Smart Book GI Flashcards
what causes an umbilical hernia
symptoms/associations
- incomplete fusion of umbilical ring
- associated with Downs syndrome. usually reducible mass at umbilicus that sticks out more when crying
What causes Hirschsrpungs?
what is it? how do they migrate?
Failure of migration of the neural crest
congenital megacolon. they migrate cadally so rectum is always affecte
What does pus consist of?
what calls in these guys to form the pus?
Nuetrophils
Luekotriene B4, C5a, IL-8
what deficiencies should you think of when you see exclusive breast feeding.
how are these deficiencies fixed?
Deficiency of Vit D & K
Vit K: given parentarraly after birth
Vit D: supplements
where are dietary lipids absorebd in the GI tract?
bile salts/vit. B12
Jejunum
-Illeum
When you see antimitochondrial antibodies
-Primary biliary cholangitis
whats the mushroom (Amanita Phalloides) aka Deathcap MOA?
It inhibites RNA reverse transcriptase II which stops mRNA synthesis
how does carcinoid tumors present?
what do you give before surgery
Flushing, asthma, diarrhea
Octreotide
which type of cell leads to the granulomas of Chrons dz? and which cytokines do they secret?
Th-1 cells
IL-2, TNF, IFN-g
When you see Stronglyoides what should you look for in intestines and stool?
Eggs in the intestine wall
Larvae in the stool
An adult comes in w/ liver Dz, COPD, panacinar emphysema and jaundice as a kid.
You should think
Alpha 1 AntiTrypsin deficiency
what is the primary site of ribosome synthesis in a cell? and walk step by step to maturity
The Nucleolus functions as the primary site of ribosome synthesis.
Nucleolus contains ribosomal DNA that gets transcribed to rRNA where they go to the cytoplasm to get translated to fully mature proteins
Moldy grain you should think of _______. which when it makes the toxin ______, it can lead to ______ carcinoma
Aspergillus, Aflotoxin, Hepatocellular
When you see a build up of adipose tissue in the liver of an alcoholic, what causes the buildup?
The alcohol fucks with NADPH by depleting glutathione stores. so you end up with decr. free fatty acid oxidation
70 old man with a big outpouching in the esophagus (zenkers duh) but which muscles have diminished relaxation causing the outpouching?
Thyropharyngeal and cricopharyngeal (Killian Triangle)
Whats a gallstone ileus?
This is when a Cholecystenteric (gallbladder-stomach) fistula forms. and it drops straight into the Gi tract where it gets stuck at the Illeum (the narrowest part of the Gi tract)
tell me about pigment gallstones
composed of Calcium Bilirubinate
due to incr. B-glucoronidase release by injured hepatocytes. (increases the amount of unconjugated billi)
B-gluco: it deconjugates billi which leads to saturation and stone formation
tell me about Whipple disease
an infection by Tropheryma Whipplei
PAS(+) foamy macrophages
Whipped “CAN” Cardiac, Arthralgia (joints), Neurologic
Recurrant respiratory infections w/ Pseudomonas, diarrahea, and failure to thrive suggests _____
what would help treat?
Cystic fibrosis
Pancreatic enzymes
Small intestine Bacterial overgrowth. These guys will prodcue a shit ton of what two things?
what deficiencies does it lead to
Vit K and Folate
-deficiency of B12, A, D, E, and iron
What enzyme deficiency causes precipiation of Cholesterol gall stones?
what drug inhibits this enzyme
7-alpha hydroxylase
Fibrates--> lead to gall stones
What are mallory weis tears due to?
Vomiting/wretching/hiccups which causes continuous increased abdominal/intraluminal pressure
HIV patients not taking their antiretrovirals, colon lesions, vessel proliferation. Reddish violet, flat maculopapular lesions. spindle shaped tumor cells
Kaposi Sarcoma
When you see VIPoma what symptoms do you think?
what do you give to treat it?
Pancreatic islet cell tumors that secrete Vasoactive intestitnal peptide
- this increases chloride loss (water follows)
- inhibits gastric acid secretion
-Somatostatin
what bodily mechanism do we use to fight off mycobacterial infections
Interferon Gamma signaling
Whats the life cycle of Hep B?
Double stranded DNA gets into the nucleus –> transcribed to (+) RNA template–> dsDNA progeny
What do you think when you see fat cell destruction and calcium deposition
Acute pancreatitis
Where do mu receptor opoids work? and what do they do?
Causes contraction of smooth muscles in the gut
how do you differ stomach ulcers vs erosions?
Erosions: mucosal defects that dont fully extend through the muscularis mucosa
Ulcers: go into the submucosa
when testing for whipplei you use PAS. what is this PAS indicates the presence of when pink?
Glycoprotein
whats a major cause of retroperitoneal bleeding
Pancreatic injury (SADPUCKER)
What do you use for recurrant c diff infections?
Fidaxomicin
Whats the equation for Bioavaiblibity
Bioavailiabity = (AUC of oral) x dose of IV /
(AUC of iv x dose of oral)
Hernia anatomy
MDs dont LIe
medial to inferior epigastric is DIRECT through Transversalis facia
________
Lateral to inferior epigastric is indirect w/ patent processus vaginalis
Difference between Lactulose and Rifaximin
Lactulose converts ammonia to ammonium
________
Rifaximin removes ammonia producing bacteria
What stain do i use for malabsorptive problems and looking for fecal fat
Sudan Stain
how would parotitis present?
its caused by intubation, dehydration, or infection
dx by imaging
incr. serum amylase
what part of the stomach does H. pylori chill in
the prepyloric ANTRUM
