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Step 1 Crush 250! - Hans > GI 357 - 361 > Flashcards

GI 357 - 361 Flashcards

(73 cards)

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1
Q

name 3 causes for acute (erosive) gastritis

A
  1. NSAIDs usage –> dec PGE2 –> dec mucosal protection
  2. Burns (Cushing ulcer) –> dec plasma volume –> sloughing of gastric mucosa
  3. Brain injury (Cushing ulcer) –> inc vagal stimulation –> inc ACh –> inc H+ production
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2
Q

what type of GI cell is inhibited by inc vagal stimulation?

A

D cells in pancreatic islets, GI mucosa

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3
Q

how is heme metabolized?

A

by heme oxygenase to biliverdin, which is reduced to bilirubin

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4
Q

explain how bilirubin is being excreted

A

unconjugated bilirubin is removed by liver, conjugated with glucuronate, and excreted in bile

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5
Q

where does RBCs –> heme –> unconjugated bilirubin

A

macrophage

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6
Q

what happens to the unconjugated bilirubin in the bloodstream?

A

binds with albumin

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7
Q

what is responsible for the yellow color of urine?

A

urobilin

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8
Q

what is responsible for the brown color of the stool?

A

stercobilin

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9
Q

what test do you use to diagnose pancreatic insufficiency?

A

D-xylose absorption test

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10
Q

do you get normal D-xylose absorption test in pancreatic insufficiency?

A

yes

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11
Q

in what situation do you get dec excretion of the D-xylose absorption test?

A

with intestinal mucosa defects or bacterial overgrowth

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12
Q

inc neutral fat in the stool indicate

A

pancreatic insufficiency

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13
Q

chronic inflammation, atrophy, calcification of the pancreas can lead to

A

pancreatic insufficiency

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14
Q

what mutation can cause chronic pancreatic insufficiency?

A

CFTR mutation

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15
Q

old men with whipple dz will present what 3 main symptoms?

A
  1. cardiac symptoms
  2. arthralgias
  3. neurologic symptoms
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16
Q

salivary gland tumors are gengerally

A

benign and occur in parotid gland

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17
Q

what is the most common salivary gland tumor?

A

pleomorphic adenoma

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18
Q

pleomorphic adenoma is also called

A

benign mixed tumor

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19
Q

pleomorphic adenoma is composed of 2 things

A
  1. chondromyxoid stroma

2. epithelium

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20
Q

presentation of pleomorphic adenoma (benign mixed tumor) is

A

painless and mobile mass

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21
Q

what is the most common malignant tumor?

A

mucoepidermoid carcinoma

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22
Q

presentation of mucoepidermoid carcinoma?

A

painless, slow growing

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23
Q

what are the components of mucoepidermoid carcinoma?

A

mucinous and squamous

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24
Q

what is the name of the benign cystic tumor with germinal center?

A

warthin tumor

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25
what is another name for warthin tumor?
papillary cystadenoma lymphomatosum
26
2 causes for secondary achalasia?
1. chagas dz (T. cruzi infection) | 2. malignancies (mass effect or paraneoplastic)
27
achalasia is due to failure of relaxation of LES due to loss of
myenteric (Auerbach) plexus
28
what 2 factors in achalasia lead to progressive dysphagia to solids and liquids (vs. obstruction - solids only)?
high LES resting pressure and uncoordinated peristalsis
29
what is the consequence of untreated achalasia?
esophageal sq. cell carcinoma
30
what path is associated with pts with rheumatoid arthritis taking NSAIDs daily?
acute (erosive) gastritis
31
name 2 types of chronic gastritis
1. type A (fundus/body) | 2. type B (antrum)
32
what is the most common type of chronic (nonerosive) gastritis?
type B (antrum) caused by H. pylori infection
33
which type of chronic gastritis is associated with inc risk of MALT lymphoma?
type B (antrum)
34
what is the cause for type A (fundus/body) chronic gastritis?
autoantibodies to parietal cells, pernicious anemia, achlorhydria
35
what path is associated with rugae of stomach so hypertrophied that they look like brain gyri
menetrier dz
36
explain the pathophysio of menetrier dz
gastric hyperplasia of mucosa --> hypertrophied rugae, excess mucus production with resultant protein loss and parietal cell atrophy with dec acid production
37
is menetrier precancerous?
yes
38
what are the 3 causes for pancreatic insufficiency?
1. cystic fibrosis 2. obstructing cancer 3. chronic pancreatitis
39
what will be the result of the lactose tolerance test for pts with disacchraridase def?
administration of lactose produces symptoms and serum glucose rises
40
why does self limited lacatse def occur following injury such as viral enteritis?
b/c lactase is located at tips of intestinal villi
41
diff btw celiac sprue and tropical sprue?
tropical sprue has similar findings as celiac sprue (affects small bowel), but responds to antibiotics
42
what is the cause for tropical sprue?
unknown, but seen in residents or recent visitors to tropics
43
name 3 antibodies found in celiac?
1. anti-endomysial 2. anti-tissue transglutaminase 3. anti-gliadin
44
what type of cancer is associated with celiac?
T-cell lymphoma, small bowel carcinoma
45
what is the problem in celiac?
autoimmune mediated intolerance of gliadin (gluten protein found in wheat)
46
what genes are associated with celiac?
HLA-DQ2, HLA-DQ8
47
what is the name for subcutaneous periumbilical metastasis in stomach cancer?
sister mary joseph nodule
48
in stomach cancer, what node is involved with Lt supraclavicular node by metastasis from stomach cancer?
virchow node
49
what is the name of the stomach tumor that is associated with bilateral metastases to ovaries with abundant mucin secreting signet ring cells?
krukenberg
50
what is the characteristic description of the stomach wall in diffuse type stomach cancer?
stomach wall grossly thickened and leathery (linitis plastica)
51
5 causes for intestinal stomach cancer?
1. H. pylori 2. dietary nitrosamines (smoked food) 3. tobacco smoking 4. achlorhydria 5. chronic gastritis
52
what is the most common location of intestinal stomach cancer?
lesser curvature
53
how does the intestinal stomach cancer lesion look like?
ulcer with raised margins
54
what are the 3 signs for stomach cancer?
1. weight loss 2. early satiety 3. acanthosis nigricans
55
what are the 2 types of ulcer complications?
1. hemorrhage | 2. perforation
56
where does hemorragic ulcer take place?
gastric, duodenal (post > ant)
57
two arteries that are ruptured in hemorrhagic ulcer?
1 .Lt gastric a from ruptured gastric ulcer on the lesser curvature of stomach 2. gastroduodenal a from ulcer on the post wall of duodenum
58
where does perforation take place as ulcer complication?
duodenal (ant > post)
59
what are the 2 unique characters of perforation from ulcer complication?
1. free air under diaphragm | 2. referred pain to the shoulder via phrenic nerve
60
what additional procedure must take place for pt with gastric ulcer?
biopsy margins to rule out malignancy
61
causes of gastric ulcer?
NSAIDs
62
cause for duodenal ulcer?
ZES
63
compare the pain from gastric vs. duodenal ulcer
in gastric, pain can be greater with meals, but pain dec with meals in duodenal ulcer
64
which type of ulcer has 100% association with H. pyroli?
duodenal
65
name 10 risk factors for esophageal cancer
1. achalasia 2. alcohol (squamous) 3. barret (adeno) 4. cigarettes - both 5. diverticula (Zenker, squamous) 6. esophageal web (squamous) 7. familial 8. fat 9. GERD 10. hot liquids (sq.)
66
what esophageal path is associated with dec LES pressure?
sclerodermal esophageal dysmotility
67
what causes the low LES pressure in sclerodermal esophageal dysmotility?
esophageal smooth muscle atrophy
68
what causes punched out ulcers?
HSV 1
69
what causes linear ulcers?
CMV
70
path associated with mucosal lacerations seen in alcoholics and bulimics?
mallory weiss
71
path associated with glossitis, esophageal webs with inc risk of esophageal sq cell carcinoma
plummer vinson syndrome
72
which path is unresponsive to GERD therapy?
eosinophilic esophagitis
73
what esophageal path is associated with lye ingestion?
esophageal strictures

Step 1 Crush 250! - Hans (41 decks)

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