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Flashcards in GI Final Details Deck (47):
1

The crypts of keiberkuhn are found in what part of the intestine?

The Jejunum

2

What is a defining feature of the ilieum on histology?

Peyers patches in the lamina promria and submucosa

Crypts

Most number of goblet cells in small intestine

3

DOC for diverticulitis

Metronidazole and a Flurorquinolone

4

Meckel diverticulum associations

Rule of 2's

-2 inches long

-2 feet from the iliocecal valve

-2% of population

-2 years of life

-2 tissue types (gastric and pancreatic)

-2x more common in males

5

Currant jelly stools- What is it and what is a major association?

Intussuception--> GI tumors (mostly idiopathic in children)

6

Layers of GI and location of nervous bundles

Mucosa

Submucosa--> contains meissners plexus

Muscularis Propria--> further divided into the inner circular and outer longitudinal. Between these two lies Auerbach's (meyenteric) plexus

Serosa

7

Mutations involved in FAP

Mutation of APC gene (autosomal-dominant)

-->K-RAS mutation--> loss of P53--> tumors

8

FAP with osseus and soft tissue tumors

Gardener's syndrome

9

FAP and a malignant CNS tumor (like mudulloblastoma)

Turcot Syndrome (turcot=turban=head tumor)

10

Apple core lesion on barium enema

colorectal cancer

11

Marker for Colorectal cancer? How about pancreatic cancer?

CEA

- CA-19-9 and CEA

12

Whic mutation allows progression from adenomas to carcinomas in CRC?

Loss of p53

13

Mechanism by which Aspirin causes Reye syndrome

aspirin metabolites inhibit B-oxidation by reversible inhibition of mitochondrial enzyme

-->fatty liver, hepatoencephalopathy

14

What is the only case in which you will use aspirin in a child?

Kawasaki Dz

15

Characteristic cell seen on biopsy of alcoholic hepatits

Mallory bodies

16

Increased risk with exposure to arsenic and PVC

Angiosarcoma of the liver

17

How do you differentiate Budd-chiari syndrome caused by Right heart failure from that caused by IVC occlusion?

JVD will be present in an individual with RHF

18

What gene is resposible for the excretion of copper in the bile?

ATP7B--> deficient in wilson disease as well as copper unable to enter circulation as ceruloplasmin

19

Serum iron findings in hemochromotosis?

Increased Ferritin

Increased Iron

Decreased TIBC (transporters are all bound)

Increased transferrin saturation (accounts for TIBC)

20

Type of cardiac issue in hemochromotosis?

Restrictive cardiomyopathy

(Restrictive like a dog on a LEASH--> Loeffler syndrome, Endocardial elastosis, Amyloidosis, sarcoidosis, hemochromotosis)

21

Difference in etiologies between primary and secondary biliary cirrhosis

Primary--> autoimmune (anti-mitochondiral ab)

Secondary--> due to some secondary obstriction (stone, tumor in pancreas head, etc)

22

Tx of 1' biliary cirrhosis?

Ursadiol

23

Primary finding in primary sclerosing cholangitis?

Onion skin bile duct fibrosis

intra and extra-hepatic ducts

24

1' sclerosing cholangitis is associated with what disease?

Ulcerative colitis

25

Classic presentation of a pt with 1' sclerosin cholangitis?

Man (40)

+pANCA

Ulcerative colitis

cholangiocarcinoma

26

Common causes of acute pancreatitis

BAD HITS

Biliary stones

Alcohol

Drugs

Hypertriclycerides/Hypercalcemia

Idiopathic

Trauma

Scorpion sting

27

Calcifications in the LUQ with chronic fat malabsorbtion

Chroninc pancreatitis

28

Obstructive jaundice with a palpable non-tender gallbladder

Pancreatic adenocarcinoma (obstructing the bile duct)--> Courvoisier's sign

29

H2 blockers commonly used in PUD

Cimetidine, ranitidine, famotidine, nazitidine

30

Problems associated with cimetidine?

Potent cyp-450 inhibitor and antiandrogenic effects

31

PGE-1 analogue used to increase gastric mucosal barrier

Other uses?

Misoprostol

Maintain PDA (close with indomethicin)

32

Major side effects associated with aluminum and Mg antacids?

Hypokalemia

Aluminum--> constipation (aluminimum feces)

Magnesium hydroxide--> diarrhea (must go to bathroom)

33

TNF-alpha inhibitor used in the Tx of crohn's, UC, and RA

Infliximab

34

What test should always be performed before giving infliximab?

TB test

35

notocord becomes what adult structure

Nucleus pulposis of intervertebral disc

36

Marker for astrocytes

GFAP

37

Phagocytes of the CNS

Microglia

38

Colonic lesion with velvety coliflower like appearence

Villious adenocarcinoma

39

Young female with symetrically distributed tender points and morning stiffness with joint pain

Fibromyagia

40

What is the first part of the brain damaged with severe global ischemia?

Hippocampus

41

Weight gain, hair loss and dry skin in a patient on psychotropic meds. What is the medication?

Lithium

Causing hypothyroidism

42

What conversion is decreased in alkoptonuria

The conversion of Tyrosine to fumerate by homogentisic acid

43

What NT need BH4 for production

catecholamines, dopamine, serotinin, NO

44

Tx for borrelia bugdorferi

Doxycycline AND ceftriaxone

45

Cause of lambert-eaton syndrome?

Ab directed against presynaptic Ca2+ channels

Weakness while rising as well as autonomic instability also symptoms improve with use as more Ca is released from the SR

46

What two drugs are administered simultaneously in status epilepsis?

Lorazapam to stop the current seizure

Penytoin (cortical Na channel blockade) to prevent further seizing

47

What vitamin should be administered to a child from a asia, africa or europe presenting with measles?

Vitamin A

WHO recommends and it improves recovery d/t endemic vit. A deficiency in these areas