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1
Q

scleroderma

A

esophageal smc atrophy/fibrosis

  • low LES pressure
  • low/absent peristaltic ativ in esophageal body
  • abnml LES relaxation w/ swallowing
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2
Q

solids only + chronic heartburn –> progressive sx –>

A

peptic stricture

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3
Q

solids and liquids + chronic heartburn –> progressive sx –>

A

scleroderma

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4
Q

adjust these meds for renal insufficiency

A

histamine antagonists

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5
Q

chronic gastritis
H. pylori + isolated in antrum
pH will be

A

low

H. pylori colonizes G cells –> hyperplasia –> inc gastrin –> inc acid –> dec pH

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6
Q

in acute pancreatitis, hypo_____ is a poor prognostic marker

A

hypOcalcemia

suggests inc Ca flux into tissues, binding up peripancreatic fat

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7
Q

temporary blockage of the exit of enzyme granules from acinar cells

A

Acute pancreatitis due to biliary sludge (early stones)

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8
Q

osmotic diarrhea osmotic gap is

A

> 125

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9
Q

which extra intestinal sx of UC is most likely to parallel disease course

A

peripheral arthritis

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10
Q

thickened gallbladder wall

A

cholecystitis

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11
Q

Effect of removing the gallbladder on lithogenic bile

A

Bile remains just as lithogenic after the gallbladder is removed

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12
Q

brown pigment stones

A

stasis of bile and anaerobic bacterial infection within the biliary tree

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13
Q

Most common site of gut carcinoids

A

terminal ileum

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14
Q

carb absorption

A

absorbed in the proximal small intestine by a sodium-dependent carrier mechanism

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15
Q

main stimulus for secretin stimulation

A

ACID

Secretin is released from intestinal mucosa into the splanchnic circulation when a higher acid load enters into the duodenum. This leads to increased bicarbonate secretion from the pancreas to help neutralize the acid and allow pancreatic enzymes (which require a more alkaline pH) to function.

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16
Q

high LFTS >1000, negative viral hepatitis labs

A

acetaminophen OD

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17
Q

secondary hemochromatosis

A

iron accumulation in kuppfer cells (macrophages)

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18
Q

Sessile serrated adenomatous polyps

likely location

A

R colon

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19
Q

tubular adenomas
tubulovillous
villous
sessile or pedunculated

likely location

A

L colon

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20
Q

Cancers presenting with iron deficiency anemia and the lack of overt rectal bleeding

likely location

A

R colon

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21
Q

Cancers presenting with blood

likely location

A

L colon

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22
Q

Although the other disorders can cause intussusception, a ________ would be more common cause in this 4 y/o age group.

A

meckel’s diverticulum

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23
Q

Air in the intestines is pneumatosis intestinalis and associated with ____________.

A

necrotizing enter colitis

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24
Q

currant jelly stool

A

intussusception

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25
Q

Omphalocele is always a defect in the

A

umbilical ring

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26
Q

Gastroschisis is a defect lateral to the

A

umbilicus

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27
Q

________(drug) has been shown to increase lower esophageal sphincter pressure

A

Metoclopramide

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28
Q

cystic fibrosis

A

chronic pancreatitis

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29
Q

hereditary hemochromatosis triad of sx

A

cirrhosis
diabetes
skin pigment (Fe+melanin=bronze)

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30
Q

small testes

A

hereditary hemochromatosis

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31
Q

Intense lymphocytic infiltration around the bile ducts in a portal triad

32
Q

Intense staining of hepatocytes with Prussian blue

A

Hereditary hemochromatosis where the excess iron stains blue

33
Q

most common salivary gland lesion

A

mucocele

most comm at lower lip

34
Q

dry eyes, dry mouth

A

Sjogren’s (immune destroy of salivary and lacrimal glands)

middle aged woman

biopsy of the lower lip for dx

35
Q

Sjorgren syndrome Abs

A

autoantibodies SS-A (Ro) and SS-B (La)

antinuclear antibody test (ANA)

36
Q

Sjorgren HLA

37
Q

Both HPV + and - tumors are more common in male or female

38
Q

which drugs worsen GERD

A

theophylline (dec LES P)

nifedipine (smc relaxant)

39
Q

MRP2

A

Dubin Johnson

inc conjugated bilirubin

40
Q

Fe deficiency
beefy red tongue
esophageal web

A

Plummer-Vinson syndrome

41
Q

chronic gastritis
H. pylori + in entire stomach
pH will be

A

high

H. pylori damages parietal cell via production of urease (urea –> ammonia + CO2

42
Q

Abs to parietal cells

A

AI gastritis

43
Q

high serum gastrin levels

A

chronic PPI use
chronic atrophic gastritis
ZE syndrome

44
Q

___ gastritis (a type of chronic gastritis) induces ____ leading to risk of ____

A

AUTOIMMUNE gastritis (a type of chronic gastritis) induces INTESTINAL METAPLASIA leading to risk of GASTRIC ADENOCARCINOMA

45
Q

NSAID induced ulcer may cause no sx except

46
Q

1 MOA of NSAID –> ulcers

A

reduced mucosal BF via COX/prostaglandin inhibition

47
Q

Which ulcers almost always involve H. pylori

A

duodenal ulcers

H. pylori –> inc gastrin acid prod

48
Q

rapid gastric emptying

A

duodenal ulcers

49
Q

which hormone increases pH in SI so pancreatic enzymes can function better

50
Q

What stimulates CCK release and increasing the amount of digestive enzymes

A

partially digested fats and proteins

51
Q

painless jaundice

A

head of pancreas neoplasm

common bile duct obstruction

52
Q

which intraductal papillary mutinous neoplasm is most likely to become malignant

A

IPMN - main duct

53
Q

ER+

A

mucinous cystic neoplasm

pancreas, some malignancy

54
Q

When do pseudopapillary tumors of the pancreas present

A

2nd-3rd decade

55
Q

NOD2/CARD15

A

Crohns, ileal

56
Q

IBD inflammatory mediators

A 
Proinflammatory:
TNFα
 IFNγ
 IL-1β
 IL-12
 IL-18
 IL-23
57
Q

cobblestoning

58
Q

Which IBD has significant risk of adenocarcinoma when certain duration/extent characteristic occur?

A

UC

> 10 yr duration

involvement of R colon or pancolitis

59
Q

2 histo subtypes of microscopic colitis

A

lymphocytic (>20 intraepithelial lymphocytes)

collagenous (still inc lymphocytes)

60
Q

ischemic bowel disease phases

A

acute: hemorrhage in lamina propria, epithelial coagulative necrosis

organizing (granulation, fibrosis)

healed (atrophy, shortened crypts, branched glands)

61
Q

ATP7B mutation

A

Wilson’s

62
Q

urosidol

A

tx for PBS, PBC

63
Q

anti-mitochondrial Ab

64
Q

SMAD4/DPC4

A

juvenile polyps

65
Q

STK11

A

Peutz-Jeghers polyps

66
Q

total colectomy indicated

A

FAP (familial adenomatous polyposis)

67
Q

Lynch syndrome has inc risk of which cancers

A

colorectal
endometrial
stomach
ovarian

68
Q

pathologic stage T3

A

Tumor invades through muscularis propria

into subserosal fat

69
Q

First degree relative with CRC or advanced adenoma < 60

Two first degree relatives with CRC or adenoma at any age

A

Begin screening at age 40
or 10 years younger than age
at first diagnosis, repeat every
5 years

70
Q

One first degree relative with CRC or advanced adenoma > 60

Two second degree relatives with CRC or adenoma

A

Begin age 40, repeat

every 10 years

71
Q

Family or personal history of HNPCC

A

Colonoscopy at age 20-25

72
Q

FAP

A

Flexible sigmoidoscopy age 12 – early total colectomy

73
Q

pancolitis, when to begin annual colonoscopy?

A

8 years after diagnosis

74
Q

PSC, when to begin annual colonoscopy?

A

at time of dx

75
Q

reduce the risk of CRC

A

aspirin

post-menopausal hormone use (estrogen + progesterone)

76
Q

reduce adenoma burden in FAP

Emma GI (18 decks)

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