First Aid pg 362-366 GI

Question 1

Which inflammatory bowel disease normally spares the rectum?

Answer 1

Crohn’s

Question 2

Which IBD is assoc with thickening of bowel walls?

Answer 2

Crohn’s

Question 3

Which IBD = granulomas?

Answer 3

Crohn’s

Question 4

IBD with lead pipe appearance of imaging?

Answer 4

UC

Question 5

Disease that could lead to fulminant colitis or toxic megacolon?

Answer 5

UC

Question 6

Blood diarrhea is more often associated with which IBD?

Answer 6

UC

Question 7

Which IBD is assoc with p-ANCA?

Answer 7

UC

Question 8

Which IBD is assoc with kidney stones and what type?

Answer 8

Crohn’s; Calcium oxalate

Question 9

What is Rosving sign? (Not in FA, but referenced to)

Answer 9

LLQ palpation –> RLQ pain

Question 10

Most common causes of appendicitis in adults/children?

Answer 10

fecalith (adults); lymphoid hyperplasia (in children)

Question 11

False diverticuli are caused by what?

Answer 11

Inc intraluminal pressure and focal weakness in colonic wall

Question 12

LLQ pain + fever + leukocytosis =?

Answer 12

Diverticulitis

Question 13

A diverticuli that involves all 3 gut wall layers?

Answer 13

Meckel’s diverticulum

Question 14

Herniation of mucosal tissue at the triangle between thyrophayngeal and cricopharyngeal part of inf pharyngeal constrictor?

Answer 14

Zenker diverticulum

Question 15

Elderly male, dysphagia, foul breath, potential cough = ?

Answer 15

Zenker diverticulum

Question 16

Meckel’s diverticulum is associated with what ectopic tissue?

Answer 16

Acid secreting gastric mucosa, pancreatic tissue

Question 17

Lab tests for Meckels?

Answer 17

Pertechnetate uptake studies (99mTc) and guaiac + stool ( in uworld Q)

Question 18

Which GI disease is associated with the same gene mutation as Medullary thyroid cancer? What is difference in the two mutations? (bonus Q)

Answer 18

Hirschsprung - RET gene loss of function

Along with Papillary thyroid cancer - those are gain of function mutations

Question 19

Hirschsprung disease - which embryonic issue?

Answer 19

Due to failure of neural crest cell migration

Question 20

Which GI disease can cause recurrent UTI and pneumaturia?

Answer 20

Chron disease, due to enterovesical fistulae

Diverticulitis, due to colorvesical fistulae

Question 21

Which IBD is Th1 mediated/Th2 mediated?

Answer 21

Th1 - Crohn (granulomas)

Th2 - UC (no granulomas)

Question 22

Which IBD may need to be treated with Citrate?,

Answer 22

Crohn - Calcium oxalate stones

Question 23

Bonus q - which complication of Crohn’s tends to occur at low pH?

Answer 23

Calcium oxalate stones

Question 24

Which IBD has oral lesions with a grey base surrounded by eythema?

Answer 24

Both Crohn’s and UC could have aphthous ulcers as a complication

Question 25

Which IBD is assoc with biliary issues? Which issues?

Answer 25

Both Crohn's - gall stones UC - Primary sclerosing cholangitis

Question 26

Which diverticula is most likely to occur where vasa recta perforate muscularis externa?

Answer 26

Psuedo (false) diverticulum - the wall is weaker there

Question 27

Possible consequence of Zenker?

Answer 27

If food aspirated - can lead to Aspiration Pneumonia

Question 28

What is a cystic dilation of vitelline duct?

Answer 28

Omphalomesenteric cyst

Question 29

Which disease is associated with failure to pass meconium within 48 hrs and bilious emesis?

Answer 29

Hirschsprung

Question 30

Which other congenital disease is assoc with Hirschsprung?

Answer 30

Down's

Question 31

red currant jelly stools seen with which Gi disorder?

Answer 31

Acute mesenteric ischemia

Question 32

Atherosclerosis of celiac a, SMA, IMA is seen in which disease?

Answer 32

Chronic mesenteric ischemia

Question 33

Colonic ischemia most likely affects which anatomical areas?

Answer 33

Watershed areas - splenic flexure, distal colon

Question 34

What is Angiodysplasia in the GI? What part of GI affected most often?

Answer 34

Tortuous dilation of vessels --> hematochezia, seen in cecum, terminal illeum, asc colon

Question 35

Pt wih constipation, no flatus, distended abdomen, low or no bowel sounds? Pot Causes?

Answer 35

Ileus; abdominal surgeries, opiates, hypokalemia, sepsis

Question 36

Which gene mutation of an ion channel will lead to failure to pass meconium at birth?

Answer 36

CFTR, Cl channel defect, meconium plug block intestine.

Question 37

Which disease is seen in formula fed premature infants?

Answer 37

Necrotizing enterocolitis - esp in premature bc of dec immune system.

Question 38

Which disease leads to pneumatosis intestinalis, free air in abdomen, portal venous gas?

Answer 38

Necrotizing enterocolitis - necrosis of colonic mucosa lead to potential perforation.

Question 39

What AD disease of chr 19 can lead to colonic polyps? what type of polyp?

Answer 39

Peutz Jeghers, Hamartomatous

Question 40

Which gene mutation in lung (and pancreatic) cancer is also associated with colonic polyps? What type of polyp?

Answer 40

KRAS mutation, Adenomatous

Question 41

T or F? Villous adenomatous polyps are more likely to be malignant than tubular polyps?

Answer 41

True - tubulovillous are intermed. Villous - villian = bad.

Question 42

Which premalignant colonic polyp is associated with CpG hypermethylation?

Answer 42

Serrated polyps, aslo assoc with microsatellite instability

Question 43

Which ser/threonine kinase gene mutation is associated with Papillary thyroid cancer, melanoma is also associated with coloic polyps - what type of polyp?

Answer 43

BRAF mutation, Serrated polyps

Question 44

Which disease is associated with thousands of polyps arising post puberty?

Answer 44

FAP

Question 45

Which poylposis syndrome is associated with CNS symptoms?

Answer 45

Turcot - ahem...according to First Aid, Turcot = Turban. *side eye*

Question 46

Which chromosome is associated with FAP?

Answer 46

5. If you laugh at the word FAP, it's because you're 5.

Question 47

Which type of polyp is seen in Juvenile polyposis syndrome?

Answer 47

hamartomatous

Question 48

Which two colonic diseases are associated with microsatellite instability?

Answer 48

Serrated colonic polyps, HNPCC

Question 49

Which colonic disease also associated with endometrial, ovarian, and skin cancer?

Answer 49

HNPCC

Question 50

Which colonic disease has a problem with DNA mismatch repair genes?

Answer 50

HNPCC -

Question 51

Most likely location for HNPCC?

Answer 51

Prox colon

Question 52

Which type of polyposis is associated with eye and teeth issues?

Answer 52

Gardner = FAP + osseus and soft tissue tumors + congenital hypertrophy of retinal pigment epithelium + impacted/supernumerary teeth