colitis (p-anca)

Increased IgM

Can lead to cholangiocarcinoma and gall cancer

95
Q

Primary biliary cholangitis pathology

A

Autoimumine reaction

Lymphocytic infiltrate with destruction of lobular bile ducts

96
Q

Primary biliary cholangitis seen (population)

A

Middle age woman

97
Q

Primary biliary cholangitis additional findings

A

Anti-mitochondichondrial antibodies

Increased IGM

Associated with autoimmune conditions

98
Q

Risk factors for gall stones

A

4 Fs

Fat female fertile forty

99
Q

Cholesterol stones feautues

A

Yellow

Radiolucent

100
Q

Cholesterol stones seen in

A

Chrons dx, elderly

101
Q

Bilirubin stone features

A

Black
Radiopaque

102
Q

Infectious stone features

A

Brown, radiopaque

103
Q

Gall stone causes

A

Increased cholesterol or bilirubin

Decreased bile salts

Gallbladder stasis

104
Q

Biliary colic caused by

A

Neurohormonal activation

105
Q

Cholecystitis causes

A

Calculous: stones

Acaclulous: gallbladder stasis, shock

106
Q

Gallstone ileus

A

Gallbladder/GI tract fistula leads to stone entering lumen and obstructing ileocecal valve

107
Q

Porcelain gall bladdercaused by

A

Chronic cholecystitis

108
Q

Porcelain gallbladder increases risk of

A

Gallbladder adenocarcinoma

109
Q

Ascending cholangitis findings

A

Really fucking sick

Fever, RUQ, jaundice

plus shock and AMS

PBL 2.2.4 (13 decks)

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