Tulane (HIGH YIELD)

Question 1

Carcinoid syndrome symptoms

Answer 1

Flushing, diarrhea

Question 2

Zollinger-Ellison syndrome pathophys, clinical signs, and associated disease(s)

Answer 2

Gastrinoma causes parietal cell hyperplasia, leading to incr. H+ secretion, multiple ulcers; gastrinemia and positive secretin test; MEN 1

Question 3

Describe the effects of acute + chronic pancreatitis on islets of Langerhans

Answer 3

Usually spared in both

Question 4

“Napkin ring” lesions are most likely to be found where?

Answer 4

Left colon

Question 5

Genes/mutations associated with Lynch syndrome, and their effect(s)

Answer 5

MMR genes: MSH2, MLH1, MSH6, PMS2 (last two less important/lower penetrance) lead to microsatellite instability

Question 6

Which cells are most important for liver fibrosis?

Answer 6

Stellate cells (aka Ito cells)

Question 7

Incr. AMA (anti-mitochondrial antibody) is diagnostic for what disease?

Answer 7

Primary Biliary Cholangitis

Question 8

“If any lesions stand out in a background of cirrhosis”

Answer 8

Think Hepatocellular Carcinoma (HCC)

Question 9

Tissue marker of HCC

Answer 9

GP3 (Glypican 3)

Question 10

PE hallmark of alcoholic cirrhosis

Answer 10

Tender hepatomegaly (obviously jaundice too)

Question 11

What type of pathogen will not cause abscesses?

Answer 11

Viruses

Question 12

“Birds beak sign” on Barium swallow esophagram

Answer 12

Achalasia

Question 13

Noteworthy symptom of trichuris trichura infection?

Answer 13

Rectal prolapse

Question 14

International travel to/from what country is associated with liver flukes (schistosomiasis)?

Answer 14

Egypt

Question 15

“If a patient presents with unexplained microcytic anemia…”

Answer 15

They have cancer until proven otherwise

Question 16

Pyloric stenosis hallmark symptom

Answer 16

Non-bilious projectile vomiting

Question 17

2 important substances absorbed in terminal ileum

Answer 17

Bile salts and vitamin B12

Question 18

Number 1 risk factor for pancreatic adenocarcinoma

Answer 18

Smoking

Question 19

Stereotypical gallstone patient

Answer 19

4 F’s: Fat, Female, Forties, Fertile

Question 20

Gross appearance of alcoholic cirrhosis

Answer 20

Micronodular

Question 21

“Anchovy paste” liver abscess

Answer 21

Entamoeba histiolytica

Question 22

Causes of ischemic bowel disease

Answer 22

Occlusive (3) & NOMI:

• Arterial emboli: acute (e.g. A fib stopped taking meds)
• Venous thrombus: chronic; think hypercoaguable state (e.g. cancer), portal HTN (causes portal stasis), DVT (systemic stasis)
• Atherosclerosis (think smokers)
• NOMI: non-occlusive; d/t renal insufficiency, dialysis, hypotension, sepsis

Question 23

Norovirus seasonality?

Answer 23

Winter (“winter vomiting virus”)

Question 24

Rotavirus stereotypical patient

Answer 24

Children < 2 y/o

Question 25

A/B cholera toxin mechanism of action

Answer 25

Attaches to GM1 ganglioside receptor, moves to ER where A1 subunit dissociates, ADP-phosphorylates Gsa protein, thusly activating adenylate cyclase (AC), leading to incr. cAMP, incr. PKA, and ultimately phosphorylation of CFTR, causing Cl- ions to be lost into the lumen

Question 26

Fasciola hepatica buzzwords

Answer 26

Think sheep, think watercress

Question 27

Embryonic origin of Meckel’s diverticulum

Answer 27

Vitelline duct