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Step 1 (Steffanie) > GI > Flashcards

GI Flashcards

1
Q

Where does iron absorption predominantly occur?

A

Duodenum and proximal jejunum

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2
Q

Malabsorption of which substances can occur after gastrojejunostomy?

A

Iron, Vit B12, folate, fat soluble vitamins, and calcium

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3
Q

Brown pigment stones

A

Associated with billiary tract infections

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4
Q

Black pigment stones

A

Chronic hemolysis (sickle cell, beta thalassemia, hereditary spherocytosis)

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5
Q

Cause of pigment stones

A

Conditions that increase the amount of unconjugated bilirubin in bile, which promotes calcium bilirubinate precipitation

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6
Q

What time of patients typically get acute acalculous cholecystitis?

A

Critically ill patients (sepsis, severe burns, trauma, immunosuppression)

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7
Q

Describe right sided colon adenocarcinoma

A

More likely to bleed and cause iron deficiency anemia

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8
Q

Describe left sided colon adenocarcinoma

A

Present with obstructing symptoms such as altered bowel habits, constipation, abdominal distension, nausea and vomiting

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9
Q

Describe the mechanism of the Shiga-like toxin in EHEC

A

Inactivates the 60s ribosomal subunit in human cells, leading to inhibition of protein synthesis and eventual cell death

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10
Q

Lynch syndrome

A

Autosomal dominant disease caused by abnormal nucleotide mismatch repair, including genes MSHS and MLH1

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11
Q

Derivatives of the dorsal pancreatic bud

A

Pancreatic tail, body, most of the head, and the small accessory pancreatic duct

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12
Q

Derivatives of the ventral pancreatic bud

A

Uncinate process, a portion of the pancreatic head, and the proximal portion of the main pancreatic duct

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13
Q

Pathophysiology of pancreatic divisum

A

Dorsal and ventral pancreatic buds fail to fuse

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14
Q

Polyethylene glycol

A

Osmotic laxative

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15
Q

Describe the cause of Hirschsprung diease

A

A result of abnormal migration of neural crest cells during embryogenesis

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16
Q

IL-8

A

Chemokine produced by macrophages that induces chemotaxis and phagocytosis in neutrophila

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17
Q

What are the 3 main causes of HIV-associated esophagitis?

A

Candida, CMV, HSV

18
Q

How is CMV esophagitis characterized endoscopically?

A

Large, shallow linear ulcerations with intranuclear and cytoplasmic inclusions seen microscopically

19
Q

List the retroperitoneal abdominal organs

A

Suprarenal (adrenal) glands, aorta and inferior vena cava, duodenum (except 1st part), pancreas (head and body), ureters and bladder, kidneys, esophagus, rectum (mid-distal)

20
Q

What is the adenoma to carcinoma sequence is most cases of sporadic colon adenocarcinoma arising from a preexisting polyp?

A

Mutation of the APC tumor suppressor gene allows for the initial appearance of small adenomatous polyps.

Mutation of the KRAS protoocogene facilitates that increase in size of the adenoma

Malignant transformation requires TP53 mutation

21
Q

Systemic mastocytosis

A

Abnormal proliferation of mast cells and increased histamine release. Histamine causes hypersecretion of gastric acid by parietal cells in the stomach as well as hypotension, flushing, pruritus, etc.

22
Q

“Watershed areas”

A

In the left colon at the splenic flexure and rectosigmoid junction

23
Q

Periodic, simultaneous, and non-peristaltic contractions of the esophagus

A

Diffuse esophageal spasm

24
Q

What causes diffuse esophageal spasm?

A

Impaired inhibitory innervation within the esophageal myenteric plexus

25
Q

How does diffuse esophageal spasm present?

A

Liquid/solid dysphagia and chest pain due to inefficient propulsion of food into the stomach

26
Q

What are 3 well known risk factors for gallbladder disease?

A

“40, fat, female”

27
Q

Which hormone is responsible for gallbladder contraction? Where is it made?

A

Cholecystokinin. Made in the duodenum and jejunum in response to fatty acids and amino acids

28
Q

What is the most important characteristic that correlates with malignancy risk in colonic polyps?

A

Increasing polyp size

29
Q

Are villous adenomas or tubular adenomas more likely to undergo malignant transformation?

A

Villous

30
Q

Common findings with a gallstoneileus

A

Pneumobilia = air in the biliary tract

31
Q

Describe diffuse gastric adenocarcinoma

A

Infiltrates the stomach wall and displays signet-ring cells on light microscopy

32
Q

Describe intestinal type of gastric adenocarcinoma

A

Forms a solid mass that projects into the stomach lumen and is composed of glandular-forming cuboidal or columnar cells

33
Q

What is a manifestation of galactokinase deficiency?

A

Cataracts

34
Q

What is accumulating and causing cataracts with a galactokinase deficiency?

A

Lenticular accumulation of galactitol

35
Q

What is the cause of pernicious anemia?

A

Autoimmune disorder caused by the cell-mediated destruction of parietal cells in the superficial upper glandular layer of the gastric body and fundus

36
Q

What is the difference in immune responses between the live attenuated oral (Sabin) poliovirus vaccine and the inactivated poliovirus (Salk) vaccine?

A

Live attenuated oral vaccine produces a stronger mucosal secretory IgA immune response

37
Q

What can prolonged cholestatic liver disease cause?

A

Malabsorption and nutritional deficiencies of fat-soluble vitamins (A, D, E, and K)

38
Q

What kind of kidney stones are seen in Crohn disease?

A

Oxalate kidney stones

39
Q

Mechanism of gallstones in Crohn disease

A

Decreased bile acid reabsorption by the inflamed terminal ileum promotes cholesterol supersaturation of the bile

40
Q

Meckel diverticulum

A

Results from failed obliteration of the vitelline duct. Presents with spontaneous but painless lower GI bleeding

41
Q

Where does iron absorption predominantly occur?

A

In the duodenum and proximal jejunum

42
Q

What kind of kidney stones are associated with Crohn disease?

A

Oxalate kidney stones

Step 1 (Steffanie) (21 decks)

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