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MD3002 > practice questions > Flashcards

practice questions Flashcards

1
Q

what is Zollinger-Elison syndrome

A

Zollinger-Ellison Syndrome is a Gastrin Secreting Tumour caused by non beta cells in the islets of langerhans
this leads to increased HCL and villous hyperplasia

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2
Q

what is the threshold potential for GI smooth muscle

A

-40mV

resting is -50 -60mV

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3
Q

where is the tail of the pancreas

A

in the lienorenal ligament, intraperitoneal

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4
Q

what is the lower oesophageal sphincter controlled by

A

VIP nerves

this is the basis for alchalasia

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5
Q

what does the cranial limb of the intestinal loop become

A

the jejenum and ileum

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6
Q

what are the lengths of the parts of the colon

A

Ascending 13cm
Transverse 38cm
Descending 25cm
Sigmoid 25-38cm

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7
Q

what drug is used to treat nematodes such as hook worm by may cause liver failure

A

albendazole

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8
Q

what is barretts oesophagus

A

long standing reflux leading to risk of adenocarcinoma of the oesophagus

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9
Q

what disorder is characterised by high serum amylase

A

acute pancreatitis

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10
Q

what drug can be used to treat peptic ulcers but may have the side effect of galactorrhoea and gynaecomastia

A

cimetidine
H2 receptor antagonist

antagonises testosterone

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11
Q

what GI tumour would look like a sheet of similar cells that have scant pink and granular cytoplasm

A

carcinoid

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12
Q

name two steroid drugs effective against chemo induced emesis and nausea

A

methylprednisolone and dexamethazone

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13
Q

what can hep C cause

A

acute liver inflammation

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14
Q

what can schistomiasis cause

A

chronic liver inflammation

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15
Q

what causes inhibition of gastric emptying

A

ph less than 3.5
hypertonic solution
fatty acid with long chain
tryptophan

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16
Q

where is secretin synthesised

A

S cells in duodenal mucosa

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17
Q

what is the intestinointestinal inhibitory reflex

A

inhibition of contractions in the adjacent regions of the small intestine

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18
Q

what does hypotonic mean

A

water from the solution will tend to osmose into the cell

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19
Q

describe the features of colonic carcinoid tumour

A

large intramural masses with polypoid excavations.

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20
Q

describe a colonic adenoma

A

napkin ring encircling and exophytic growths

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21
Q

describe a villous adenoma

A

1-3 cm velvety masses

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22
Q

describe leimyosarcomas

A

large bulky intra mural masses that may ulcerate

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23
Q

what hormones mediate the efferent limb of the gastrocolic reflex

A

cholecystokinin and acetylcholine

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24
Q

what NSAID is best for a patient with GI problems

A

paracetamol

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25
Q

what vertebral level is the subcostal plane

A

L3

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26
Q

what structures does the sigmoid mesocolon cross in the left iliac fossa

A

bifurcation of the left common iliac artery

left ureter

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27
Q

where does the base of the mesentery begin

A

left of the L2 vertebra

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28
Q

what is the purpose of a paramedian incision

A

avoids cutting the linea alba

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29
Q

which artery enters the rectus sheath between the sternal and costal attachments of the diaphragm

A

superior epigastric

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30
Q

what is a feature of the rome 3 criteria of IBS

A

reccurent abdo pain within the last 3 months

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31
Q

what drugs absorption is slowed by food in the stomach

A

paracetamol

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32
Q

what factors can affect oral drug absorption

A

GI motility
particle size
splanchnic blood flow

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33
Q

what microbiota are commonly found in the duodenum

A

lactobacili

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34
Q

what hormone inhibits glucagon

A

somatostatin

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35
Q

what cells secrete secretin

A

S cells

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36
Q

what is the only essential secretion of the stomach

A

intrinsic factor -vitamin b12

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37
Q

what is the function of somatostatin

A

inhibits glucagon and insulin secretion

inhibits gastric acid production

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38
Q

what causes secretion of secretin

A

drop in pH

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39
Q

what cells produce somatostatin

A

delta cells in pylorus, duodenum and pancreas

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40
Q

what embryonic tissue gives rise to the liver

A

endoderm

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41
Q

what percentage of colon cancers does hereditary nonpolyposis coli account for

A

1-5%

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42
Q

how many life years are lost by a woman with a BMI of 30 as oppose to 25

A

7 years

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43
Q

which antiemetic causes sedation

A

haloperidol

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44
Q

what are the histological features of ulcerative colitis

A

crypt abscesses
crypt atrophy
inflammatory infiltration of lamina propria

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45
Q

what are the features of duodenal ulcer

A

even distrubution amongst social classes

high or normal acid levels

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46
Q

which antihelminthic acts by increasing permeability of the nematode to calcium ions

A

praziquantel

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47
Q

what is a risk factor for adenocarcinoma of the oesophagus

A

smoking

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48
Q

what neoplasm accounts for 98% of colorectal cancers

A

adenocarcinoma

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49
Q

what IBD is more common among non smokers

A

ulcerative colitis

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50
Q

what proportion of bile salts are reabsorbed

A

95%

all in the small intestine

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51
Q

what can cause gastroenteritis

A

salmonella

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52
Q

what is active helminth transmission

A

lavae penetrate the skin

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53
Q

what is intermediate transmission

A

ingestion of the parasite

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54
Q

what do parietal cells secrete

A

acid and intrinsic factor

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55
Q

omeprazole

A

PPI

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56
Q

Ranitidine

A

histamine receptor antagonist

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57
Q

pepto bismol

A

antacid and anti inflammatory

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58
Q

skip lesions

A

crohns disease- patchy mucosal inflammation

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59
Q

what part of the intestine is most commonly infected in crohns

A

terminal ileum and ascending colon

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60
Q

what layers does UC affect

A

superficial layer

crohns disease can affect all layers

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61
Q

in what disease is crypt hypertrophy and villous atrophy seen

A

coeliac disease

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62
Q

what bacteria is associated with food esp rice

A

B. cereus

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63
Q

what bacteria cause rice water stools with severe dehydration and often caused by shellfish consumption

A

V. cholerae or V.volnificus

64
Q

what bacteria causes haemolytic uraemic syndromw

A

enterohaemorrhagic e. coli

65
Q

what is the most common cause of viral enteritis in infants

A

rotavirus

66
Q

what is the most common cause of viral enteritis in adults

A

norovirus

67
Q

where is the pain of diverticulitis usually felt

A

LIF

68
Q

what enzyme is released in bile duct disease

A

ALP

69
Q

what enzymes are released by damaged hepatocytes

A

aspartamate and alanine aminotransferase

70
Q

what is normal body temperature

A

36.5 - 37.2

71
Q

what bacteria might cause bloody stools and severe septic shock and haemolytic uraemic syndrome

A

e. coli

72
Q

what bacteria is associated with antibiotic therapy

A

c. diff

73
Q

what is the surface marker for the femoral pulse

A

along the inguinal ligament, midway

74
Q

what is the function of secretin

A

increases volume and alkalinity of pancreatic juice

75
Q

what is the function of substance P

A

increases peristalsis

76
Q

what are the immune functions of the liver

A

protein synthesis
kupffer cells which phagocytose bacteria
pro inflammatory cytokines

77
Q

what percentage of secretions are formed in the cephalic phase

A

30%

78
Q

what do cheif cells produce

A

pepsinogen

79
Q

what receptors does the vomiting centre contain

A

muscarinic and Histamine1

80
Q

what receptors does the CTZ contain

A

dopamine 2 receptors

81
Q

what are antimuscarinics used for

A

vestibular apparatus stimulated vomiting but not CTZ induced

82
Q

what is swan neck deformity of the oesophagus a sign of

A

alchalasia

may show dilation of the oesophagus

83
Q

what type of mesoderm do the kidneys develop from

A

intermediate mesoderm

84
Q

what do the glomruli develop from

A

the mesonepros

85
Q

what do the gonads develop from

A

intermediate mesoderm

86
Q

what do the adrenal glands develop from

A

intermediate mesonephros

87
Q

when does organogenesis happen

A

6 weeks

88
Q

what are the features of extrahepatic jaundice

A 
pale stools due to bile not entering the intestine
conjugated bilirubin (water soluble) - dark urine
pruritis due to increased bile salts
raised ALP
89
Q

what is pre hepatic jaundice

A

increased haemolysis

90
Q

how long does it take food to reach the stomach

A

9 seconds

91
Q

what hormone stimulates ECL cells and gastric acid secretion

A

gastrin

92
Q

what is the function of the posterior fibres of temporalis

A

retraction of the mandible

93
Q

what is the function of medial pterygoid

A

elevation and protrusion

94
Q

what is the function of lateral pterygoid

A

depression and protrusion

95
Q

what does coeliac disease predispose to

A

small bowel lymphoma

96
Q

where in the stomach is mucin secreted

A

pylorus and cardia

97
Q

what nerves are carried to the hindgut along the IMA

A

least splanchnic nerve and parasympathetic from S2-4

98
Q

what is an omphacele

A

herniation of the stomach through the umbilicus. covered by peritoneum

99
Q

what does the ventral mesentery form

A

lesser omentum and falciform ligament

100
Q

what structures form the stomach bed

A

central tendon of diaphragm
left colic flexure
spleen

101
Q

what may result from a patent tunica vaginalis

A

cytocele
hydrocele
indirect hernia

102
Q

how much rotation of the intestine happens around the SMA

A

270 degrees anticlockwise

103
Q

which of the forces in the nephron is the weakest

A

oncotic pressure of the tubule

104
Q

what is tubuloglomerular feedback

A

increased flow rate of sodium past the macula densa sends a message to afferent arterioles when BP increases

105
Q

what ion is found a lot in saliva

A

potassium

106
Q

what factors decrease the rate of action potentials in slow waves

A

sympathetic
gastrin
gip
secretin

107
Q

where is the second part of the duodenum

A

anterior to the hilum of the right kidney, right side of L2,3 vertebrae

108
Q

what is an indicator of acute pancreatitis

A

low serum calcium

109
Q

what are the features of pancreas secretion

A

amylase, lipase and protease
(cholecystokinin reduces secretion)
high bicarbonate content
isotonic

110
Q

what is the blood supply to the lower pharynx

A

inferior thyroid

111
Q

what percentage of gastric secretions is the gastric phase responsible for

A

60%

112
Q

loose foul smelling fatty stools

A

giardiasis

113
Q

what paracrines are secreted from the stomach

A

somatostatin

histamine

114
Q

what is the only endocrine secretion of the stomach

A

gastrin

115
Q

what are the exocrine secretions of the stomach

A

HCl
intrinsic fx
pepsinogen
ions

116
Q

what are the borders of the epiploic foramen

A

porta hepatis- ant
IVC- post
duodenum-inf
caudate lobe-sup

117
Q

what are vitamins

A

essential to life but cannot be made by the body

118
Q

what is enterokinase

A

converts trypsinogen to trypsin

119
Q

what is the ph of pancreatic juice

A

8

120
Q

what is the nerve supply of the small intestine

A

lesser splanchnic nerve t10 and 11 and vagus nerve via the superior mesenteric plexus

referred pain is peri umbilical

121
Q

where are the peyers patches

A

ileum

122
Q

where does small intestinal wall lymph drain to

A

mesenteric nodes on the SMA and then the cysterna chyli

123
Q

what is meckel’s diverticulum

A

a patent remnant of the vitello intestinal duct

2 inches long, 2 feet from the end of the ileum in 2% of people

it may ulcerate - feels like apendicitis
faecal discharge at the umbilicus

124
Q

how big is the caecum

A

7.5 cm. covered by peritoneum but not on a mesentery. RIF

125
Q

which part of the appendix contains lymphoid tissue

A

submucosa

126
Q

what are the possible locations of the appendix

A

pelvic; subcaecal; retrocaecal; retro-ileal; pre-ileal

use the taenia coli to locate

127
Q

what is the blood and nerve supply of the appendix

A

ileocolic branch of the superior mesenteric, from the aorta at L1 with nerves derived from T10/11,

128
Q

what is the blood supply of the caecum

A

iliocolic, anterior and posterior caecal plus appendicular artery from posterior caecal

129
Q

where does the sigmoid start and end

A

pelvic brim and s3

130
Q

what are the ascending and descending colons related to

A

kidneys

131
Q

what do the branches of the IMA cross

A

ureter and gonadal vessels

132
Q

what is the nerve supply of the hindgut

A

least splanchnic nerves s2,3,4 -para
T12- sympathetic
referred pain is to t12 -supra pubic region

133
Q

where is the rectum

A

S3

134
Q

is alpha 1 antitrypsin dominant or recessive

A

recessive

135
Q

what does scarpa’s fascia go on to form

A

fascia lata

and buck’s and colle’s in the penis and scrotum

136
Q

what aponeurosis forms the inguinal ligament

A

external oblique

137
Q

what is the most common cause of kidney stone

A

calcium oxalate

138
Q

what is the most common cause of chronic renal failure

A

DM

139
Q

what are the possible causes of kidney stones

A

uric acid
magnesium ammonium phosphate
cystine

140
Q

what factors contribute to renal stones

A

poor urine output
infection
low pH
low concentration of factors that inhibit stones such as citrate

141
Q

name some causes of metabolic acidosis

A 
increased renal bicarbonate loss 
hypokalaemia 
increased fixed H+ production 
increased intake of dietary acid 
decreased renal H+ secretion
142
Q

furosemide

A

loop diuretic

143
Q

what proportion of an adult is water

A

60%

increased adiposity mean decreased water proportion

144
Q

what proportion of water is intracellular

A

40%

145
Q

what proportion of body water is extracellular

A

20%

146
Q

what proportion of water is plasma

A

5%

147
Q

what proportion of body water is interstitial fluid

A

15%

148
Q

increases the tubular reabsorption of sodium

A

aldosterone

149
Q

what hormone increases renal blood flow

A

dopamine

150
Q

is tubular fluid in the distal tubule hypotonic or hypertonic

A

hypotonic

151
Q

henderson hasselback equation

A

ph = pk + log10 base/ acid

152
Q

what bacteria can reduce nitrates to nitrites

A

Most gram negs

153
Q

S cells in duodenal mucosa

stimulates bicarbonate and fluid secretion by the pancreas

A

secretin

presence of hydrocholoric acid in the small intesting

154
Q

D cells

A

somatostatin

155
Q

itching, rectal pain and rectal bleeding

A

haemorrhoids

156
Q

left iliac fossa pain, mass, nausea, bleeding

A

diverticulitis

MD3002 (56 decks)

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