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Flashcards in GI must knows Deck (95)
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1

Risk factor pnemonic for Esophageal cancer

AABCDEFFGH

Alcohol- Squamous (upper and Middle Esophagus)
Achalasia
Barrett's- Adeno
Cigarretes- both
Diverticula- Squamous
Esophageal web- Squamous
Familial-
Fat-
GERD- Adeno
H- Hot liquids- Squamous


2

Carcinoid Tumor is made up of what type of cell

neuroendocrine cells

3

Chromogranin positive tumor...think what?

Carcinoid Tumor

4

Carcinoid tumors often secrete what?

Serotonin

5

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).

6

Most common location of gastric ulcer

Antrum of the stomach (lesser curvature I think)

7

Black gallstones indicate

hemolysis

8

What makes the black gallstones black?

High Billirubin content

9

Acute Gastritis is or is not related to H. Pylori?

NOT
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
- NSAIDS
- ALcohol
- Chemo
- Shock

10

Chronic Gastritis causes

- Autoimmune
- H Pylori

11

What does a Urea breath test test for?

H Pylori...remember they give off urease

12

Chronic Autoimmune gastritis, whats the best way to test for it?

- Test for antibodies against parietal cells and intrinsic factor.

13

Know Ulcerative Colitis vs Crohns

ok

14

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

15

What enzyme is responsible for activating all other pancreatic enzymes?

Trypsin! MUST KNOW THAT

16

two causes of acute pancreatitis

alcohol and gallstones

17

Which pancreatic enzyme is more specific for acute pancreatitis

serum lipase

18

What truly characterizes chronic pancreatitis?

Fibrosis of the pancreatic parenchyma

19

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

20

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

21

Hyperplastic polyps most commonly found where

Left colon

22

What findings = bad prognosis with adenomatous polyp

Greater than 2cm, Sessile growth, villous histology

23

FAP?

Familial Adenomatous Polyposis Syndrome
This is an inherited APC (Adenomatous polyposis coli) mutation.
Colon and rectum removed prophylactically.

24

Gardner Syndrome

FAP + Fibromatosis + Osteomas

25

Turcot Syndrome?

FAP with CNS tumors

26

2 pathways that lead to CRC?

1) Adenoma - Carcinoma pathway
2) Microsatellite Instability Pathway

27

Tumor marker for pancreatic cancer

CA19-9

28

Major signs/symptoms for pancreatic adenocarcinoma in the head of the pancreas?

Obstructive Jaundice, Pale stools. Palpable gallbladder,

29

Major signs and symtpoms with pancreatic adenocarcinoma that arises in the tail or body?

Secondary diabetes Mellitus

30

Jaundice Bilirubin level?

Over 2.5 mg/dl