UW GI

Question 1

Inhibit the rate-limiting step in cholesterol biosynthesis (HMG-CoS reductase)

Answer 1

Statins

Question 2

SE statins

Answer 2

Hepatotoxicity, muscle toxicity

Question 3

Increase lipoprotein lipase activity,
decrease hepatic VLDL secretion,
increase HDL synthesis

Answer 3

Fibrates (Gemfibrozil, fenofibrate)

Question 4

SE fibrates

Answer 4

muscle toxicity, esp when combined with statins; gallstones

Question 5

Bind bile acids in the intestine; decrease reabsorption and increase de novo synthesis form cholesterol

Answer 5

Bile acid sequestrants (cholestyramine, colestipol, colesevelam)

Question 6

Bile acid sequestrants SE

Answer 6

nausea, bloating, cramping; decreased absorption of digoxin, warfarin, and fat-soluble vitamins

Question 7

Decreased lipolysis in adipose tissue causing decreased VLDL synthesis, increased HDL by reducing clearance

Answer 7

Niacin

Question 8

Niacin SE

Answer 8

flushing, warmth, pruritius, hepatotoxicity

Question 9

Decreased cholesterol absorption at the brush border of the intestine

Answer 9

Ezetimibe

Question 10

Ezetimibe SE

Answer 10

Increased hepatotoxicity when coadministered with statins

Question 11

Decreased synthesis of mycolic acid. Bacterial catalase-peroxidase (encoded by KatG) needed to convert this drug to its active metabolite.

Answer 11

Isoniazid (INH)

Question 12

INH side effects

Answer 12

Neurotoxicity, hepatotoxicity, Pyroxidine (B6) can prevent neurotoxicity, lupus.

Question 13

The biologically active form of pantothenic acid is

Answer 13

coenzyme A

Question 14

Coenzyme A binds with oxaloacetate in the first step of the Krebs cycle to form

Answer 14

citrate and then succinyl-CoA

Question 15

Artery behind lesser curvature of stomach

Answer 15

L. gastric

Question 16

Third part of duodenum is in close association with

Answer 16

uncinate process of pancreas, SMA, + SMV

Question 17

Pts receiving TPN are at risk for biliary stones d/t

Answer 17

decreased CCK release due to the lack of enteral stimulation

Question 18

mutations associated with colitis-associated carcinoma are

Answer 18

early p53 and late APC (opposite)

Question 19

Association with gallstone ileus

Answer 19

pneumobilia (air in the biliary tract)

Question 20

Acute hepatitis on histology

Answer 20

hepatocyte ballooning degeneration and apoptosis

Question 21

C diff toxin A attracts PMNs causing

Answer 21

mucosal inflammation, loss of water into the gut lumen and diarrhea, as well as mucosal death.

Question 22

C diff toxin B causes

Answer 22

actin depolymerization, loss of cellular cytoskeleton integrity, cell death, and mucosal necrosis

Question 23

lecithinase

Answer 23

C perfringens exotoxin

Question 24

CEA

Answer 24

colon cancer

Question 25

CA-125

Answer 25

ovarian cancer (and many others)

Question 26

PSA

Answer 26

prostate cancer

Question 27

hCG

Answer 27

gestational trophoblastic dz

Question 28

AFP

Answer 28

HCC

Question 29

Dilation of sinusoids and perivenular hemorrhage

Answer 29

acute venous outflow obstruction within the liver

Question 30

substance accumulation within hepatocytes

Answer 30

Dubin-Johnson

Question 31

Intrahepatic hyadatid cysts with surrounding fibrous reaction

Answer 31

Echinococcus

Question 32

Granulomatous destruction of bile ducts

Answer 32

primary biliary cirrhosis

Question 33

Diffuse hepatic fibrosis and nodular parenchymal regeneration

Answer 33

Cirrhosis

Question 34

Pats with Crohns are prone to the development of gallstones d/t

Answer 34

increased biliary acid wasting

Question 35

This parasite can destroy the myenteric plexi in the esophagus, intestines, and ureters, causing secondary achlasia, megacolon, and megaureter, respectively

Answer 35

Trypanosoma cruzi

Question 36

The most common outcome in HBV-infected adults (>95%) is

Answer 36

complete resolution

Question 37

Lipids are predominantly absorbed in the

Answer 37

jejunum

Question 38

Histology of GERD

Answer 38

Basal zone hyperplasia, elongation of lamina propria papillae, and inflammatory cells (eos, neutrophils, and lymphocytes)

Question 39

hemochromatosis gene (HLA-H) is on the short arm of what chromosome?

Answer 39

6

Question 40

elevated ferritin

Answer 40

hemochromatosis

Question 41

histology of primary biliary cirrhosis

Answer 41

destruction of interlobular bile ducts by granulomatous inflammation ("florid duct lesion") and a heavy portal tract infiltrate of inflammatory cells

Question 42

middle-aged caucasian female with a long history of pruuritis and fatigue who develops pale stool and xanthelasma (cholestasis)

Answer 42

Primary biliary cirrhosis

Question 43

middle-aged obese female with fever and prolonged episode of RU abdominal pain after fatty meal ingestion

Answer 43

acute cholecystitis

Question 44

Male with a long history of UC presenting with fatigue and high alk phos

Answer 44

primary sclerosing cholangitis

Question 45

older female with weight loss, abdominal discomfort, jaundice, and epigastric mass

Answer 45

pancreatic cancer

Question 46

homeless male with fever, abdominal pain, jaundice

Answer 46

acute cholangitis