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Flashcards in GI Deck (16):
1

Herniation of gallbladder mucosa into the muscular layer causing diverticula
-occurs in chronic cholecystitis

Rokitansky-Aschoff sinuses

2

Autoimmune fibrosis of intrahepatic bile duct destruction that can cause hepatic cirrhosis
-woman 40-50

S/s: early
-pruritus, fatigue, anorexia, painful hepatomegaly

S/s late: xanthelasmea, jaundice

Dx
Labs
Complications
Tx

Primary biliary cholangitis

Labs:
-lymphocyte infiltrates
-ANA, ASMA, IgM
-HDL > LDL

Complications: portal HTN (before cirrhosis) and hepatocellular carcinoma

Tx: ursodiol

3

Causes of secondary biliary cirrhosis

Obstruction of extrahepatic biliary ducts
-MC is choledocholithiasis

4

Proliferation of glands w/o atypia
-sawtooth glandular epithelium w/ proliferation of goblet and columnar epithelial cells

Hyperplastic polyps
-no malignant potential

5

Why is oral glucose cleared from the plasma faster than IV glucose load?

Gastric inhibitory peptide (GIP): released in presence of fat, carbohydrates, or ptn in GI tract from K cells
-stimulates insulin release
*thus oral glucose releases more insulin and is metabolized more rapidly

IV glucose: does not stimulate the release of GIP

6

Crigler Najjar type 1 vs type 2
-UDP-glucuronyltransferase levels
-prognosis
-conjugated vs unconjugated bilirubin

1: absent UDP-glucuronyltransferase
-fatal d/t kernicterus

2: decreased UDP

Both: unconjugated

7

Dubin Johnson vs Rotor syndrome
-conjugated vs unconjugated

Both hereditary conjugated hyperbilirubinemia

Dubin: black pigment in hepatocytes

8

Pt presents w/
-episodes of jaundice d/t stress, fasting or infection

Dx
Conjugated vs unconjugated
Defect

Gilbert syndrome

Defect: UDP-gluconyltransferase

Unconjugated

9

Defect in PMNT leads to a deficit in what catecholamine?
-during periods of stress, what is released that stimulates the expression of PNMT?

Decreased epinephrine
-increased expression by cortisol during stress

10

-eosinophilic cytoplasmic inclusions that form when hepatocytes degenerate and leave behind cytoskeletal (cytokeratin) intermediate filaments
-PAS negative

Name of inclusion bodies
What syndrome are they found with

Mallory bodies

Alcoholic hepatitis

11

-enlarged rugal folds
-increased proliferation of mucus producing cells of the stomach
-may also lead to hypoalbumenemia and peripheral edema
-assoc w/ increased amounts of TGF-alpha
-s/s: diarrhea, epigastric discomfort, wt loss

Dx
Fecal loss of what would be clinically significant?

Menetrier disease

Loss of ptn

12

Volvus location in elderly vs children

Elderly: sigmoid colon

Children: cecum and ascending colon

13

What 3 structures run through the lesser omentum/hepatoduodenal ligament

Common bile duct

Proper hepatic artery

Portal vein

14

Patient is given triple therapy for PUD
-week later she became ill after having a glass of wine

D/t reaction of which drug is she on?

Triple therapy:
-bismuth subsalicylate
-omeprazole
-tetracycline or amoxicillin or metronidazole

Disulfram like reaction = metronidazole

15

Location of
-crohns dz
- UC

Crohns: patchy and involve distal ileum -> esophagus

UC: rectum and extend proximally

16

What does prussian blue stain for?

Iron -> hemochromatosis
-AR
-weakness, fatigue, loss of libido, wt loss, abdominal pain
-accumulation: joints, liver, heart