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Flashcards in GI High Yield Deck (146):
1

What organs are derived from the foregut?

Esophagus --> duodenum

2

artery of the foregut?

celiac

3

PNS innervation of midgut and foregut?

Vagus

4

PNS innervation of hindgut?

Pelvic splanchnic nerves

5

What organs are derived from the midgut?

Duodenum--> transverse colon

6

What organs are derived from the hindgut?

Transverse colon--> anal canal

7

Artery of the midgut?

SMA

8

Artery of the hindgut?

IMA

9

Opmaphalocele and gastrochisis result from a failure of what type of closure?

Lateral fold

10

Bladder exstrophy results from a failure of what type of closure?

caudal fold closure

11

"extrusion of abd contents through abdominal folds not covered by peritoneum"

gastroschisis

12

"persistance of herniation of abd contents into umbilical cord, sealed by peritoneum"

omaphalocele

13

What chromosomal abnormality is associated with duodenal atresia?

Trisomy 21

14

What causes atresia of jejunum, ileum and colon?

vascular accident

15

What presents with drooling, choking and vomiting with first feeding?

Tracheoesophageal anomalies

16

What is a clinical test for tracheoseophageal fistulas?

passing nasogastric tube into the stomach

17

"palpable 'olive' mass in epigastric region and nonbilous projectile vomiting at 2-6 weeks"

congeital pyloric stenosis

18

What causes congeital pyloric stenosis?

hypertrophy!

19

The liver is derived from what embryonic layer?

endoderm (of the foregut)

20

What is the pancreas derived from?

foregut (endoderm)

21

Which pancreatic duct contributes to teh pancreatic duct?

ventral bud

22

BOTH pancreatic buds contribute to the ________ of the pancreas

Head of the pancreas

23

Which pancreatic bud encircles the 2nd part of the duodenum?

ventral bud

24

"ventral and dorsal parts of the pancreas fail to fuse at 8 weeks"

pancreas divism

25

What does the spleen arise from?

mesentery of the stomach (mesoderm)

26

Which organs are retroperitoneal?

DAD PUCKER

Suprarenal glands
Aorta and IVC
Duodenum

Pancreas
Ureter
Colon (ascending and descending)
Kidneys
Esophagus
Rectum

27

What ligament encloses the portal triad?

Hepatoduodenal ligament

28

Which ligament encloses the gastric arteries?

Gastrohepatic

29

Which ligament encloses the gastroepiploic arteries?

gastrocolic

30

Which nerve plexus (Meissner or auerbach) aids in secretion of fluid?

Meissner (submucosal)

31

Frequency of the basal electic rhythm of:
1- stomach
2- duodenum
3- ileum

1- stomach: 3/ min
2- duodenum: 12/ min
3- ileum: 8-9/min

32

Where are brunner glands found? What is their function?

Duodenum

Secretes HCO3-

33

Where are peyers patches found?

Ileum

34

Where are crypts of Lieberkuhn found?

duodenum, jejunum, ileum and colon

35

What section of the small intestine has the largets amount of goblet cells?

Ileum

36

What causes SMA syndrome?

Transferse portion (3rd portion) of te duodenum is entrapped between SMA and Aorta--> intestinal obstruction

37

Where is the "watershed" area between the SMA and IMA?

Splenic Flexure of colon

38

Which arteries lie on the lesser curvature of the stomach?

Left and right gastric

39

Which arteries lie on the greater curvature of the stomach?

Left and right gastroepiploic

40

What artery do the short gastric arteries come off of?

splenic

41

Which branch of the celiac tree can supply the seophagus?

Left gastric

42

Which 2 vessels compose esophageal varices?

Left gastric (portal) and esophageal (systemic)

43

Which 2 vessels compose umbilical varices?

Paraumbilical (portal) and small epigastric veins of the anterior sbd wall (systemic)

44

Which 2 vessels compose rectal varices?

Superior rectal (portal) and middle and inferior rectal (systemic)

45

What defines the pectate line?

formed where the endoderm (hindgut) meets to ectoderm

46

Internal hemorrhoids are caused by which artery?

Superior rectal artery (branch of the IMA)

47

External hemorrhoids are caused by which artery?

inferior rectal artery (branch of internal pudendal artery)

48

Do external or internal hemorrhoids normally drain into the portal system?

Internal

49

Which hemorrhoids are painful... internal or external?

External (somatic innervation)

50

"painless jaundice"

tumors at the head of the panceras that cause

51

"GE junction is displaced upward through the diaphragm"

Hourglass stomach

Sliding hiatal hernia

52

"GE junction is normal but the fundus of the stoach protrudes into the thorax"

diaphragmatic hernia

53

Which inguinal ring are indirect inguinal hernia associated with?

deep inguinal ring--> follows the path of the descent of the testes

54

Hernia common in older men?

direct inguinal hernia

55

Which hernia is common infemales?

femoral hernia

56

Cell source of gastrin?

G cells

57

Cell source of smatostatin?

D cells

58

Cell source of CCK?

I cells

59

What is the "inhibitory" hormone of the GI system?

Somatostatin

60

Cellular source of secretin?

S cells

61

Which hormone works to increase pancreatic HCO3- secretion, increase bile secretion, and decrease gastric acid secretion?

Secretin

62

Cellular source of GIP?

K cells

63

Cellular source of motilin?

small intested

64

What does motilin do?

produces migrating motor complexes

65

What does motilin do?

produces migrating motor complexes

66

Which cells produce intrinsic factor?

parietal cells

67

Which cells produce gastric acid?

parietal cells

68

What cells produce pepsin?

chief cells

69

Which pancreatic enzyme activates the others? (cleave proenzymes to enzyme)

Trypsinogen/ trypsin

70

How is trypsinogen activated

Converted by trypsin by enterokinase/ enteropeptidase (brush- border enzyme)

71

How are glucose and galactose taken up from the lumen of the intestine?

SGLT1 (Na dependent)

72

What enzyme catalyzes the RLS of bile synthesis?

Cholesterol 7alpha- hydroxylase

73

Bile salts are bile acids conjugated to either....

glycine or taurine (so they are water soluble)

74

What enzyme s responsible for metabolizing heme?

Heme oxygenase

75

Which type of salivary gland tumor is the most common and also recurrs after resection?

Pleomorphic adenoma

76

What is the most common malignant salivary tumor that has both mucinous and squamous components?

mucoepidermoid tumor

77

Which salivart gland usually involves the facial nerve?

mucoepidermoid tumor

78

"benign cystic salivary gland tumor with germinal centers"

Warthing tumor

79

"loss of auerbach plexus and failure of relaxation of LES"

achaasia

80

Which infectious disease is associated with chagas disease?

achalasia

81

"trachealization of the esophagus"

Eosinophilic esophagitis

82

Linear ulcers in the esophagus?

CMV esophagitis

83

Punched out ulcers inthe esophagus?

HSV1 ensophagitis

84

"dysphagie + Fe deficient anemia + esophageal webs"

Plummer vinson syndrome

85

Curling ulcers are due to...

burns!

86

Cushing ulcer is due to...

brain injury (increased vagal stimulation)

87

"gastric hyperplasia (hypertrophied rugae), excess mucus production with resultant protein loss and parietal cell atrophy"

Menetriers disease

88

Is intestinal adenocarcinoma of the stomach or diffuse adenocarcinoma of the stomach associated with H. pylori?

Intestinal type

89

"signet ring cells found int he stomach"

difuse type adenocarcinoma

90

Which ulcer type (gastric or duodenal) is assocated with decreased pain with feeding?

duodenal

91

Gastric ulcer perforation lead to referred shoulder pain through whch nerve?

phrenic nerve

92

HLA type associated with celiac disease?

HLA DQ2
HLA DQ8

93

Immune cell types found in lamina propria of villi in celiac disease?

Lymphocytes--> Helper T cell mediated damage

94

Inheritance pattern of lactase deficiency?

AR

95

Test to differentiate pancreatic insufficiency from intestinal mucosal deficiencies?

D- xylose absorption test--> normal in pancreatic insufficiecny and decreased in intestinal mucosal defects

96

Difference between tropical sprue and celiac sprue?

tropical responds to Abx

97

"cobblestone mucosa, creeping fat, bowel wall thickening- string sign on barium swallow"

Crohn disease

98

Which is mediated by Th1...ulcerative colitis or crohn?

Crohns

99

Skin condition assocaited with CD and UC?

erythema nodosum

100

Does IBS pain improve or worsen with defecation?

Improve

101

"blind pouch protruding from the alimentary tract that communicates with the gut"

diverticulim

102

What factors can increase the risk of diverticulosis (caused by false diverticula)?

increased intraluminal pressure and focal weakness in the colon

103

What type of fistula can be seen in diverticulitis?

colovesical fistula...fistula with bladder

104

What part of the esophagus are zenker diverticulum found in?

upper (it is a false diverticulum)

105

"failure of the vitelline duct to involute"

Meckel diverticulum

106

2 complications of meckel diverticulum?

Intussusception and volvulus

107

Most common site of volvulus in infants and children?

Midgut

108

Most common location of volvulus in elderly?

Sigmoid colon

109

What is the most common site of intussuscpetion?

iliocecal junction

110

"currant jelly stools"

Intussusception or acute mesenteric ischemia

111

Hirschsprung disease is associated with what mutation?

RET gene mutation

112

"intestinal hypomotility without obstruction"

ileus

113

Where is APC gene located?

Chromosome 5

114

"FAP + osteoma/sarcoma + hypertrophy of retinal pigment + impacted teeth"

Gardner syndrome

115

"FAP + malignant CNS tumor"

Turcot syndrome

116

"Hamartomas throughout the GI tract and hyperpigmentation on mouth, lips, genitals and hands"

Peutx- Jeghers Syndrome

117

Which adenomatous polyps have higher malignant potentioal...tubular or villous?

Villous

118

Most common location of colon cancer?

Rectosigmoid > ascending > descending

119

Most common location of colon cancer?

Rectosigmoid > ascending > descending

120

Tumor marker for colorectal cancer?

CEA tumor marker

121

Adenoma- carcinoma sequence?

APC--> KRAS--> p53

122

ALP is a marker for...

Cholestatic and obstructive hepatobiliary disease, HCC, infiltrative disorders, bone disease

123

Cerulopasmin is decreased in....

Wilson disease

124

If you have an elevated ALP how can you differentiate liver / biliary disease from bone diseaes?

gamma glutamyl transpeptidase (GGT)

125

What organelle is targeted in Reye syndrome?

Mitochondria--> aspirin metabolites decrease beta oxidation by reversible inhibition of mitochondrial enzymes

126

Mallory bodies?

Alcoholic hepatitis

127

Which zone in the liver is effected most in alcoholic cirrhosis?

Zone III (central vein)

128

Common benign liver tumor?

Cavernous hemangioma

129

What exposure are angiosarcoma of the liver associated with?

arsenic and vinyl chloride

130

3 more common tumors to met to the liver?

GI, breast and lung

131

"misfolded gene product protein aggregates in hepatocelluar ER"

A1AT defciency

132

What is kernicterus?

Bilirubin deposition in brain (particulary the basal ganglia)

133

"mildly decreased UDPGT conjucation and impaired bilirubin uptake"

Gilbert syndrome

134

"grossly black liver due to defective liver excretion of CB"

Dubin- Johnson Syndrome

135

Mutation seen in Wilson disease?

AR inherited defect in Cu excretion into bile by hepatocyte Cu trasporting ATPase (ATP7B) gene

136

Treatment for Wilson disease?

Penicillamine or trientine

137

HLA type associated with Hemochromatosis?

HLA- A3

138

autoantibodies seen in primary biliary cirrhosis?

Anti-mitochondrial antbody (including IgM

139

"beading/ onion skinning of bile dict"

primary sclerosing cholangitis

140

"fistula between gallbladder and small intestine leading to air in biliary tree and allowing the passage of gallstones into the intestinal tract"

gallstone ileus

141

Which viris can cause cholecystitis?

CMV

142

"autodigestion of pancreas by pancreatic enzymes"

acute pancreatitis

143

Which viral infection is associated with acute pancreatitis?

mumps

144

Hypo or hypercalcemia associated with acute pancreatitis?

Hypocalcemia

145

Tumor marker of pancreatic adenoma?

CA 19-9

146

Trousseau syndrome?

Migratory thrombophlebitis associated with pancreatic adenocarcinoma

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