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USMLE > USMLE GI > Flashcards

USMLE GI Flashcards

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USMLE® Step 1 flashcards
1
Q

Liver to anterior abdominal wall

A

Falciform

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2
Q

Liver to duodenum

A

Hepatoduodenal, portal triad: hepatic artery, portal vein, common bile duct

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3
Q

Liver to lesser curvature of stomach

A

Gastrohepatic, gastric arteries

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4
Q

Greater curvature and transverse colon

A

Gastrocolic, gastroepiploic arteries

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5
Q

Greater curvature and spleen

A

Gastrosplenic, small gastric arteries, left gastroepiploic vessels

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6
Q

Spleen to posterior abdominal wall

A

Splenorenal, splenic artery and vein

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7
Q

Octreotide is a _____ analog used to treat what 4 conditions?

A 
Somatostatin
Acromegaly
Insulinoma
Carcinoid syndrome
Variceal bleeding
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8
Q

Gastrin - source

A

G cells

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9
Q

Gastrin - action (3)

A

Increase H+ secretion
Increase growth of gastric mucosa
Increase gastric motility

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10
Q

Gastrin - regulation (6)

A 
Increased by: 
stomach distention, 
alkalinization, 
amino acids, 
peptides, 
vagal stimulation
Decreased by pH
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11
Q

Somatostatin - source

A

D cells in pancreatic islets and GI mucosa

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12
Q

Somatostatin - action (4)

A

Decrease gastric acid and pepsinogen secretion
Decrease pancreatic and SI secretion
Decrease gallbladder contraction
Decrease insulin and glucagon secretion

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13
Q

Somatostatin - regulation (2)

A

Increased by acid

Decreased by vagal stimulation

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14
Q

CCK - source

A

I cells in duodenum, jejunum

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15
Q

CCK - action

A

Increase pancreatic secretion
Relax Sphincter of Oddi
Increase gallbladder contractions
Decrease gastric emptying

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16
Q

CCK - regulation

A

Increased by fatty acids and amino acids

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17
Q

Secretin - source

A

S cells (duodenum)

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18
Q

Secretin - action (3)

A

Increase pancreatic HCO3 secretion
Increase bile secretion
Decrease gastric acid secretion

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19
Q

Secretin - regulation

A

Increased by acid, fatty acids in lumen of duodenum

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20
Q

GIP (Gastric inhibitory peptide) - source

A

K cells (duodenum, jejunum)

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21
Q

GIP (Gastric inhibitory peptide) - action

A

Decrease H+ secretion

Increase insulin release

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22
Q

GIP (Gastric inhibitory peptide) - regulation

A

Increased by fatty acids, amino acids, oral glucose

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23
Q

Motilin - source

A

Small intestine

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24
Q

Motilin - action

A

Produces migrating motor complexes to stimulate intestinal peristalsis

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25
Q

Motilin - reg

A

Increased in fasting state

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26
Q

What structure lies lateral to a femoral hernia?

A

Femoral vein

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27
Q

What artery is located posterior to the duodenal bulb?

A

Gastroduodenal artery

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28
Q

1 g of protein yields how many calories of energy?

A

4 cal

29
Q

What vitamins do you need supplement a purely breastfed baby?

A

Vit D & K

30
Q

Carcinoid tumour and other neuroendocrine tumours will be positive for what?

A

Chromogranin

31
Q

Under what conditions will you see carcinoid syndrome from a carcinoid tumour

A

Metastases to liver due to first pass metabolism of serotonin

32
Q

What is the histologic hallmark of ulcerative colitis?

A

Crypt abscesses with neutrophils

33
Q

Risk of carcinoma in UC depends on what factors?

A

Extent (more = worse) and duration (>10 years) of involvement

34
Q

What is the histologic hallmark of Crohn’s disease?

A

Noncaseating granulomas with lymphoid aggregates

35
Q

What test do you need to dx Hirschsprung’s?

A

Rectal suction biopsy

36
Q

What condition is Hirschprung’s classically associated with?

A

Down Syndrome

37
Q

What are the complications of a diverticulum?

A

Rectal bleeding (hematochezia)
Diverticulitis
Fistula

38
Q

Where in the colonic wall is particularly susceptible to diverticulum formation?

A

Where vasa recta perforate the muscularis propria

39
Q

What protects against the Adenoma-carcinoma sequence?

A

Aspirin, by blocking COX

40
Q

What increases the risk of progression from colonic adenoma to carcinoma?

A
  1. > 2cm
  2. Sessile growth (flat)
  3. Villous histology
41
Q

What cancers are colorectal carcinomas associated with?

A

Endometrial
Ovarian
Skin

42
Q

What is CEA useful for in Colon CA?

A

Treatment response and recurrence; NOT screening

43
Q

What is the first enzyme that is activated in acute pancreatitis?

A

Trypsin

44
Q

What is a complication of an annular pancreas?

A

Duodenal obstruction

45
Q

What do you think of when you see a thin elderly person with new onset T2DM?

A

Pancreatic cancer in the body/tail.

46
Q

What biomarker is associated with pancreatic cancer?

A

CA 19-9 (more specific than CEA)

47
Q

What do you think of when you see an elderly woman with new onset cholecystitis?

A

Gallbladder carcinoma

48
Q

What causes dark urine in gallbladder problems?

A

Excessive urubilinogen

49
Q

What is the mechanism by which phototx resolves physiologic neonatal jaundice?

A

Converts unconjugated bilirubin to a water-soluble form

50
Q

A surgeon is operating and finds a pitch black liver. What condition does this patient have?

A

Dubin Johnson Syndrome

51
Q

What do you worry about in a pregnant woman with Hep E?

A

Fulminant hepatitis

52
Q

What cell mediates fibrosis in cirrhosis?

A

Stellate cell

53
Q

In what condition will you find Mallory bodies and what do they contain?

A

Alcoholic hepatitis, contain damaged keratin filaments

54
Q

What is the mechanism of injury in hemochromatosis?

A

Free radical generation

55
Q

What marker do you look for in primary biliary cirrhosis?

A

Anti-mitochondrial antibody

56
Q

What is damaged in Reye syndrome?

A

Hepatic mitochondria

57
Q

Hepatic adenomas are related to what drug use?

A

OCP, will go away with cessation

58
Q

What tumour marker is used in hepatocellular carcinoma?

A

Alpha-fetoprotein

59
Q

Bloody diarrhea from E. Coli produces a substance that inhibits protein synthesis. What is this substance and what is it most similar to?

A

Shiga-like toxins, shigella.

60
Q

Prolonged cholestasis can lead to poor absorption of fat soluble vitamins, leading to what condition?

A

Osteomalacia

61
Q

Direct vs indirect inguinal hernia?

A

Medial and lateral to inferior epigastric artery

62
Q

What organ is derived from mesoderm but supplied by foregut vessel?

A

Spleen

63
Q

What hematologic side effect do you see with alcoholism?

A

Macrocytosis

64
Q

Cecum stuck to RUQ. What happened?

A

Midgut failed to rotate around SMA

65
Q

What is another name for lactose?

A

Galactosyl B-1,4-glucose

66
Q

PAS = stain for what?

A

Glycoprotein

67
Q

Recurrent pseudomonas infections =?

A

CF

68
Q

Cancer in 3rd part of duodenum invades what structure?

A

SMA

USMLE (23 decks)

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