Warm Up: Med in Society

Question 1

What are the branches of the Common Hepatic Artery?

Answer 1

1) Gastroduodenal Artery
a) Ant. Sup. Pancreaticoduodenal Artery
b) R. Gastro-omental (Epiploeic) Artery
2) R. Gastric Artery
3) Hepatic Artery Proper
a) R. and L. Hepatic Artery

Question 2

What do Enterochromaffin-like cells (ECL) do?

Answer 2

Produce Histamine –> stimulates parietal cells –> Gastric Acid Production

Question 3

First line Anti-hypertensive Rx for Diabetics?

Answer 3

ACE Inhibitors (ARBs)

• Protect against diabetic nephropathy and renal disease
• Reduce the progression of proteinuira

Question 4

Features of Plummer Vinson Syndrome (3)

Answer 4

1) Dysphagia (Esophageal Webs)
2) Glossitis
3) Iron deficiency

Question 5

Dressler Syndrome

Answer 5

1) Pericarditis
- Usually 2-4 week after an MI
2) Chest Pain
3) Fever
4) Increased ESR

Question 6

What are the branches off the Common Hepatic Artery

Answer 6

1) Gastroduodenal Artery

Question 7

What is seen histologically in pt’s with Celiac Sprue (3)

Answer 7

1) Blunting of Villi
2) Hyperplastic Crypts
3) Lamina propria - lymphocytes

Question 8

Arteries off of Celiac Trunk

Answer 8

1) Left Gastric A.
2) Splenic A.
3) Common Hepatic A.
- R. Gastric A.
- Anastamose with L. Gastric A.
- Gastroduodenal A.
- Ant. Sup. Pancreaticoduodenal A.
- R. Gastro-omental A.
- Hepatic A.

Question 9

Pt with sudden sharp pain radiating towards the back.

1) Classic signs of ____
2) Chest X-ray:

Answer 9

1) Aortic Dissection

2) Widening of the Mediastinum

Question 10

Risk factors for Esophageal Cancer (2)

Answer 10

1) Adenocarcinoma (More common in USA)
- GERD
- Barrett esophagus
- Smoking
- Obesity
- Diet (Increase nitrosamines)
2) SCC (more common world wide)
- smoking
- alcohol
- Diet (Increase nitosamines)
- Achalasia
- Esophageal Webs
- Strictures

Question 11

#1 Salivary Gland Tumor
#2 Salivary Gland Tumor
Most common location for Salivary Gland Tumor

Answer 11

1) Pleomorphic Adenoma
2) Mucoepidermoid Carcinoma
- Most common MALIGNANT tumor
3) Parotid gland

Question 12

Ca Channel blockers that can treat both Hypertension and Tachyarrhythmia (2)

Answer 12

1) Diltiazem

2) Verapamil

Question 13

Disease:

1) Proximal to the Pectinate Line
2) Distal to the Pectinate Line

Answer 13

1) Adenocarcinoma, Internal Hemorrhoids (Non-Painful)

2) SCC, External Hemorrhoids (Painful)

Question 14

Side effects of Anti-hypertensive Rx

Answer 14

1) First dose orthostatic hypotension
- a1-blockers (-zosins)
2) Hypertrichosis
- Minoxidil (Rogaine)
3) Cyanide toxicity
- Nitroprusside
4) Dry mouth, sedation, with sever rebound hypertension
- Clonidine
5) Bradycardia, impotence, asthma exacerbation
- B-blockers
6) Reflex Tachycardia
- Vasodilators: Nitrates, Dihydropyridine CCBs (Ca Channel Blockers), Minoxidil, Hydralazine
7) Metabolic Alkalosis
- Loop diuretics –> Dehydration (Volume Contraction) –> Contraction Alkalosis
- Loop diuretics also lose Ca
8) Elevated anti-histone Ab –> Lupus
- Hydralazine
9) Hypercalcemia
- HTCZ (Thiazides retain Ca)

Question 15

Common prognosis of Hypertrophic Cardiomyopathy

Answer 15

Young high school athlete dies suddenly.