GI Flashcards by Rika Ravi

Name the retroperitoneal organs of the GI tract

Suprarenal glands (adrenal), 
Aorta + IVC
Duodenum (2-4 parts)
Pancreas
Ureter
Colon (ascending and descending)
Kidneys
Esophagus (lower 2/3)
Rectum

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Spinal cord level of celiac trunk

T12

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Spinal cord level of superior mesenteric artery

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Spinal cord level of inferior mesenteric artery

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Divisions of celiac trunk and supply

Splenic artery, left gastric and common hepatic. CH splits into gastroduodenal and proper hepatic. Proper hepatic gives off right gastric

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Divisions of SMA

inferior pancreato-duodenal, middle colic, right colic, ileocolic

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Divisions of IMA

left colic, sigmoidal, superior rectal

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Fracture of 10th and 11th ribs may result in injury of what organ?

Spleen

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Zollinger-Ellison is a _______ secreting tumor

Gastrin

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What hormone normally inhibits gastrin secretion, but increases gastrin secretion in gastrinomas?

Secretin

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Gastrin is secreted by _______ and normally functions to _______

G cells; increase acid secretion by parietal cells, increase gastric motility increase growth of mucosa

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Secretin is secreted by _______ and normally functions to _______

S cells; inhibit gastrin secretion

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Muscles of esophagus

Upper 1/3 is striated, Middle is mixed, and lower 1/3 is smooth muscle

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Hyperplastic polyps are ______ (benign/malignant) growths characterized by ______ on histology

Benign (and the most common); saw-tooth appearance

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Intussusception is caused by ______ (deformity) and presents with ______ stools.

Telescoping of bowel segment (typically ileum into cecum). Bloody “jelly” stools.

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Most common age of presentation for intussusception is

3-6 months

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Pyloric stenosis presents with ______ at ______ (age)

Forceful, nonbilious vomiting at 3-6 weeks

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Pyloric stenosis can be detected through _______

Abdominal ultrasound

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Lab values in pyloric stenosis show

hyperchloremic metabolic alkalosis (due to vomiting)

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G cells are located in _______

Antrum, duodenum and jejunum

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Chronic gastritis (autoimmune) is caused by ______ (pathophysiology)

Attack of CD4+ on the H+/K+ transporter in parietal cells

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What type of anemia is present in chronic gastritis?

Megaloblastic anemia. Parietal cells are unable to secrete intrinsic factor which assists in B12 absorption. Without B12, RBC cannot fully mature, resulting in megaloblastic anemia.

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Celiac’s disease is an intolerance to _______

Gluten

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A late complication of celiac’s disease involves in ______ , a skin manifestation

Dermatitis Herpetiformis

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On histology, celiac's disease is characterized by ______.

Flattening of the villi

Gallbladder pain radiates to ______

The back shoulder

Choledocholithiasis is obstruction of ______. On presentation, the patient has ______ and labs show ______.

Common bile duct, jaundice, elevated direct bilirubin

Pain from the gall bladder radiates to ______

Right scapula

Charcot's triad is seen in ______ and means _______.

Acute cholangitis; fever, jaundice and RUQ pain

Management for acute cholangitis is ______.

ERCP: endoscopic retrograde cholangiopancreatography

Meconium ileus is characterized by ______ and is seen in this disease.

Failure to pass first stool; cystic fibrosis

Necrotizing colitis presents ______ (age) and is associated with ______ (feeding)

2-3 weeks of life; formula-fed babies

Gastrinomas most often occur in _____ and _____

duodenum and pancreas

Meckel's diverticulum results from ______ .

Persistence of vitellin duct which is a connection between ileum and yolk sac

The Apoprotein molecule responsible for activating Lipoprotein Lipase is ______

Apo CII

Pernicious anemia is caused by ______. Symptoms include ______

Lack of Vit B12 absorption (could be due to damaged parietal cells). Weakness, fatigue, glossitis (big tongue), neurological deficits

Type I hyperlipidemia is characterized by increased ______ due to ______

chylomicrons; defective LPL or ApoCII

Enteric fistula to the bladder results in _____ in urine and is suggestive of ______

fecal matter; Crohn's disease

Barium study will show a ______ for Crohn's Disease

"string sign"

The inflammation in Crohn's disease is ______ vs in Ulcerative colitis is ______

transmural and has skipping; mucosa and submucosa and continuous

Most common site of inflammation in Crohn's is ______ and in Ulcerative Colitis is ______

ileum, rectum (goes proximal but never ileum)

The post-ganglionic cells of autonomics are derived from ______

neural crest cells

______ are cells of the adrenal gland that secrete epinephrine. They are derived from ______

chromaffin; neural crest cells

Colonic diverticula are out-pouchings of the ______ layers of the colon; and hence are called ______ diverticulum

mucosal and submucosal; false

Diverticulosis vs diverticulitis

diverticulosis is presence of diverticula without inflammation; diverticulitis is presence of diverticula with inflammation

The most common cause of painless bleeding in the elderly is ______

diverticulosis

Gastroschisis is caused by ______ and presents

incomplete fusions of lateral body folds; abdominal intestinal projections not covered by amnion adjacent to the midline

Barium enema of Hirschsprung's shows ______. The affected area is ______

Narrow rectum and dilated proximal colon; the narrow part that is aganglionic

The short gastric artery is a branch off ______ and supplied the ______

splenic artery; fundus of the stomach

In alcoholic hepatitis; LFTs reveal

Elevated AST and ALT with and AST:ALT ratio of >2

Alcoholic hepatits on histology is characterized by _____

Swollen and necrotic hepatocytes and Mallory hyaline bodies

An epigastric pain that is relieved by food indicates possible ______

ulcer in duodenum

Reye's Syndrome is damage to the ______ that causes ______

mitochondria, fatty liver and encephalopathy

______ causes fatty liver and encephalopathy and typically occurs post-viral illness

Reye's Syndrome

_______ enzyme deficiency presents during infancy with intolerance to fruit products. Known as ______.

Fructose-1-phosphate aldolase B

The problem in fructose 1 phosphate aldolase B deficiency is ______ which leads to (hyper/hypo) glycemia.

Trapping of inorganic phosphate. Leading to hypoglycemia (as glycogenolysis and gluconeogenesis require P)

Essential fructosuria is a deficiency in ______ and presents ______

fructokinase; asymptomatically

Classical galactosemia is caused by a _______ deficiency. Its inheritance pattern is ______. A prominent feature is ______

Galactose 1 phosphate uridylyl transferase; autosomal recessive; cataracts

What leads to cataracts in deficiencies of galactose metabolism?

Galactose gets converted to galactitol via aldose reductase. Leads to build up in lens

Dietary modification for deficiencies in galactose metabolism

Strict lactose restriction

Regulation of PDH

There is a PDH kinase which phosphorylates and inactivates. The kinase is activated by acetyl-coa, NADH and ATP. The kinase inhibited by pyruvate and ADP. The phosphatase is activated by Ca2+.

Lesch-Nyann Syndrome is a deficiency in ______ which is part of ______ pathway. This leads to ______ (metabolic). Features include ______ (various).

HGPRT, purine salvage; excessive de novo purine synthesis and uric acid (monosodium urate crystals). Self-mutilation, mental retardation

What area is below the pectinate line and what is the blood supply?

Bottom part of anus; supplied by inferior rectal artery.

Varicosities in the inferior rectal vein produce (internal/external) hemorrhoids that are (painful/painless)

External; painful

Sliding hiatal hernias

Gastroesophageal junction found significantly above the hiatus

Familial adenomatous polyposis typically occurs on the _____ side and arises from which pathogenesis pathway? Caused by what mutation?

Left; loss of APC, leading to KRAS mutation; 5q22

Hyperthyroidism caused by Graves disease is caused by which hypersensitivity?

Type II - noncytotoxic

What is Mallory-weiss tear?

Severe vomiting can result in a tear in the gastroesophageal junction which can lead to vomiting blood

Areas of rich anastamoses in the gut

Lesser curvature (Left and right gastric); greater curvature (right and left gastroepiploic)

MEN Type II is characterized by a mutation in ______

RET

Infant with hypothyroidism only shows symptoms and failure to thrive after a few weeks, why?

Maternal-fetal- transfer of T4

If you eat a ton of salt, what hormone maintains your plasma salt level?

ADH - thirst mechanism

MMC and role in bacteria

Maintain low bacterial count

Hemolytic anemia causes what kind of stones in the gallbladder

Bilirubinate stones (dark pigmented)

Intestinal metaplasia of the esophagus in Barrett's has what epithelium

Nonciliated columnar

The splenic artery and vein travel within what ligament

Splenorenal ligament

Pregnancy and its effects on thyroid hormone

Pregnancy increases estrogen which increases thyroid binding globulin. This results in increased Total T4 but TSH is normal because only free T4 can modulate TSH

Gastrin's role in mucosal barrier

Increases mucosa to thicken the barrier

GI Flashcards

(78 cards)