UNDF - Gastrointestinal Flashcards
Internal hemorrhoids are painless and only sensitive to stretch.
They are formed from folds of mucous membrane and submucosa of the anal canal which contains varicose tributaries of which vessel?
- a. Inferior rectal artery
- b. Inferior rectal vein
- c. Middle rectal artery
- d. Middle rectal vein
- e. Superior rectal vein
= e. Superior rectal vein
Through which mechanism does aspirin damage the gastric mucosa?
- a. Delaying gastric emptying
- b. Increasing acid production from gastric chief cells
- c. Increasing mucosal blood flow
- d. Increasing surface bicarbonate by gastric parietal cells
- e. Reducing surface mucus secretion
= e. Reducing surface mucus secretion
What is the superior margin of the epiploic foramen (foramen of Winslow)?
- a. Caudate lobe of the liver
- b. Common bile duct
- c. First part of the duodenum
- d. Head of pancreas
- e. Hepatic veins
= A. Caudate lobe of the liver
The greater sac communicates with the lesser sac through the epiploic foramen of Winslow. The superior boundary is the caudate lobe of the liver. The common bile duct lies in the free edge of the lesser omentum that forms the anterior boundary. The first part of the duodenum is the inferior boundary. The posterior boundary is in the inferior vena cava.
Which artery is a branch of the superior mesenteric artery?
- a. Common hepatic artery
- b. Gastroduodenal artery
- c. Inferior pancreaticoduodenal artery
- d. Left gastric artery
- e. Splenic artery
= c. Inferior pancreaticoduodenal artery
The celiac trunk (axis) comes off from the anterior surface of the aorta at the level of T12
What passes through the structure shown?
- a. Bile only
- b. Bile + pancreatic juice + insulin and glucagon
- c. Bile + pancreatic juice only
- d. Insulin and glucagon only
- e. Pancreatic juice only
= c. Bile + pancreatic juice only
Transient lower esophageal sphincter relaxation has been implicated as a factor in gastro-esophageal reflux disease. What is the major stimulus for transient lower esophageal sphincter relaxation?
- a. A high gastric pH in the absence of food in the stomach
- b. Sensory input, primarily olfactory, via cranial nerve I
- c. Sensory input (taste) via cranial nerve IX
- d. Stimulation of mechanoreceptors by proximal gastric distention
- e. The presence of bile in the duodenum
= d. Stimulation of mechanoreceptors by proximal gastric distention
A patient complains of ‘heartburn’, present for several months. The patient’s photomicrograph of an esophageal biopsy is shown. It has been stained routinely with haematoxylin and eosin.
What is your interpretation?
- a. Accidental biopsy of gastric mucosa (possible hiatus hernia, or passing endoscope beyond lower esophageal sphincter)
- b. Metaplastic change (Barrett’s esophagus)
- c. Neoplastic change to adenocarcinoma
- d. Neoplastic change to squamous cell carcinoma
- e. Normal esophageal epithelium
= e. Normal esophageal epithelium
Which bacterium causes acute onset food poisoning by producing pre-formed toxins within incorrectly handled and stored food?
= D. Staphylococcus aureus
= E. It needs surface antigen from Hepatitis B infection for virion assembly
= D. Retroperitoneal veins
= B. AST, ALT and LDH
On the images shown, which arrow best indicates the left colic flexure?
= C
What is the best study type to provide information about why people attending a diabetes clinic do not take their medications?
= Qualitative study
List four public health interventions currently implemented in Australia to reduce Hepatitis C transmission (2 marks).
Ask about:
- SNAP (Smoking, Nutrition, Alcohol, Physical actitivyt) and readiness to change
- Early signs of skin cancer
- Complete a family history screening questionnaire
Measure:
- Weight & Height → BMI calculation & Weight circumference
- BP
- Fasting lipids
Perform:
- Colorectal cancer screening with Fecal occult blood test at least every 2 years - check pt has received kit in the mail and completed it, on turning 50
- 5 yearly cervical cancer screening (HPV test)
- Mammography for females dependent on individual degree of risk
- 23vPPV and influenza vaccination for all Aboriginal and Torres Straight Islander peoples
- Vaccination for diphtheria, tetanus (DT); dTpa should be used in place of DT when providing booster tetanus immunisations
Calculate:
- Risk of diabetes using AUSDRISK
- Review fracture risk factors for osteoporosis for women ages >45yrs and men >50yrs
- Absolute cardiovascular risk
A 54 year old male is being treated for peptic ulcer disease. Identify the cells labelled 1 and 2 on the micrograph of the fundic mucosa shown. For each of these cells state which chemical is produced. (2 marks)
This photomicrograph of the small intestine shows normal histological features. Describe what changes would be expected in a biopsy from a person with coeliac disease. (2 marks)
