U-World: Block 8 (GI, Endocrine, Repro) Flashcards
Mom takes DES (Diethylstibestrol) while pregnant to a baby girl. When the baby girl is born, what defect is she likely to have due to teratogen exposure?
Reproductive tract abnormalities (vaginal clear cell adenocarcinoma, congenital Mullerian anomalies like abnormally shaped uterus)
Why should non-selective beta-blockers be used WITH CAUTION in diabetics?
Non-selective beta blockers block both beta 1 and beta 2 receptors and mask sympathetic symptoms (anxiety, tremor, palpitations) that would normally occur in hypOglycemia. So if a diabetic on one of these drugs takes too much insulin and becomes hypOglycemic, he/she may not realize it, won’t eat to restore glucose levels, and this can be dangerous!
First-born baby boy. Has visible peristalsis in the epigastrium and olive shaped mass in right upper abdomen. He vomits (non-bilious) every time he eats. Diagnosis?
Pyloric stenosis
Mild jaundice from high UCB after stress like a hiking trip or fasting. What is the diagnosis most likely?
Gilbert syndrome (reduced UGT activity, which is the enzyme in the liver hepatocytes that conjugates bilirubin…so in stress, this leads to build up of UCB, which backs up to liver—> blood)
What determines poor prognosis for colorectal cancer?
Tumor has spread to regional lymph nodes
Esophageal cancer in the middle 1/3rd of the esophagus is what type of cancer specifically? What lymph nodes can it spread to?
Squamous cell carcinoma
Drains to mediastinal (or trancheobronchial) lymph nodes
Scrotum drains into what lymph nodes?
Superficial inguinal
Abdominal pain and white lesions in the mesenteric with fat destruction and calcium deposition. What is the diagnosis?
Pancreatitis
(Premature activation of pancreatic enzymes—> auto-digestion of the pancreas—> also of the surrounding fat and that fat gets calcified)
What is the most common organ to rupture in a car accident/ trauma?
The spleen
Esophageal cancer in the lower 1/3rd of the esophagus is what type of cancer specifically? What lymph nodes can it spread to?
Adenocarcinoma (from Barrett esophagus—> dysplasia—> adenocarcinoma)
Drains to celiac and gastric lymph nodes
What hormones does somatostatin decrease/ suppress/ inhibit?
Somatostatin released by the hypothalamus inhibits GH (growth hormone).
Somatostatin released by pancreatic delta cells inhibits glucagon, insulin (insulin more so than glucagon—> hyperglycemia), secretin, CCK, and gastrin.
Thyroid carcinoma that has nuclei with finely dispersed chromatin and intracellular grooves. What is it?
Papillary carcinoma. This is describing the Orphan Annie nuclei (cleared centers) and the Psomomma bodies (calcium layering).
“Papa (papillary) and mamma (psomomma bodies) adopted Orphan Annie (Annie eye nuclei).”
How can congenital rubella present in an infant?
Mental retardation, microcephalic, deafness, blindness, cataracts, jaundice, PDA, pulmonic stenosis, and blueberry muffin rash.
What ligament in the female pelvis is most likely to be involved in ovarian torsion?
The inundibulopelvic ligament aka suspensory ligament of the ovary
What parts of the pancreas are formed by the ventral bud of the pancreas? Dorsal bud?
Ventral bud (smaller one)—> uncinate process & main pancreatic duct Dorsal bud (larger one)—> all other parts of the pancreas (body, tail, isthmus, accessory pancreatic duct) *both buds together form the head of the pancreas
What would be seen in the uterus of a patient with elevated hCG and lung masses (not pregnant)?
Proliferated cytotrophoblasts and syncitiotrophoblasts. This is choriocarcinoma.
Guy has GERD. But now presents with worsening substernal chest pain especially at night and antacids aren’t helping much at all. What is probably going on?
Esophageal ulcer
This is NOT Barrett esophagus (pre-cancer metaplasia)—that means the cells have transitioned from squamous—> columnar to cope with the excess acid, but would not cause a sudden increase in pain from acid
(Note: ulcers are not limited to the duodenum and lesser curvature of the stomach. esophageal ulcers can form from acid overtime or even from a pill you are taking)
What does “small phallus” mean?
Small penis (not fully formed)
What is vasopressin?
Another name for ADH (anti-diuretic hormone), which retains water via aquaporin channels in the collecting duct
Exposure to what teratogen may result in a baby girl being born with reproductive tract abnormalities like vaginal clear cell adenocarcinoma or an abnormal uterus?
DES (Diethylstibesterol)
*this drug used to be used to prevent miscarriage before the harm was realized. Now it has been removed from the market.
What are the 3 antibiotics that can treat C. Diff?
- Oral vancomycin
- Metronidazole
- Fidaxomicin
What is biliary atresia?
Failure to form (or early destruction of) extrahepatic biliary ducts (bile ducts outside of the liver)—> biliary obstruction within first 2 months of life
Presents with jaundice, progresses to cirrhosis
What type of cell (histo) are cervix cells?
Ectocervix (outer)—> stratified squamous (non-keratized) (like the vagina)
——-transformation zone——-
Endocervix (inner)—> simple columnar (like the uterus) (have cilia and secrete thin and watery mucus in ovulation, mucus plug in pregnancy)
Mutation in what gene would cause an early colonic adenoma to progress to a late adenoma?
KRAS mutation
(Talking about the adenoma-carcinoma sequence for colon CA development)
normal colon—> at risk colon by APC
At risk colon—> pre-cancer adenocarcinoma polyp by KRAS
Adenocarcinoma polyp—> Colon CA by TP53