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PHYSIO-PATHO-IM > Gastro > Flashcards

Gastro Flashcards

1
Q

Occurs when gastrin is secreted by non-beta-cell tumors of the pancreas

A

Zollinger-Ellison syndrome (gastrinoma)

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2
Q

The only GI hormone that is released in response to fat (fatty acids), protein (amino acids), and carbohydrate (orally administered glucose).

A

Glucose-dependent insulinotropic peptide (GIP)

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3
Q

GI neurocrines (3)

A

Vasoactive intestinal peptide (VIP)
GRP (bombesin)
Enkephalins

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4
Q

GI paracrines (2)

A

Somatostatin

Histamine

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5
Q

GI hormones (4)

A

Gastrin
Cholecystokinin
Secretin
GIP

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6
Q

Portal triad

A

Portal vein
Hepatic artery
Common bile duct

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7
Q

The most potent stimuli for gastrin secretion from antrum are (2)

A

Phenylalanine

Tryptophan

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8
Q

A mucosal disease usually involving the rectum, extending proximally to involve all or part of the colon. A type of IBD

A

Ulcerative Colitis

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9
Q

Microscopic feature of ulcerative colitis, characterized as villous atrophy and crypt regeneration with increased inflammation

A

Backwash ileus

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10
Q

IBD for at least 3 months

A

Ulcerative colitis

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11
Q

Diarrhea (nocturnal or postprandial)
Rectal bleeding
Tenesmus
Crampy abdominal pain

A

Ulcerative colitis

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12
Q

Abdominal exam shows direct tenderness on palpation over colon, hepatic tympany with megacolon, signs of peritonitis

A

Ulcerative colitis

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13
Q

UC: mild, moderate, severe:

No ulcerations

A

Moderate

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14
Q

UC: mild, moderate, severe:
Febrile
Tachypnic
Tachycardic

A

Severe

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15
Q

UC: mild, moderate, severe:

With ulcerations

A

Severe

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16
Q

UC: mild, moderate, severe:

Bowel movement

A

Mild

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17
Q

UC: mild, moderate, severe:

Bowel movement 4-6 per day

A

Moderate

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18
Q

UC: mild, moderate, severe:

Bowel movement >6 per day

A

Severe

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19
Q

Complications of ulcerative colitis

A

Massive hemorrhage
Toxic megacolon
Perforation
Strictures

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20
Q

Most dangerous complication of ulcerative colitis

A

Perforation

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21
Q

Cobblestone appearance

A

Crohns disease

Amebic colitis

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22
Q

Most common location of urinary stones

A

Ureterovesical junction as it pierces the bladder

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23
Q

UC or Crohn’s:

ANCA positive

A

Ulcerative colotis

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24
Q

UC or Crohn’s:

Responds to antibiotics

A

Crohn’s

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25
Q

UC or Crohn’s:

Recurrence after surgery

A

Crohn’s

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26
Q

UC or Crohn’s:

Fistulas

A

Crohn’s

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27
Q

UC or Crohn’s:

Gross blood in stool

A

Ulcerative colitis

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28
Q

UC or Crohn’s:

“Cobblestoning”

A

Crohn’s

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29
Q

UC or Crohn’s:

Granuloma on biopsy

A

Crohn’s

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30
Q

UC or Crohn’s:

Related to vasculitis disease Wegeners disease

A

Ulcerative colitis

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31
Q

Mainstay therapy for ulcerative colitis

A

Sulfasalazine

5-ASA agents

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32
Q

Diagnostic used, Highly sensitive marker for intestinal inflammation in ulcerative colitis

A

Fecal Lactoferrin

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33
Q

Diagnostic used,

Correlate well with histologic inflammation, predict relapses, and detect pouchitis in ulcerative colitis

A

Fecal calprotectin

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34
Q

Diagnostic used to assess disease severity, extent of ulcerative colitis

A

Sigmoidoscopy or colonoscopy

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35
Q

The earliest histologic change in single-contrast barium enema of ulcerative colitis

A

Fine mucosal granularity

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36
Q

“Collar-Button ulcers”

A

Ulcerative colitis

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37
Q 
Rectum is spared
Skip lesions
Aphthous ulcers
"Cobblestone appearance"
Focal transmural inflammatory process
"Creeping fat"
A

Crohn’s

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38
Q

Pathologic hallmark of Crohn’s

A

Focal transmural inflammatory process

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39
Q

“Creeping fat” or “Fat wrapping”

A

Crohn’s

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40
Q

Pathognomonic sign of Crohn’s

A

“Creeping fat”

“Fat wrapping”

41
Q

Histological hallmark of Crohn’s

A

NonCaseating granulomas

42
Q

First line diagnostic test for Crohn’s

A

CT Enterography

43
Q

“String sign”

A

Crohn’s

44
Q

DOC for Crohn’s

A

Sulfasalazine

45
Q

Most common cause of acute pancreatitis

A

Gallstones

46
Q

Most common cause of chronic pancreatitis

A

Alcohol

47
Q

Endocrine function if pancreas

A

Islets of Langerhans

48
Q

Exocrine function of pancreas

A

Pancreatic acini

49
Q

Cardinal manifestation of acute pancreatitis

A

Abdominal pain

50
Q

Collon Cut-off sign

A

Acute pancreatitis

51
Q

“Chain of Lakes appearance”

A

Chronic pancreatitis

52
Q

Irreversible loss if exocrine pancreatic parenchyma

A

Chronic pancreatitis

53
Q

Pain in pancreatitis, constant, intense, referred to upper back and left shoulder, is due to irritation of what nerve

A

Retroperitoneal nerve

54
Q

Enzyme that increases in the first 24hours in pancreatitis

A

Serum amylase

55
Q

More severe form of pancreatitis

A

Acute necrotizing pancreatitis

56
Q

Most severe form of pancreatitis

A

Hemorrhagic pancreatitis

57
Q

RED BLOCK HEMORRHAGE interspersed with foci of yellow white, chalky fat necrosis

A

Acute necrotizing pancreatitis

58
Q

Extensive parenchymal necrosis accompanied by dramatic hemorrhage within substance of the gland

A

Hemorrhagic pancreatitis

59
Q

Enzyme that increases within 72-96hours in pancreatitis

A

Serum lipase

60
Q

Most important triggering event in acute pancreatitis

A

Inappropriate activation of trypsinogen

61
Q

Ominous complication of acute pancreatitis

A

ARDS

Acute Renal failure

62
Q

Most common cause of pancreatitis in children

A

Cystic fibrosis

63
Q

Most common cause of chronic pancreatitis in adults

A

Chronic alcoholism

64
Q

Diagnostic test of chronic pancreatitis with best specificity and sensitivity

A

Secretin test by hormone stimulation

65
Q

Most common primary tumor of the liver

A

Hepatocellular carcinoma / Hepatoma

66
Q

Most common malignancy of the liver

A

Metastasis

67
Q

Chemical carcinogen causing HCC

A

Aspergillus fungus aflatoxin

Aflatoxin B1

68
Q

Most common cancer death in both sexes

A

Lung cancer

69
Q

Most common cancer in females

A

BREAST
Colon
Lung
Cervix

70
Q

Most common cancer in males

A

LUNG
Prostate
Colon

71
Q

Vinyl chloride

A

Angiosarcoma

72
Q

Asbestos

A

Mesothelioma

73
Q

Heroin

A

Focal Segmental GN

74
Q

Aflatoxin

A

HCC / Hepatoma

75
Q

Oncogene causing HCC

A

KRAS

p53

76
Q

Most common sign of HCC

A

Hepatomegaly

77
Q

Hepatic VEIN Thrombosis

POST-sinusoid obstruction

A

Budd-Chiari syndrome

78
Q

PRE-sinusoidal obstruction

A

Schistosomiasis

79
Q

Organism associated with Cholangipcarcinoma

A

Chlonorchis sinensis

80
Q

Mucin-producing adenocarcinoma NOT ASSOCIATED with Hepa B or Cirrhosis

A

Cholangiocarcinoma

81
Q

Most common liver CA in children

A

Hepatoblastoma

82
Q

Hepatoma serologic assays

A

Serum alpha-fetoprotein (AFP)

Des-y-carboxy prothrombin (DCP)
induced by protein induced vitamin K absence (PIVKA-2)

83
Q

Criteria for HCC

A

Child-Turcotte-Pugh score

Class A 5-6
Class B 7-9
Class C 10-15 (75-80% mortality)

84
Q

Stigmata of liver cirrhosis

A

Palmar erythema
Spider angiomata
Gynecomastia

85
Q

Complications of cirrhosis

A

Portal HTN
Hepatorenal syndrome
Hepatic encephalitis

86
Q

Metabolite that kills the liver cells in alcoholic cirrhosis

A

Acetaldehyde

87
Q

Acetaldehyde is metabolized to acetate by

A

Aldehyde dehydrogenase (ALDH)

88
Q

Hallmark of alcoholic cirrhosis

A

Activation of STELLATE CELLS or KUPFER CELLS

89
Q

Alcoholic cirrhosis, macro or micro nodular?

A

Micronodular

90
Q

“Blind man’s disease”

A

Alcoholic cirrhosis

91
Q

Cornerstone of therapy for alcoholic cirrhosis

A

Abstinence

92
Q

Drug that reduces craving for alcohol

A

Acamprosate calcium

93
Q

Tx for cirrhosis due to chronic viral hepatitis B

A

Antiviral therapy

LAMIVUDINE

94
Q

Tx for cirrhosis due to chronic viral hepatitis C

A

Pegylated interferon
RIBAVIRIN
Ae: decreased platelet and WBC

95
Q

Most common symptom of Primary Biliary Cirrhosis

A

Pruritus

96
Q

Antibodies in Primary biliary cirrhosis

A

AMA

Anti-Mitochondrial Antibodies (90%)

97
Q

Tx for decompensated cirrhosis due to primary buliary cirrhosis

A

Liver transplant

98
Q

Improves both biochemical and histologic features of primary biliary cirrhosis

A

UDCA

99
Q

When to do liver biopsy

A

Liver biopsy is withheld until abstinencw has been maintained for at least 6 months

PHYSIO-PATHO-IM (7 decks)

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