Shit - GIT UWorld Flashcards
Niacin main role and toxicity
Raises HDL (also lowers VLDL and TG synthesis) Toxicity = flushing, hyperuricemia (ppt gout), hyperglycemia (acanthosis nigracans), hepatitis
Mechanism of base exception repair
Glycosylase recognizes deaminated base and removes it
Endonuclease and lyase remove the remaining sugar-Phosphate part
Polymerase puts new base in
ligase seals it
Gastrin on parietal cells
Secrete acid
also TROPHIC = parietal cell hyperplasia (seen in ZE)
PPT factors of SMA syndrome
Anything that causes decreased mesenteric fat (drops the angle) i.e. catabolism, bed rest
Also scoliosis correction
Superficial inguinal nodes drain:
all skin below bellybutton except posterior calf (popliteal)
Arsenic poisoning s/s and Rx
s/s = stomach pain, vomiting, delerium, GARLIC breath
Rx = Dimercaprol (which is nephrotoxic and hypertensive)
Cholestyramine AE
increased TAG and VLDL synthesis
Increased cholesterol content of bile so cholesterol stones
Decreases statin absorption (give 4 hrs apart)
Oxyphil histo
Eosinophils in upper glandular area of mucosa
Signs of poor prognosis in liver failure
Prolonged PT, low albumin, high bilirubin
[indicate liver function]
CREST esophagus shit
replace muscle with fibrosis –> dilated LES –> reflux -> barretts –> ACA
Esophageal hypomotility
TZDs mechanism
binds nuclear receptor PPAR-g to increase adiponektin levels to decrease insulin resistance
Pancreatic pseudocyst lined by; found where
granulation tissue and fibroblasts [real cysts = epithelium]
MC in lesser sac; boarders are stomach (ant), transverse colon, and duodenum
NFKB role in inflammation
cytokine production
Types of esophagitis and appearance
Eosinophilic = eosinophils, strictures Reflux = metaplasia Candida = plaques CMV = linear ulcers HSV = punched-out ulcers Chemical ingestion
colonic diverticula = what kind of diverticulum
pulsion
Causes of acute pancreatitis
GET SHMASHED
[gallstones, ethanol, trauma, surgery, hypertriglyceridemia, mumps (coxsakie B and myco pneumo), Autoimmune, Scorpion sting, Hypercalcemia, ERCP, Drugs (sulfa, azathioprine, furosemide, valproic acid)
COX-2 and colon cancer
INCREASES the risk of adenomatous polyps
Arteries that run being posterior duodenum
Gastroduodenal
Branches = superior pancreaticoduodenal and right gastroepiploic
Malrotation of midgut: GI positioning, s/s
Cecum fixed to duodenum in URQ via Ladd bands.
Whole midgut fixed to SMA
s/s =
volvulus
Duodenal obstruction (bilious vomiting)
Acute opioids on the GIT
Contraction of smooth muscle of sphincter of Oddi –> increase biliary pressure –> biliary colic
Which has more acute s/s; hep B or hep C?
Hep B - serum-sickness-like: fever, malaise, rash, pruritis, LAD, joint pain
Acute Hep C usually asymptomatic
APC gene role:
Intracellular adhesion and inhibition of proliferation
Boarders of femoral hernias
Medial = inguinal ligament Lateral = Femoral vein
GIT condition mimicking unstable angina
Diffuse Esophageal Spasms
- chest pain not relieved by rest and intermittent dysphagia
Carcinoid cells
Neuroendocrine: APUD/enterochromaffin
Drugs to slow down gastric motility
Loperamide and diphenoxylate - mu opioid agonists
Ribavirin MOA
interferes with duplication of viral genetic material
Causes of granulomatous bile duct destruction and lymphocyte-rich portal tract infiltrate
Primary biliary cirrhosis
Graft vs. host disease
Balloon degeneration vs bridging necrosis
Balloon = hepatocyte injury
Bridging necrosis = hepatocyte death
Increased estrogens in liver failure. mechanism and s/s
Decreased estrogen metabolism
Increase SHBG production (binds T more, increase E:T ratio)
Gynecomastia
Spider angiomas
Testicular atrophy
Decreased body hair
Ground-Glade hepatocytes =
HepB; full of HBsAg
MC watershed areas of the bowel
Splenic flexure
Distal sigmoid colon
Bioavailability (F) =
AUC oral / AUC IV
NAC mechanism
1) Glutathione substitute to detoxify NAPQI
2) Donates sulfhydryl to enhance non-toxic sulfaton elimination of acetaminophen (normal mechanisms @ low doses = sulfation and glucuronide conjugation)
Treatments for different types of nausea:
Visceral (chemo, GI bug, anesthesia) = 5HT3 antagonist
Vestibular = antimuscarinic and H1G1
Migraine = dopamine antagonists
all are antagonists
Secretin test
Normally secretin (from duodenum, in response to low pH) causes HCO3- from pancreas and inhibits gastrin release from G-cells
In ZE, secretin stimulation INCREASES gastrin levels
(ZE = ulcers past duodenal bulb
Hepatic steatosis mechanism:
1) inhibition of FA oxidation by increase NADH form alcohol metabolism
2) decrease lipoprotein synthesis and secretion
3) increased peripheral fat catabolism
Enzyme that’s inhibition leads to cholesterol stones
7a-hydroxylase
Abetalipoproteinemia s/s
Malabsorption stuff
SI with foamy cytoplasm
Acanthocytes
Neurological: progressive ataxia and retinitis pigmentosa
UC CRC vs. sporatic
- younger
- early p53 and late APC
- come form flat lesions (not polypoid)
- mucinous/signet ring
- proximal colon
- multifocal
- higher grade
cause of direct inguinal hernias; covering
Weakness of transversals fascia
Covering = only external spermatic fascia
Calculating calories
protein = 4 carbs = 4 fat = 9 ethanol = 7
