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GI > Random extra GI questions > Flashcards

Random extra GI questions Flashcards

1
Q

What do parietal cells secrete?

A

Gastric acid (HCl) & intrinsic factor

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2
Q

What stimulates the release of CCK?

  • what cells produce CCK?
  • what does CCK do?
A

Fat/chyme entering duodenum stimulates release of CCK from L-cells in the gut

  • stimulates pancreatic acinar cells to release zymogens
  • also acts as a hunger suppressant
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3
Q

In a patient with RUQ pain, fever, and jaundice, what is the most likely diagnosis? What is this group of three symptoms called?

A

Triad of symptoms is Charcot’s Triad.

–> indicates Cholangitis –> Medical Emergency!!

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4
Q

What GI problem has pathology with transmural infection of the colon?

A

Crohn’s disease

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5
Q

Which disease is associated with initial infection of rectum and proximal progression?

Pathologically, is this a continuous or patchy disease?

A

Ulcerative colitis.

Continuous disease.

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6
Q

What histological layers of the intestinal walls get affected by ulcerative colitis?

A

Just the mucosal layer. It is a superficial disease.

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7
Q

What is fulminant colitis?

What is it a major risk factor for?

A

Very severe ulcerative colitis with bloody diarrhea, fever, transmural inflammation, and perforation.

Risk for toxic mega colon.

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8
Q

In which type of disease would removal of the colon be a cure?

A

Ulcerative colitis (because it doesn’t extend into the small intestine whereas Crohn’s may involve entire GIT)

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9
Q

Which colonic disease has patchy discontinuous inflammation?

A

Crohn’s disease

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10
Q

Why is the approach to DDx of liver disease?

ie. Categories of dx’s to consider with liver problems.

A
  • EtOH
  • metabolic (especially with fam Hx)
  • NAFLD
  • infection (usually viral)
  • autoimmune
  • drugs (Rx or non-Rx)
  • also consider infiltrative diseases (sarcoidosis, diffuse mets, TB)
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11
Q

What does a high IgA indicate?

A

EtOH overuse

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12
Q

What does a high IgG indicate?

A

Autoimmune liver disease & cirrhosis

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13
Q

What does a high IgM indicate?

A

Primary biliary cirrhosis

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14
Q

What is the 1000+ club?

- list club members.

A

Disease where ALT & AST are elevated above 1000.

Includes the following diseases:

  • acute viral hepatitis
  • drug induced (acetaminophen)
  • ischaemia
  • acute biliary obstruction
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15
Q

If you want to test a patient to see if he/she has an acute infection of Hep A, what test would you order and why?

A

IgM because this is elevated in acute infection whereas IgG would be elevated if the patient had ever had exposure to Hep A.

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16
Q

If patient has fatty infiltration of the liver, what are the three most common causes of this?

A
  • NAFLD
  • EtOH
  • viral Hepatitiss
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17
Q

What is the mechanism for how stenosis can occur due to Crohn’s disease?

A

Transmural inflammation –> fibrosis & scarring –> stenosis

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18
Q

What is dysentery?

A

Bloody and mucousy diarrhea

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19
Q

What is suggested by a finding of neutrophils in intestinal crypts?

A

Cryptitis

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20
Q

What’s the most likely mechanism of disease in a patient with painful jaundice?

A

Extrahepatic obstruction

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21
Q

What intestinal disease shows pathology with edematous ‘cobblestone-like’ mucosa?

A

Crohn’s disease

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22
Q

What’s the most common type of colonic adenoma?

Other causes?

A

Tubular adenoma is most common.

Others include colloid adenoma and tubulovillous adenoma.

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23
Q

Where are the majority of colorectal cancers located?

A

Ascending colon/cecum
&
Sigmoid colon/rectum

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24
Q

What is the treatment of IBD?

A

Anti-inflammatory (5-ASA)
& Immunosuppresant (Azathioprine)
& anti-TNF therapy (Infliximab)

25
Q

Where in the GIT are tight junctions (paracellular transport) most permeable?

A

Small intestine

26
Q

Which requires energy, paracellular transport or transcellular transport?

A

Transcellular requires energy at the apical and/or basal membrane.

27
Q

What is the mechanism for diarrhea in celiac sprue?

A
  1. Decreased brush border enzymes
  2. Villus atrophy & malabsorption
  3. Crypt hyperplasia & increased secretion
  4. Inflammation-induced hypersecretion from crypt
28
Q

Where are bile salts mostly absorbed?

A

Ileum

29
Q

Where is Vit B12 absorbed?

A

Ileum

30
Q

Where is calcium absorbed?

A

All through small bowel

31
Q

Where are carbs & proteins mainly absorbed?

A

Most in proximal small bowel and tapers off as they progress through small bowel.

32
Q

Where is Fe absorbed?

A

Duodenum

33
Q

Where is folate absorbed?

What B vitamin is this?

A

Duodenum.

Folate = B9

34
Q

What B vitamin is thiamin?

A

B1

35
Q

Where are lipids mainly absorbed?

A

Jejunum & proximal ileum

36
Q

Histologically, what is a sign of Barrett’s esophagus?

A

Intestinal epithelium (presence of goblet cells) in esophagus.

37
Q

What are some causes of SCC (squamous cell carcinoma) of the esophagus?

A
  • Alcohol overuse
  • nutrition deficits
  • smoking
  • HPV virus
  • nitrosamines in water/food
38
Q

How is gastritis classified?

- list the types of gastritis.

A

Acute vs. chronic

Acute: hemorrhagic/erosive gastritis

Chronic: H. pylori, autoimmune, & multifocal atrophic gastritis

H. pylori gastritis is further classified into atrophic and non-atrophic gastritis.

39
Q

A superficial band of inflammatory cells in the lamina propria of the stomach lining and neutrophils in the gastric pits would indicate what?

A

H. pylori gastritis

40
Q

What would be seen on a histological section of a stomach from someone who had a gastric ulcer?

A

Erosion - through the muscularis mucosa

41
Q

Which gross portion of the stomach is the most involved with H. pylori infection?

A

Antrum

42
Q

What is a worrisome complication of H. pylori infection?

A 
Gastric cancer (carcinoma) or MALT lymphoma. 
Also causes ulcers.
43
Q

What are the HLA types associated with Celiac disease?

A

HLA DQw2
&
HLA DQ8

44
Q

How does autoimmune gastritis work & what can it lead to?

A

Immune destruction of secretory cells.
Ab to parietal cells &/or IF.
Loss of IF decreases Vit B12 absorption –> pernicious anemia.

45
Q

What type of neoplasm in the stomach is linked to HIV?

A

Kaposi’s sarcoma

46
Q

What types of neoplasms can be present in the stomach?

A
  • epithelial
  • stromal
  • lymphoid
  • vascular
47
Q

What type of neoplasm is Kaposi’s sarcoma?

A

Vascular

48
Q

What does a signet ring cell indicate?

A

Poorly differentiated cancer

49
Q

What is a lab test for Celiac disease?

Why?

A

TTG (transglutaminase) along with IgA.

Direct gliadin toxicity causes inflam response (t-cells) and leads to release of transglutaminase

50
Q

What is Marasmus?

A

Deficiency of energy and protein –> depleted body fat & muscle wasting –> very thin appearance

51
Q

What is Kwashiorkor?

A

Protein deficiency –> muscle atrophy and lots of edema

52
Q

Which intestinal disease is more prone to rupture?

A

Crohn’s

53
Q

Which intestinal disease is more likely to develop stricture?

A

Crohn’s

- if stricture is seen in UC, should suspect cancer

54
Q

What is the diagnostic criteria for diagnosing IBS?

A

Symptoms for > 6 months.
& 2 of the following:
- pain relieved with bm
- onset of pain a/w change in stool frequency
- onset of pain a/w change in stool appearance

55
Q

What are the pacemaker cells of the GIT?

A

Interstitial cells of Cajal –> make slow-wave action potentials that set the rate of peristalsis

56
Q

Where exactly are the parietal cells, chief cells, mucous neck cells, & paracrine cells located?

A

In gastric pits (oxyntic glands)

57
Q

What are the enteroendocrine cells of the stomach?

- where exactly are they located?

A

G cells
- located in pyloric glands

D cells (paracrine)
 - located in pyloric and glastric glands
58
Q

What are 4 functions of gastric acid?

A
  1. Bacteriostatic
  2. Activate enzymes
  3. Initiates protein denaturation
  4. Facilitates absorption of Fe/Ca/VitB12

GI (13 decks)

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