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Flashcards in GI Deck (134):
1

foregut

pharynx to duodenum
celiac artery
vagus n

2

celiac artery supplies

foregut
spleen

3

midugt

duodenum to tranverse colon
SMA
vagus n

4

hind gut

distal transverse colon to rectum
IMA
pelvic nerves

5

duodenal atresia

failure to recanalize
associated with Down syndrome

6

jejunal, ileal, colonic atresia

vascular accident
apple peel atresia

7

olive mass

pyloric stenosis

8

annular pancreas

abnormal migration of ventral pancreatic bud

9

lesser omentum

liver to lesser curvature
contains hepatogastric and hepatoduodenic ligaments

10

hepatoduodenal ligament

portal triad

11

hepatogastric ligament

gastric arteries

12

less curvature of stomach blood vessel

left gastric a.

13

greater curvature of stomach blood vessel

gastroepiploic aa

14

falciform ligament

ligamentum teres hepatis

15

spleen - embryo origin

mesoderm

16

esophageal varices

left gastric and esophageal aa

17

caput medusae

paraumbilical and superficial/inferfior epigastric aa

18

internal hemorrhoids

superior rectal a
middle or inferior rectal aa

19

above pectinate line

adenocarcinoma
superior rectal artery
drains to superior rectal vein --> IMV --> portal system
deep nodes

20

below pectinate line

squamous cell carcinoma
inferior rectal artery
inferior rectal vein --> internal pudeneal vein --> internal iliac vein --> IVC
superficial inguinal nodes

21

delta aminolevulinic acid

lead poisoning
need vit B6 for synthesis of ALA

22

periportal zone of liver

viral hepatitis

23

pericentral / centrilobular zone of liver

alcoholic hepatitis
ischemia

24

Somatostatin

inhibits VIP
D cells of pancreas

25

VIPoma

watery diarrhea
HYPOkalemia
ACHLORhydria

26

iron absorbed

duodenum, proximal jejunum

27

folate absorbed

jejunum

28

achalasia

failure of LES to relax
dysphagia to solid and liquids
risk of SCC

29

Squamous Cell Carcinoma of esophagus

keratin nests and pearls
smoking and alcohol -- most important risk factors
achalasia, diverticular, esophageal web, hot liquids

30

Whipples Disease

PAS positive foamy macropphages
gram psoitive organisim
cardiac symptoms, arthralgias, neurologic symptoms

31

+PAS due to

glycoprotein

32

Type A gastritis

autoimmune
pernicious anemia
achlorhydria
affects the body

33

Type B gastritis

H pylori
affects antrum
risk of MALT lymphoma and adenocarcinoma

34

Intestinal Stomach Cancer

H pylori, type A gastritis, smoked foods

35

Diffuse Stomach Cancer

signet ring cells
linits plastica

36

malignant polyps

villous

37

risk of hepatocellular carcinoma

hep B and C
biliary dz
hemochromatosis
wilson's dz, alpha1antitrypsin
aflatoxin
cirrhosis

38

Reye's syndrome

aspirin
liver dz - microvesicular fatty change
encephalopathy

39

hepatic steatosis

macrovesicular fatty change

40

alcoholic hepatitis path

mallory bodies

41

Acute Hep A

balloon degeneration
Councilmen bodies (apoptosis)

42

nodular regeneration

chronic hep

43

hobnail apperance of liver

alcoholic cirrhosis

44

increased alpha fetoprotein

hepatocellular carcinoma

45

cavernous hemangioma

common benign liver tumor

46

hepatic adenoma

bengin
OC or steroid use

47

angiosarcoma

malignant
exposure to arsenic, polyvinyl chloride

48

Budd Chiari

occlusion of IVC or hepatic veins
hypercoaguable states

49

black liver

Dubin-Johnson syndrome
can't excrete conjugated bilirubin

50

mitochondrial antibodies

PBC

51

destruction of interlobular bile ducts by granulomas

PBC

52

PSC

onion skin bile duct
beading
hypergammaglobulinemia -- IgM

53

mass in ileocecal valve

gallstone ileus
air in biliary tree

54

acute pancreatitis complications

pseudocysts, necrosis

55

7 alpha hydroxylase suppresion

fibrates

56

CA 19-9

pancreatic adenocarcinoma

57

migratory thrombophelbitis

trosseau's (redness and tenderness of extremities)
pancreatic adenocarcinoma

58

arsenic posioning

garlic breath
dimercaprol

59

Courvoiser sign

palable but non tender gallbladder
usually due to adenocarcinoma at head of pancreas

60

pancreatic cancer RF

age, smoking, DM, chronic pancreatitis, genetic

61

Hep B

integrates DNA into host

62

left sided CC

obstruction

63

right sided CC

anemia, anorexia

64

portal vein thrombosis

portal htn, no change in liver histo

65

CREST - immunopath

CD4 accumulation

66

most likely location of colon adenocarcinoma

rectosigmoid

67

hereditary pancreatitis

SPINK1

68

periodic, non peristatlic contractions

diffuse esophageal spasm
corkscrew esophagus

69

vomitting causes

metabolic alkalosis
loss of acidic stomach contents

70

chalky white lesions in mesentery

acute pancreatitis

71

octreotride

somatostatin analong
treats acute variceal bleeds, acromegaly, VIPoma, carcinoid tumors

72

Hirschsprung Disease

failure of neural crest cells to migrate and become ganglion cells of submucosal and myenteric plexuses

73

imperforate anus

associated with GU tract malformations

74

pancreas divisum

ventral and dorsal buds fail to fuse
2 separate duct systems

75

dorsal pancreatic duct forms

body, tail, most of head

76

ventral pancreatic duct forms

unicate process
inferior/posterior portion of head
major pancreatic duct

77

Secretin

made in S cells of duodenum
increases Bicarb secretion

78

COX-2, increased levels

can be associated with colon adenocarcinoma

79

MTP gene

abetalipoproteinemia

80

abetalipoproteinemia histo

acanthocytes
foamy cytoplasm

81

HIV esophagitis

candida
CMV
HSV-1

82

lipophilic compounds metabolized by

liver

83

t 1/2 =

Vd x ln 2 / CL

84

Colon Cancer in UC pts

multifocal
early p53 mutations, late APC mutations
high histological grades

85

liver cysts

echinococcus
anaphylatic shock

86

GERD histology

elongation of lamina propriae
eosinophil/neutrophil/lymphocyte infiltrate

87

lactase def

decreased stool PH
increase stool osmotic gap
increase H2 breath content

88

H pylori - greatest concentration in

prepylroic region

89

anal fissure location

distal to dentate line
posterior midline

90

fine granular eosinophilic apperance of liver/ground glass

HBsAg tubules

91

toxic mega colon diagnosis

flat plain X ray

92

diphenoxylate

opiate anti-diarrheal

93

meperdine

opiate anti-diarrheal

94

secretory diarreha treatment

ocretide

95

Chron's dz granulomas

TH1 response

96

hepatic steatosis - pathophys/histo

excess NADH production
decrease free FA oxidation
TG accumulation

97

NFKB

K(C)rohn's disease
stimulates cytoKines

98

CD -- HLA associations

HLA 1,5

99

UC - HLA associations

HLA 2

100

epinephrine metabolites within liver lysosomes

Dubin-Johnson syndrome

101

Chronic mesenteric ischemia

atherosclerosis + postprandial pain

102

cricopharyngeal muscle dysfunction

Zenkers

103

what is between SMA and aorta

transverse portion of duodenum

104

Indinavir

protease inhibitor
lipodystrophy, hyperglycemia, P450 inhibition

105

parietal cells stimulated by

gastrin, ach, histamine

106

parietal cell hypertrophy by

gastrin

107

Acute ACALCULOUS cholecystitis

no stones
pts who are hospitalized, seriously ill

108

pancreatic pseudocyst consists of

fibrous and granulation tissue

109

diarrhea and spindle cells in AIDs pt

kaposi's

110

meckel diverticulum

incomplete obliteration of omphalomesenteric duct
variety of tissue types
ectopy

111

N acetyl cysteine

acetaminophen overdose
provides sulfhydral group
glutathione substitue

112

nests of uniform cells

carcinoid

113

gall stones in IBD due to

decrease bile acid reabsorption

114

Wilson dz, copper accumulation in

corena
basal ganglia (basal ganglia atrophy)

115

lipid absorption occurs in

jejunum

116

diverticular protruding from wall, mechanism is

pulsion

117

PBC has similar histo to

GVHD

118

calliflower like mass with hypokalemia

villous adenocarcinoma

119

telescoping

intussecption

120

copper is removed from body by

hepatic excretion into bile

121

hepatic abscess

S. aureus

122

spordiac colon cancer pathway

APC - K-ras - p53

123

total gastrectomy, supplement

B12

124

99mTc-pertechnetate

tests for gastric mucosa (meckels)

125

watershed areas of GI tract

splenic flexure
distal sigmoid colon

126

erosions

do not fully extend through muscularis mucosa

127

Crohn's dz - type of stone

oxalate calcium

128

Zidovudine

AZT
nucleoside reverese transcripatse inhibit
incorpated into molecule and prevent chain elongation since no free 3'oh
(prevents 3-5' phophodiester bond)

129

omphalomesenteric duct

vitelline duct

130

halothane fulminant hepatitis histo

increase aminotransferase
increased PTT
eosinophili

131

weird causes of pancreatitis

increase TG, CA

132

Hep B -- mechanism

CD8 T lymphs respond to viral antigens

133

gallstones caused by

increased cholesterol
low phospholipid
decreased bile acid

134

calcification/porecelian gallbladder

risk fro cancer, remove