1
Q
What are the borders of the foregut?
A
pharynx to duodenum
2
Q
What are the borders of the midgut?
A
duodenum to proximal 2/3 of transverse colon
3
Q
What are the borders of the hindgut?
A
distal 1/3 of transverse colon to anal canal above pectinate line
4
Q
What is gastroschisis?
A
extrusion of abdominal contents through abdominal folds
5
Q
Is gastroschisis covered by peritoneum?
A
no
6
Q
What is an omphalocele?
A
protrusion of abdominal contents through the umbilicus
7
Q
What does the E of SAD PUCKER stand for?
A
Rectum
8
Q
Duodenal atresia is a common defect in what disease?
A
Down’s Syndrome
9
Q
What week does the midgut herniate through the umbilical ring? What week does it return?
A
herniate = 6th week
return = 10th week
10
Q
What week does the midgut rotate? Around what vessell?
A
rotate = 10th weeks
SMA
11
Q
Pyloric stenosis manifests at what age?
A
2-6 weeks
12
Q
What does the V of VACTERL stand for?
A
vertebral defects
13
Q
What does the C of VACTERL stand for?
A
cardiac defects
14
Q
What does the T of VACTERL stand for?
A
tracheoesophageal fistula
15
Q
What does the E of VACTERL stand for?
A
esophageal atresia
16
Q
What does the R of VACTERL stand for?
A
renal and radial defects
17
Q
What does the L of VACTERL stand for?
A
limb defects
18
Q
What part of the gut is the pancreas derived from?
A
foregut
19
Q
Which bud, ventral or dorsal, forms the uncinate process?
A
ventral
20
Q
What pancreatic bud is defective during annular pancreas?
A
ventral bud
21
Q
What does the S of SAD PUCKER stand for?
A
suprarenal glands
22
Q
What does the A of SAD PUCKER stand for?
A
aorta and IVC
23
Q
What does the D of SAD PUCKER stand for?
A
2-4th part of duodenum
24
Q
What does the P of SAD PUCKER stand for?
A
pancreas (except the tail)
25
What does the U of SAD PUCKER stand for?
ureters
26
What does the C of SAD PUCKER stand for?
descending and ascending
27
What does the K of SAD PUCKER stand for?
kidney
28
What does the K of SAD PUCKER stand for?
kidney
29
What does the E of SAD PUCKER stand for?
esophagus
30
What is the function of the falciform ligament?
attach liver to anterior abdominal wall
31
What is the falciform ligament a remnant of?
ligamentum teres hepatis
fetal umbilical vein
32
What is the falciform ligament a remnant of?
ligamentum teres hepatitis
33
What three structures are contained within the hepatic triad?
common bile duct
portal vein
proper hepatic artery
34
From inside to out, what are the four layers of the stomach?
1. mucosa
2. submucosa
3. muscularis mucosa
4. serosa
35
What are the two layers of the mucosa?
epithelium
lamina propria
36
In what layer of the GI tract is Meissner's plexus contained?
submucosa
37
What is the 4th layer of GI tract in the intraperitoneum?
serosa
38
What is the 4th layer of GI tract in the intraperitoneum?
serosa
39
What is the 4th layer of GI tract in the retroperitoneum?
adventitia
40
What part of the GI tract are Brunner's glands located?
Duodenum
41
What layer of the GI tract are Brunner's glands located?
Submucosa
42
What do Brunner's glands secrete?
bicarb
43
What are plicae circulares? Where are the plicae circulares located?
circular folds
jejunum
44
Where in the GI tract features the largest collection of goblet cells?
ileum
45
Where in the GI tract features the largest collection of Crypts of Lieberkuhn?
ileum
46
What arteries does the common hepatic artery branch into?
proper hepatic
gastroduodenal
47
What arteries does the common hepatic artery branch into?
proper hepatic
right gastric
48
What two vessels does a TIPS procedure connect?
portal vein to hepatic vein
49
What is significant about the pectinate line?
where endoderm meets ectoderm
50
What type of hemorrhoids occur above the pectinate line?
internal hemorrhoids
51
What type of cancer occurs above the pectinate line?
adenocarcinoma
52
What is the arterial supply of the rectum superior to the pectinate line?
superior rectal artery
53
What is the venous drainage of the rectum superior to the pectinate line?
superior rectal vein
54
What type of cancer would occur below the pectinate line?
squamous cell carcinoma
55
What is the arterial supply of the rectum below the pectinate line? Branch of?
inferior rectal artery
internal pudendal
56
What is the venous drainage of the rectum below the pectinate line?
inferior rectal vein
57
What are Kupffer cells?
macrophages in the liver
58
What cell in the liver is responsible for liver fibrosis?
Stellate cell
59
What zone of the hepatic lobule is most effected by ingested toxins and viruses?
zone 1
60
What zone of the hepatic lobule is most effected by ischemia?
Zone 3
61
What zone of the hepatic lobule most susceptible to metabolic toxins?
three
62
What zone of the hepatic lobule is the site of alcoholic damage?
zone 3
63
What zone of the hepatic lobule is the site of cytochrome p450?
zone 3
64
Regarding the femur, does NAVEL go from lateral to medial or medial to lateral?
lateral to medial
65
What three structures form the femoral triangle?
inguinal ligament
sartorius
adductor longus
66
What inguinal ring does an indirect hernia penetrate? What muscle layer?
deep ring
transversus abdominis
67
What inguinal ring does an indirect hernia penetrate? What muscle layer?
deep ring
transversalis fascia
68
If a hernia occur medial to the inferior epigastric atery, what type is it?
direct
69
If a hernia occur medial to the inferior epigastric atery, what type is it?
direct
70
If a hernia occur lateral to the inferior epigastric atery, what type is it?
indirect
71
Are femoral hernias more common in males or females?
females
72
What are the borders of hesselbechs triangle?
rectus abdominus
inferior epigastric artery
inguinal ligament
73
What does the I-cell secrete? What are the two locations of the I-cells?
CCK
duodenum and jejunum
74
What does CCK do to pancreatic secretions?
increase
75
What does CCK do to gallbladder contractions?
increases contrations
76
What does CCK do to gastric emptying?
decrease
77
What does CCK do to the Sphincter of Oddi?
relax
78
What two substances trigger the release of CCK?
fats and amino acids
79
What cell release gastrin? Where is this cell found?
G-cells
antrum of stomach
80
What does gastrin do to gastric acid secretion?
increase
81
What does gastrin do to gastric mucosa?
increase
82
What does gastrin do to gastric motility?
increase
83
What two amino acids are potent stimulators of gastrin?
Trp and Phe
84
What cells release glucose-dependent insulinotropic hormone? Where are these cells found?
K-cells
duodenum and jejunum
85
What does GIP due to gastric acid secretion?
decrease
86
What does GIP due to insulin release?
increases insulin release
87
What are the three triggers for the release of GIP?
fatty acids
amino acids
oral glucose
88
Where is motilin released from?
small intestine
89
What is the function of motilin?
induce MMCs
90
When does motilin release most often occur?
fasting state
91
What drug is a motilin receptor agonist?
erythromycin
92
What type of cells release secretin? Where are these cells?
S-cells
duodenum
93
What does secretin do to bicarb secretion?
increase
94
What does secretin do to bile secretion?
increase
95
What does secretin do to gastric acid release?
decrease
96
What type of cells release somatostatin?
D-cells
97
What does somatostatin do to gastric acid secretion?
decrease
98
What does somatostatin do to pepsinogen release?
decrease
99
What does somatostatin due to intestinal fluid release?
decrease
100
What does somatostatin do to gallbladder contraction?
decrease
101
What does somatostatin do to insulin release?
decrease
102
What does somatostatin do to glucagon release?
decrease
103
What increases somatostatin release?
acid
104
What decreases somatostatin release?
vagal stimulation
105
What two neurotransmitter are implicated during achalasia?
NO and VIP
106
What structure releases VIP?
parasympathetic ganglia
107
What does VIP do to intestinal water secretion?
increase
108
What does VIP do to intestinal electrolyte secretion?
increase
109
What does VIP do to intestinal smooth muscle contraction and sphincters?
relax
110
What two factors increase VIP release? What decreases VIP release?
distension and vagal tone
adrenergic tone
111
What is the mnemonic for the symptoms of a VIPoma?
WDHA
112
Regarding a VIPoma, what does the W and D of WDHA stand for?
Watery Diarrhea
113
Regarding a VIPoma, what does the H stand for?
Hypokalemia
114
Regarding a VIPoma, what does the A stand for?
achlorhydria
115
Regarding a VIPoma, what does the A stand for?
achlorhydia
116
What type of cell is pepsinogen released from? What activates pepsinogen into pepsin?
chief
H+
117
Where are Brunners glands located? What do Brunners glands secrete?
duodenum
bicarb
118
What hormone increaes the pancreatic secretin of bicarb?
secretin
119
Atropine will block acid secretion of what cells? The acid secretion of what cells will not be affected?
parietal
g-cells
120
Gastrin release leads to increased acid secretion by what mechanism?
stimulation of ECL cells to secrete histamine
121
What hormone leads to the release of gastrin?
gastrin releasing peptide (GRP)
122
What is the tonicity of pancreatic secretions?
isotonic
123
What ion is low flow pancreatic secretion rich in?
chloride
124
What ion is high flow pancreatic secretion rich in?
bicarb
125
What G-protein will somatostatin activate on gastric parietal cells?
Gi
126
What two 2nd messengers will activate the H+/K+ ATPase?
Ca2+ and cAMP
127
When do Brunner's glads hypertrophy?
duodenal ulcer
128
What ion is released during low flow pancreatic secretions?
chloride
129
What ion is released during high flow pancreatic secretions?
HCO3
130
What four peptidases are released from the pacreas as zymogens?
trypsin, chymotrypsin, elastase and carboxypeptidase
131
What is the enzyme responsible for activating other zymogens?
trypsin
132
What two monosaccharides are taken up by SGLT1? What ion is this dependent on?
glucose and galactose
sodium
133
What monosaccharide is taken up by GLUT5?
fructose
134
What monosaccharides are taken up by GLUT2?
glucose, galactose and fructose
135
What drug is used to Dx pancreatic insufficiency?
D-Xylose
136
Where in the GI tract is iron absorbed? In what oxidation state?
duodenum
Fe2+
137
Where in the GI tract is folate absorbed?
jejunum and ileum
138
Where in the GI tract is B12 absorbed?
terminal ileum
139
Where in the GI tract are bile salts absorbed?
terminal ileum
140
In what two layers of the GI tract are Peyer's patches located?
Submucosa and lamina propria
141
In what part of the GI tract are Peyer's patches located?
ileum
142
What type of specialized cells are contained in Peyer's patches?
M-cells
143
What is the function of M-cells?
sample and present antigens to immune cells in Peyers patches
144
What three genus of bacteria can attach to M-cells and be transported across the intestinal epithelium?
Shigella, Salmonella and Yersinina
145
What specific virus can use M-cells to be transported across Mcells?
CXCR4 HIV
146
Stimulated plasma cells located in Peyer's Patches secrete what type of immunoglobulin? What layer do these Plasma cells eventually reside?
IgA
lamina propria
147
What two prosthetic groups are bile acids attached to?
glycine and taurine
148
What enzyme is the RLS of bile salt synthesis?
Cholesterol 7α-hydroxylase
149
What is bilirubin conjugated to?
glucoronate
150
Which form, direct or indirect, of bilirubin is conjugated to glucoronate and is water soluble?
direct = conjugated
151
What protein carries unconjugated bilirubin in the blood stream?
albumin
152
What is the RLS enzyme of bilirubin degradation?
UDP-glucoronosyl Transferase
153
What turns conjugated bilirubin into Urobilinogen?
gut bacteria
154
How is bilirubin secreted into urine? Fecess?
urine = urobilin
feces = stercobilin
155
What gland do most salivary gland tumors present in?
parotid
156
What is the most common benign type of salivary gland tumor?
pleomorphic adenoma
157
What are the two most common components of a pleomorphic adenoma?
stromal
epithelial cells
158
What is the name for a benign cystic tumor of the salivary glands? What is another name for this tumor?
Warthin Tumor
Papillary Cystadenoma Lymphomatosum
159
What structure is contained within a Papillary Cystadenoma Lymphomatosum?
germinal centers
160
What are the two prevalent cell types of a mucoepidermoid adenoma?
mucinous and squamous
161
What plexus is defective in Achalasia?
Myenteric / Auerbach
162
A pt with achalasia has a greater chance of developing what type of cancer?
squamous cell carcinoma
163
What disease may produce achalasia?
Chagas
164
What bug causes Chagas?
T. .cruzi
165
What three organs succumb to Chagas disease?
Heart failure
colon
esophagus
166
What is Boerhaave Synrome? What usually causes Boerhaave Syndrome?
Transmural distal Esophageal Rupture
violent retching
167
What is atopy?
predisposition to develop hypersensitive allergic rxns
168
Esophageal strictures are associated with what two happenings?
lye ingestion
alcohol consumption
169
What causes esophageal varices?
portal hypertension
170
Other than relfux, what is esophagitis associated with?
immunocompromised individuals
171
What three pathogens cause the majority of esophagitis cases?
Candida, HSV-1 and CMV
172
How does Candidia esophagitis present?
white film
173
How does HSV-1 esophagitis present?
punched out lesions
174
How does CMV esophagitis present?
linear ulcers
175
What is Mallory-Weiss Syndrome? What does Mallory-Weiss syndrome lead to?
gastro-esophageal syndrome
hematemesis
176
What two types of pt's present with Mallory-Weiss Syndrome?
alcoholics and bulimics
177
What does the C of CREST stand for?
calcinosis
178
What does the R of CREST stand for?
raynauds
179
What does the E of CREST stand for?
Esophageal dysmotility
180
What does the S of CREST stand for?
sclerodactyly
181
What does the T of CREST stand for?
telangiectasia
182
What is the pathogenesis of Sclerodermal Esophageal Dysmotility?
esophageal smooth muscle atrophy
183
What is the metaplasia that takes place during Barrett's Esophagus?
NKSS to non-ciliated epithelium with goblet cells
184
What type of cancer can Barrett's esophagus give rise to?
Adenocarcinoma
185
What are the two histologies of esophageal cancer?
Squamous cell carcinoma
adenocarcinoma
186
What part of the esophagus does squamous cells carcinoma likely to develop?
upper 2/3
187
What part of the esophagus does adenocarcinoma likely to develop?
lower 1/3
188
What is the mnemonic to remember the causes of esophageal cancer?
AABCDEFFGH
189
What do the A's of AABCDEFFGH stand for?
achalasia and alcohol
190
What type of esophageal cancer does alcohol predispose to?
squamous
191
What does the B of AABCDEFFGH stand for? What type of cancer does this predispose a pt to develop?
Barrett's
adeno
192
What does the C of AABCDEFFGH stand for? What type of cancer does this predispose a pt to develop?
cigarettes
both
193
What does the D of AABCDEFFGH stand for? What type of cancer does this predispose a pt to develop?
Diverticula (Zenker)
squamous
194
What is a Zenkers Diverticulum? True or false?
Pharyngo-Esophageal
false
195
What does the E of AABCDEFFGH stand for? What type of cancer does this predispose a pt to develop?
esophageal web
squamous
196
Where in the esophagus do esophageal webs develop?
upper esophagus
197
What layers of the esophagus are effected by esophageal webs?
mucosa and submucosa
198
What are esophageal webs associated with?
chronic iron deficient anemia
199
What do the F's of AABCDEFFGH stand for?
fat and familial
200
Obesity is associated with what type of esophageal neoplasia?
adeno
201
What does the G of AABCDEFFGH stand for? What type of cancer does this predispose a pt to develop?
GERD
adeno
202
What does the H of AABCDEFFGH stand for? What type of cancer does this predispose a pt to develop?
Hot liquids
203
What is acute gastritis?
disruption of mucosal layer of stomach
204
What causes a Curling's ulcer? What happens? Why?
Burns
decreased plasma volume
sloughing of gastric mucosa
205
Where is the GI tract do Curling's Ulcers arise?
duodenum
206
What causes a Cushing's Ulcer? Why? What is produced?
elevated intracranial pressure
too much vagal tone
excessive acid
207
What is Type A Chronic Gastritis caused by? What is Type B Chronic Gastritis caused by?
A = autoimmune
B = H. pylori
208
Where do Type A chronic gastritis ulcers occur?
fundus/body
209
Where do Type B chronic gastritis ulcers occur?
antrum
210
Where in the stomach does H. pylori adhere itself? What two types of cancer can H. pylori cause?
antrum
gastric adenocarcinoma and MALT lymphoma
211
What macromolecule is lost during Menetrier disease?
protein
212
What cell atrophies during Menetrier disease?
parietal cell
213
What cells undergoes hyperplasia during Menetrier disease?
mucus cell
214
Menetrier disease is associated with excess of what cytokine?
TGF-β
215
Stomach cancer is almost always what type of cancer?
adenocarcinoma
216
What are the two common locations of stomach cancer metastasis?
nodes and liver
217
What dermatological condition can arise during stomach cancer?
acanthosis nigricans
218
What group of nodes are most likely to present with a metastasis during stomach cancer?
Virchow
219
What type of dietary carcinogen is associated with gastric cancer?
nitrosamines
220
Is stomach cancer more commonly on the greater curvature or lesser curvature?
lesser
221
What is a Krukenberg tumor? What type of cells are found in this tumor?
bilateral metastasis to ovary
signet ring cell
222
What is a Sister Mary Joseph nodule?
periumbilical metastasis
223
What type of cell is present in a Krukenburg Tumor?
signet ring cell
224
Which H2R is a potent inhibitor of Cyp p450?
Cimetidine
225
Which two H2R blockers decrease creatinine release?
cimetidine and rinatidine
226
The use of PPI's increase the risk of what type of infection?
C. difficile
227
Long term PPI use can cause a decrease in what metal ion?
magnesium
228
Which H2R is a potent inhibitor of Cyp p450?
Cimetidine
229
What drug is used to maintain a PDA?
misoprostol
230
What osmotic laxative can be used to treat hepatic encephalopathy? Why?
lactulose
acetic acid and lactic acid bind to NH4 and promote their excretion
231
Which type of ulcer improves with meals?
duodenal
232
Which type of cancer worsens with meals?
gastric
233
H. pylori infection is almost always associated with what type of ulcer?
Duodenal
234
Would Zolliner-Ellison cause a gastric or duodenal ulcer?
duodenal
235
Which types of ulcers are almost always benign?
duodenal
236
What cell hypertrophies with a Duodenal ulcer?
Brunner
237
How is Tropical Sprue Treated?
antibiotics
folate
238
What type of macrophages are seen in Whipple Disease?
foamy
239
How does WHipple Disease stain? What layer?
PAS positive
lamina propria
240
What is the triad of symptoms in Whipple Disease? What is the mneminoc to remember the symtpoms?
Cardiac/Arthralgia/Neurology
CAN
241
What two haplotypes are seen in celiac sprue?
DQ2 and DQ8
242
Antibodies against what three antigens are found in Celiac Sprue?
endomysium
gliadin
tissue transglutaminase
243
What type of immune cell is present during celiac disease? What specific lamina propria in the GI tract?
lymphocyte
lamina propria
244
Serum levels of what protein are used to diagnose celiac disease?
tissue transglutaminase
245
Dermatitis herpetiformis is associated with what other disease?
Celiac
246
What structure is affected during Dermatitis herpetiformis?
Dermal papillae
247
What antibody deposits during Dermatitis Herpetiforms?
IgA
248
What cancer can celiac disease increase the chance of developing?
T-cell lymphoma
249
Lactose Intolerance can be diagnosed if the glucose levels rise below what level after a meal?
20 mg/dL
250
What part of the GI tract is least likely to be affected during Crohns?
rectum
251
Which form of IBS presents with pseudopolyps?
UC
252
What two immune structures are found during Crohns?
lymphoid aggregrates
non-caseating granulomas
253
What immune structure are found during UC? Wich immune cells?
Crypt abscesses
neutrophils
254
Which form of IBS can present with sclerosing cholangitis?
UC
255
Which form of IBS can present with toxic megacolon?
UC
256
Which form of IBS could present with bloody stool?
UC
257
Which GI disease presents with pain that improves with defecation?
IBS
258
What is the cause of appendicitis in adults? Kids?
Adults = fecalith
kids = lymphoid hyperplasia
259
What is the most common location for a colonic diverticula?
sigmoid
260
Diverticulosis is associated with which type of diet?
diet low in fiber
261
Where does a Zenker diverticulum often arise?
Pharyngo-esophageal junction
262
Are Zenker's true or false diverticula?
false
263
What is the pathological anatomy behind a Meckel's diverticulum?
persistence of Vitelline/omphalomesenteric duct
264
What two types of tissues can be found in a Meckels Diverticulum?
gastric mucosal or pancreatic
265
Is Meckels Diverticulum a true or false diverticulum?
true
266
What stain is used to diagnose a Meckel's Diverticulum? What type of tissue does this stain identify?
Pertechnetate
gastric tissue
267
Where is itussusception most commonly found?
ileo-cecal junction
268
What disease most often presents with a 'Currant Jelly' stool?
Intussusception
269
What type of volvulus is most common in the elderly?
sigmoid
270
What is the most common area for a volvulus in a child or infant?
midgut
271
Hirschsprung Disease is associated with what gene?
RET
272
Hirschsprung Disease is most common in patients with what other type of disease?
Down's Syndrome
273
What three locations is angiodysplasia most often found?
ileum, cecum and ascending colon
274
Is angiodyaplasia more common in elderly or young patients?
elderly
275
Duodenal atresia is associated with what other disease?
Down Syndrome
276
How does duodenal atresia present on X-ray?
double bubble
277
What is the most common location for Ischemic Colitis? Why?
splenic flexure
watershed of SMA
278
How does ischemic colitis often present?
pain after eating
279
A meconium ileus is common in patients with what disease?
cystic fibrosis
280
What patient group has the largest chance of necrotizing enterocolitis?
premature infants
281
What part of the GI tract is most commonly effected during necrotizing enterocolitis?
colon
282
What layer of the GI tract is most effected by necrotizing enterocolitis?
mucosa
283
What is the mode of inheritance for Peutz Jeghers?
Autosomal Dominant
284
What chromosome is APC located on?
5q
285
Other than FAP, what two cancers can arise in Gardner Syndrome?
osteoma
fibromatosis
286
Other than FAP, what cancer can arise in Turcot Syndrome?
brain tumors
287
What is the mode of inheritance for HNPCC?
autosomal dominant
288
What part of the GI tract is HNPCC always involved in?
proximal colon
289
What is the most common site for colorectal carcinoma to arise?
recto-sigmoid
290
How does right sided colorectal carcinoma present?
iron deficiency anemia
291
What bacteria, though rare, would be suggestive of colorectal carcinoma?
Strep. bovis
292
What is the sign of a colorectal carcinoma on a barium enema?
Apple core
293
Microsatellites are indicative of mutation in what genes?
DNA mismatch repair
294
In order,loss of what three genes are implicated in colorectal carcinoma?
APC, K-ras and p53
295
What three disease would present with elevated ALP?
biliary obstruction
hepatocellular carcinoma
bone disease
296
During viral hepatitis which is more elevetaed, AST or ALT?
ALT
297
During alcoholic hepatitis which is more elevated, AST or ALT?
AST
298
What two disease can present with increased serum amylase?
acute pancreatitis and mumps
299
Is Ceruloplasmin increased or decreased during Wilsons disease?
decreased
300
What serum marker is the most specific for acute pancreatitis?
serum amylase
301
What is the diagnostic value of GGT and ALP?
GGT is not elevated in bone disease
302
What two organs does Reye Syndrome primarily effect?
Hepatoencephalopathy
303
What two viruses are most commonly involved in Reye SYndrome?
VZV and influenza B
304
What organelle is abnormal during Reye Disease?
mitochondria
305
What immune cell invades during alcoholic hepatitis?
neutrophil
306
What are Mallory Bodies composed of?
cytokeratin
307
What liver enzyme is increased during alcoholic hepatitis? To what ratio?
AST
1.5x
308
Where does alcoholic cirrhosis occur in the hepatic lobule?
central vein
309
What is the pattern of liver enzyme levels in non-alcoholic fatty liver disease?
ALT > AST
310
What drug is used to remove ammonium from the circulation?
lactulose
311
Which antibiotic is used to treat hyperammonemia?
Rifaximin
312
Hepatitis B and C can give rise to what liver cancer?
HCC
313
Wilsons disease can cause what type of cancer to develop?
HCC
314
Hematochromatosis can cause what type of cancer to develop?
HCC
315
α1 anti-trypsin deficiency can give rise to what cancer?
HCC
316
What type of cancer can Aflatoxins give rise to?
HCC
317
What is the diagnostic marker for HCC?
α-fetoprotein
318
What two compounds can give rise to angiosarcoma?
arsenic and vinyl chloride
319
What two conditions can give rise to Nutmeg liver?
right-sided heart failure
Budd-Chiari Syndrome
320
What stain can be used for α1 anti-trypsin deficiency?
PAS
321
What type of emphysema would α1 anti-trypsin deficiency present with?
panacinar
322
What enzyme is defective during Crigler-Najjar Syndrome?
UDP glucoronosyltransferase
323
What enzyme is deficient during Crigler-Najjar and Gilbert Syndrome?
UDP-glucoronosyltransferase
324
In what disease is UDP-glucoronosyltransferase absent? What does this lead to an elevation of?
Crigler-Najjar
highly elevated unconjugated bilirubin
325
In what disease is UDP-glucoronosyltransferase reduced? What does this lead to an elevation of?
Gilbert
mildly elevated unconjugated bilirubin
326
What form of bilirubin accumulates during Dubin Johnson Syndrome?
conjugated bilirubin
327
What enzyme may be deficient during neonatal jaundice?
UDP-glucoronosyltransferase
328
What drug can be used to treat Cirggler-Najjar Syndrome? Why? Which type?
phenobarbital increases hepatic enzyme synthesis
Type II
329
What disease can produce a black liver?
Dubin-Johnson
330
What is the problem in Dubin-Johnson Syndrome?
defective excretion of conjugated bilirubin
331
What is the problem in Gilbert Syndrome?
bilirubin uptake
332
What is the problem in Crigler-Najjar?
bilirubin conjugation
333
Where in the eye does copper accumulate during Wilsons disease?
cornea
334
Where in the eye does copper accumulate during Wilsons disease?
Basal ganglia
335
What two drugs are used to treat Wilsons disease?
Penicillamine
trientine
336
What type of movement can Wilsons disease produce?
Asterixis
337
What blood disorder can wilsons disease produce?
hemolytic anemia
338
What are the three D's of Wilsons disease?
dysarthria/dyskinesia/dementia
339
What is the triad of hemochromatosis?
micronodular cirrhosis
diabetes mellitus
skin pigmentation
340
What organ can fail during hemochromatosis?
heart failure
341
What can atrophy during Hemochromatosis?
testicular atrophy
342
What haplotype is hemochromatosis associated with?
HLA-A3
343
What two drugs is hemochromatosis treated with?
deferasirox
deferoxamine
344
What are the two appearances of primary sclerosing choangitis ?
onion skin
beaded
345
What two types of immune cells are present during Primary Biliary Cirrhosis?
lymphocytic infiltrate
granulomas
346
What is the cause of Secondary biliary Cirrhosis?
extrahepatic biliary cirrhosis
347
What are the five classical presentations for Biliary tract disease?
pruritis
pale stool
jaundice
splenomegaly
dark urine
348
What is secondary biliary cirrhosis complicated by?
ascending cholangitis
349
What specific bile duct obstruction presents with an auto-antibody? What is the antibody against? What angiten?
Primary Biliary Sclerosis
anti-Mitochondrial
PDC-E2
350
What other type of disease is primary biliary cirrhosis associated with?
autoimmune disease
351
What bile tract disease can present with hypergammaglobulinemia? Which immunoglobulin?
Primary sclerosing cholangitis
IgM
352
What disease is associated with the four F's? What are the four F's?
cholelithiasis
fat/forty/female/fertile
353
Which cholesterol stones are radio-opaque?
bilirubin
354
Which cholesterol stones are radio-lucent?
cholesterol
355
Which type of gall stones would Crohns disease likely present with?
cholesterol
356
Which type of gall stones would cystic fibrosis likely present with?
cholesterol
357
Which type of gall stones would clofibrate therapy likely present with?
cholesterol
358
Which type of gall stones would females likely present with?
cholesterol
359
Cholesterol gallstones can be present in what ethnic group?
Native Americans
360
Which type of gall stones would alcoholic cirrhosis likely present with?
bilirubin
361
Which type of gall stones would biliary obstruction likely present with?
bilirubin
362
What is biliary colic?
gall stone obstructing cystic duct
363
What is hormonal signal for gallbladder contraction?
CCK
364
How is duodenal colic diagnosed?
air in biliary tree
365
What is the most common cause of cholecystisis ?
cholelithiasis
366
What lab is order to Dx cholecystitis?
ALP
367
What are the three labs for Secondary Biliary Cirrhosis?
↑ ALP
↑ cholesterol
↑ UNconjugated bilirubin
368
What is the main cause of porcelain gall bladder?
chronic cholecystitis
369
What is the Tx for porcelain gallbladder?
cholecystectomy
370
What is the reason behind treating porcelain gallbladder by removal?
to avoid carcinoma
371
What is the mnemonic to remember Acute Pancreatitis?
GET SMASHHED
372
What is the G of GET SMASHED?
gall stones
373
What are the two E's of GET SMASHED?
ethanol
endoscopic retrograde cholangiopancreatography
374
What is the T of GET SMASHED?
trauma
375
What is the S of GET SMASHED?
steroids
376
What are the H's of GET SMASHED?
hypertriglyceridemia (> 1,000)
Hypercalcemia
377
What is the D of GET SMASHED?
drugs (sulfa)
378
Where does acute pancreatitis radiate?
back
379
What are the two labs for acute pancreatitis? Which is more specific?
Amylase and lipase
lipase = more specific
380
What two potentially fatal diseases can acute pancreatitis lead to?
ARDS and DIC
381
What ion disturbance can acute pancreatitis produce?
hypocalcemia
fat necrosis of peri-pancreatic fat requires Ca2+
382
What can rupture during Acute Pancreatitis?
pseudocyst
383
What happens to the pancreas during Chronic Pancreatitis?
calcification
384
What type of cancer can Chronic Pancreatitis lead to?
adenocarcinoma
385
What is the difference in labs between acute and chronic pancreatitis
amylase and lipase may not be elevated during chronic pancreatitis
386
What can Chronic Pancreatitis lead to?
pancreatic enzyme deficiency
387
Where is the most common location for a pancreatic adenocarcinoma?
head
388
What are the two markers for pancreatic adenocarcinoma? Which is more specific?
CA 19-9 and CEA
CA 19-9 = more specific
389
What are the two major risk lifestyle risk-factors for pancreatic adenocarcinoma?
tobacco
diabetes
390
What two ethnicities present with pancreatic adenocarcinoma the most often?
Jewish and AA males
391
What finding on physical exam may suggest pancreatic adenocarcinoma?
migratory thrombophlebitis
392
Would the gallbladder be palpable or non-palpable during pancreatic adenocarcinoma?
non-palpable
393
Is H2 blockade by -dine reversible or irreversible?
reversible
394
PPIs increase the risk of infection from what organism?
C. difficile
395
What ion can PPIs deplete?
magnesium
396
What are the four uses of octreotide?
variceal bleeds, acromegaly, VIPoma, Steatorrhea
397
When is misoprostol contraindicated? Why?
pregnancy
can induce uterine contractions
398
Which antacid can cause constipation?
aluminum hydroxide
399
Which antacid can cause hypophosphatemia?
aluminum hydroxide
400
What drug can calcium carbonate deplete?
tetracyclines
401
Which antacid can cause diarrhea?
magnesium hydroxide
402
What is inflixamab an antibody against?
TNF
403
Which four diseases can be treated by inflixamab?
IBS, Rheumatoid, Ankylosing spondylitis, psoriasis
404
What bug could inflixamab cause reactivation of?
latent TB
405
What two drugs compose sulfasalazine?
Sulfapyridine
5-aminosalicyclic acid
406
What part of the GI tract does metoclopramide not effect?
colon
407
What drug is metoclopramide known to interact with?
digoxin
408
In what two situations would metoclopramide be contraindicated?
Parkinsons
bowel obstruction
409
The ventral bud contributes to what two parts of the pancreas?
head and duct
410
What part of the pancreas would annular pancreas encircle?
2nd
411
What is pancreas divisum? When would pancreas divisum happen?
ventral and dorsal dont fuse
8th week
412
What layer of embryological origin iis the spleen?
mesodermal
413
Which zone of the hepatic lobule is effected by yellow fever?
2nd zone
414
At what vertebral level is the bifurcation of the aorta?
L4
415
What is Cullens Sign?
bruising around periumbilical area
416
What is Cullens sign indicative of?
Acute pancreatitis
417
What drug is used to treat a variceal bleed?
octreotide
418
Do anal fissures arise from anterior or posterior to the anus?
posterior
419
Veous near the???
penis
420
An indirect hernia in males can be attributed to the failure of what structure to close? What can this lead to in infants?
processus vaginalis
hydrocele
421
What inguinal ring do indirect hernias pass through?
internal inguinal ring
422
What inguinal ring do direct hernias pass through?
external
423
Is an oral glucose load or IV glucose load used quicker? Why?
oral
GIP
424
What enzyme activates Trypsin?
enteropeptidase
425
Where is enteropeptidse located?
brush border of duodenum/jejunum
426
What is the MOA of Rifaximin?
inhibits bacterial RNA polymerase
427
What two receptors can metoclopramide block in the CTZ?
5HT3 and D2
428
What is the main cause of eosinophilic esophagitis?
allergies
429
What does candida esophagitis look like?
pseudomembrane
430
What does HSV-1 esophagitis look like?
punched out lesions
431
What does CMV esophagitis look like?
linear ulcers
432
What is the C of CREST?
calcinosis
433
What is the R of CREST?
Reynauds syndrome
434
What is the E of CREST?
esophageal dysmotility
435
What is the S of CREST?
Sclerodactyly
436
What is the T of CREST?
Telangiectasia
437
Are Signet Ring cells found in intestinal or diffuse gastric cancer?
diffuse
438
A peptic ulcer that ruptures the posterior wall of the duodenum carries a greater risk of causing what vessell to rupture?
Gastroduodenal
439
When is erythromycin used to promote motility?
when gastroparesis doesnt respond to metoclopramide
440
What is the triad of whipple disease?
cardiac abnormalities
arthralgia
neurological issues
441
What are the anti-Spasmotics for IBS?
hyoscamine and dicyclomine
442
What is the most common electrolyte disturbance during IBS?
hypomagnesium
443
What enzyme activates Trypsin?
enterokinase
444
What is the radiological sign for volvolus in an elderly patient?
coffee-bean sign
445
What ion abnormality is ileus associated with?
hypokalemia
446
What two GI drugs are known to impair creatinine clearance?
cimetidine and rinatidine
447
What process in inhibited during Reye Syndrome?
β-oxidation
448
Is an angiosarcoma benign or malignant? Angiosarcoma is a cancer of what cell type?
malignant
Endothelial
449
Which liver cancer is associated with Budd Chiari Syndrome?
HCC
450
What is the mode of inheritance for α1-anti-trypsin deficiency?
co-dominant
451
What is the landmark to separate the upper GI tract from the lower GI tract?
Ligament of Treitz
452
What are the two iron chelators used in hematochromatosis?
Deferasirox
Deferoxamine
453
Which monoclonal antibody can be used to treat Menetriers disease?
cetuximab
454
What is Ogilvie's Syndrome?
Acute dilation of the RIGHT colon in absence of obstruction
455
What two amino acids substitutions can be present during hemochromatosis?
C282Y
H63D
456
Which virus can cause cholecystitis?
CMV
457
What is the most common location of a carcinoid tumor?
ileo-cecal junction
458
What type of tissue lines a pancreatic pseudocyst?
granulation tissue
459
Rhabdomyolysis can be caused by what drug?
fibrates
460
Other than being a p450 inhibitor, what two other deleterious effects can cimetidine produce?
anti-andronergic
can cross BBB
461
What causes Type A Chronic Gastritis?
autoimmune
462
What causes Type B Chronic Gastritis?
H. pylori
463
In type A gastritis, what are autoantibodies produced against?
parietal cells
intrinsic factor
464
What cell hypertrophies during Type A gastritis?
G-cells
465
What are the two primary gastric causes of peptic ulcer disease?
decreased bicarb secretion
increased acid secretion
466
What form of gastritis has the greatest chance to transform into carcinoma?
Type B
467
What is the diarrhea and constipation cycle of Diverticulitis?
diarrhea followed by constipation
468
What makes the livers endothelial cells unique?
liver endothelial cells dont possess basement membrane
469
What two fish is scombroid toxin found in?
tuna and mackerel
470
What molecule does scombroid most closely act like?
histamine
471
What anterior abdominal fold is disrupted during omphalocele or gastroschisis?
lateral fold
472
Which anterior abdomnial wall fold is disrupted during bladder exstrophy?
caudal
473
What is the most common TEF?
proximal Esophagus atresia
distal esophageal/tracheal fistula
474
What is the most serous salivary gland? What is the most mucinous gland?
serous = parotid
mucinous = sublingual
475
What is the most common cause of liver failure in US? Asia?
US = acetominophen
ASIA = HEV or HAV
476
Through what type of mechanism is chloride reabsorbed?
paracellular
477
What type of drug is glycopyrollate?
anti-muscarinic
478
What is the difference between glycopyrollate and atropine?
atropine crosses BBB
479
What is the problem during jejunal atresia?
jejunum fails to vascularize
480
Is saliva hypotonic or hypertonic to the blood?
hypotonic
481
What structure is obstructed during Superior Mesenteric Syndrome? What is this structure trapped between?
duodenum
SMA and aorta
482
What is the difference between PPIs and H2Rs in therms of their effects on gastric emptying?
H2Rs do not effect gastric emptying like PPIs do
483
What cell releases inflammatory cytokines tat are picked up by the stellate cells?
Kupffer
484
What type of cell are stellate cells?
pericytes
485
What is it called if pain radiates to the back from acute pancreatitis?
Boas sign
486
What is the RLS of heme metabolism?
excretion of conjugated bilirubin
487
What are the GI pacemaker cells?
interstitial cells of Cajal
488
Where are Paneth cells located? What is the function of paneth cells?
small intestine
anti-microbial
489
Where is the most common location for a VIPoma?
tail of pancreas
490
Bombesin stimulates the release of what in the stomach?
gastrin
491
What is the alkaline tide?
secreting bicarb into blood when secreting protons into stomach
492
What is the tonicity of pancreatic secretions?
isotonic
493
What two proteins does APC sequester?
WNT and β-catenin
494
Which two genes are involved with Microsatellite Instability?
MLH1 and MSH2
495
What cell in the small intestine would likely secrete lysozyme?
Paneth cells
496
What type of dysphagia does achalasia present with?
progressive
497
Would esophageal carcinoma have dysphagia for solids, liquids or both?
only solids
498
What is tenesmus?
feeling one has to defecate with empty rectal vault
499
Which form of esophageal cancer is more common worldwide?
squamous
500
Which form of esophageal cancer is more common in the US?
adeno
501
What drug can be used to treat Menetrier's Disease?
Cetuximab
502
What type of cancer can Celiac Disease lead to?
T-cell lymphoma
503
How would abetalipoproteinemia present? What age group?
child
ataxia and night blindness
504
How is D-xylose normally eliminated?
urine
505
Which two conditions can cause an abnormal excretion in D-xylose?
intestinal mucosal damage
bacterial overgrowth
506
What are the two antispasmodics for IBS?
Hyoscyamine and dicyclomine
507
Which electrolyte disturbance is most common during PPI therapy?
hypomagnesia
508
Which form of IBS is more likely to present with Colorectal Carcinoma?
UC
509
What two molecules is cholesterol converted into?
cholic acid
chendeoxycholic acid
510
What three diseases are likely to produce a diverticulitis?
ED
Marfan
ADPKD
511
What lab should be performed in diverticulitis?
leukocytosis
512
What two GI diseases can cause a fistula formation with the bladder?
Crohns and Diverticulitis
513
What two muscles ae involved in a Zenker diverticulim?
cricopharyngeal and thyropharngeal
514
What is the most common reason for intussusception in an adult?
tumor or obstruction
515
What is the most common reason for intussusception in children?
lymphoid hyperplasia
516
A radiologic coffee bean sign is indicative of what disease?
volvulus
517
What is he most common cause of a small bowel obstruction?
adhesions after surgery
518
What drug is used in pt's for intubation with renal failure?
rucuronium
519
What junction are most GI polyps found?
recto-sigmoid
520
What is the most common site for juvenile polyposis?
rectum
521
What is the most common component of Peutz-Jeghers Syndrome?
smooth muscle
522
What gene is defective in Peutz Jeghers?
STK11
523
What are the two changes seen during CCl4 ingestion?
centrolobular necrosis
fatty change
524
Other than osteomas and fibromas, what would be visible on a patient with Gardner Syndrome?
Retinal Epithelium Hyperpigmentation
525
What is the mnemonic to remember the locations where Peutz-Jeghers can produce neoplasms?
CUP BLOT
526
What is the T of CUP BLOT?
testicular
527
What is the mnemonic to remember the order of k-Ras/APC/p53 mutations in colorectal cancer?
AK53
528
What hormone cant be processed during liver failure?
estrogen
529
What can hyper-estrogenism in males lead to?
gynocomastia
spider angioma
testicular atrophy
palmar erythema
530
What metabolite is abnormal during Reye Syndrome?
hypoglycemia
531
In what cell is vitamin A stored in the liver?
Stellate
532
What five cancers like to metastisize to the liver?
Colorectal, Stomach, Panceas, Breast, Lung
533
What are the three most common locations for a cavernous hemangioma?
Brain/Liver/Orbit
534
What are the two most common causes of a hepatic adenoma?
OCPs and anabolic steroids
535
Would Budd-Chiari Syndrome present with JVD?
no
536
What gene is defective during α1 anti-trypsin deficiency? What chromosome?
SERPIN1
chromosome 14
537
What is the main cause for the increase in unconjugated and conjugated bilirubin?
hepatitis
538
Would a biliary tract disease produce an increase in conjugated or unconjugated bilirubin?
conjugated
539
What β2 agonist is used in the treatment of asthma?
salmeterol
540
What two conditions can lead to jaundice during Gilbert Syndrome?
stress and fasting
541
What are the two treatments for Criggler-Najjar?
fasting and plasmapharesis
542
What three drugs are used in the Tx of Wilsons disease?
D-penicillamine
zinc acetate
trientine
543
What gene is defective during Wilsons disease?
ATP7B
544
What chromosome is ATP7B located on?
13
545
Other than hyoscamine or dicyclomine, what drug can be used to treat bowel spasms? What is the MOA of this drug ?
propantheline
AchR antagonist
546
What haplotype is associated with Primary Sclerosing Cholangitis?
HLA-DR52A
547
What is primary sclerosing cholangitis?
inflammation and fibrosis of INTRA and EXTRA hepatic bile ducts
548
What makes primary biliary sclerosis unique?
portal HTN occurs before the cirrhosis
549
Which biliary tract disease cad lead to cholangiocarcinoma?
Primary Sclerosing Cholangitis
550
Which zone of the liver is cholesterol synthesized in?
Zone 1
551
How would pancreatitis present in relation to Vitamin A?
night blindness
552
How would pancreatitis present in relation to Vitamin D?
osteomalacia
553
How would pancreatitis present in relation to Vitamin E?
ataxia
554
How would pancreatitis present in relation to Vitamin K?
bleeding
555
Which endocrine tumor can Gardner Syndrome produce?
thyroid
556
What layer of the GI tract is damaged during toxic megacolon?
muscularis externa
557
What is the most common presenting symptom of toxic megacolon?
bloody diarrhea
558
What two parts of the GI tract are most effected by celiac disease?
distal duodenum and proximal jejunum
559
Does alcohol produce a micro or macro nodular hepatitis?
micro
560
Does viral hepatitis produce a micro or macro nodular hepatitis?
macro
First Aid
flashcards
Decks in class (21)
# Cards
-
Biochemistry372
-
Biochemistry/Nutrition417
-
Heme and Onc.501
-
GI560
-
Pharmacology192
-
Cardiovascular392
-
Renal377
-
Neurology523
-
Respiratory187
-
Reproductive377
-
Endocrine254
-
Muscle/Skin/CT344
-
Immunology324
-
Antimicrobrials216
-
Micro Systems33
-
Bacteriology261
-
Mycology/Parasitology98
-
Virology163
-
Pathology174
-
Psychiatry172
-
Behavioral Science66
