Flashcards in GI must knows Deck (95)
Risk factor pnemonic for Esophageal cancer
Alcohol- Squamous (upper and Middle Esophagus)
Esophageal web- Squamous
H- Hot liquids- Squamous
Carcinoid Tumor is made up of what type of cell
Chromogranin positive tumor...think what?
Carcinoid tumors often secrete what?
How does Carcinoid syndrome develop?
Carcinoid tumors release serotonin. As long as the tumor is somewhere in the GI that is not the liver, this serotonin is secreted into the portal circulation which brings it to the liver where it is metabolized by MAO into 5-HIAA. If the tumor mets to the liver however, it can secrete serotonin into the hepatic vein which can bypass liver metabolism and cause serotonin to enter the systemic circulation causing bronchospasm, diarrhea, and skin flushing. May also cause Carcinoid heart disease which is right sided valvular fibrosis (not left side because there is MAO in the lungs).
Most common location of gastric ulcer
Antrum of the stomach (lesser curvature I think)
Black gallstones indicate
What makes the black gallstones black?
High Billirubin content
Acute Gastritis is or is not related to H. Pylori?
Acute Gastritis risk factors include:
-Curling Ulcer (Burn- leads to hypovolemia which leads to decreased blood supply to the stomach. Normally the stomach is aided by blood supply which picks up leaked acid)
- Cushing ulcer- increased vagal nerve stimulation from increased intracranial pressure
Chronic Gastritis causes
- H Pylori
What does a Urea breath test test for?
H Pylori...remember they give off urease
Chronic Autoimmune gastritis, whats the best way to test for it?
- Test for antibodies against parietal cells and intrinsic factor.
Know Ulcerative Colitis vs Crohns
The inflammation and hemorrhage of the pancreas during acute pancreatitis is due most generally to what?
autodigestion of the pancrease by inappropriately activated pancreatic enzymes
What enzyme is responsible for activating all other pancreatic enzymes?
Trypsin! MUST KNOW THAT
two causes of acute pancreatitis
alcohol and gallstones
Which pancreatic enzyme is more specific for acute pancreatitis
What truly characterizes chronic pancreatitis?
Fibrosis of the pancreatic parenchyma
Clinical features of chronic pancreatitis
Pain that radiates to the back, steatorrhea, fat soluble vitamin deficiency, diabetes mellitus secondary to the destruction of islets, increased risk for pancreatic cancer
Peutz Jeghers Syndrome
Hamartomatous polyps throughout GI and freckle like spots on lips, oral mucosa.
Increased risk for colorectal, breast, and Gynecologic cancer
So, Polyps and Freckles...high cancer risk
Hyperplastic polyps most commonly found where
What findings = bad prognosis with adenomatous polyp
Greater than 2cm, Sessile growth, villous histology
Familial Adenomatous Polyposis Syndrome
This is an inherited APC (Adenomatous polyposis coli) mutation.
Colon and rectum removed prophylactically.
FAP + Fibromatosis + Osteomas
FAP with CNS tumors
2 pathways that lead to CRC?
1) Adenoma - Carcinoma pathway
2) Microsatellite Instability Pathway
Tumor marker for pancreatic cancer
Major signs/symptoms for pancreatic adenocarcinoma in the head of the pancreas?
Obstructive Jaundice, Pale stools. Palpable gallbladder,
Major signs and symtpoms with pancreatic adenocarcinoma that arises in the tail or body?
Secondary diabetes Mellitus