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GI Random Flashcards

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1
Q

caudal fold closure

A

bladder extrophy

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2
Q

lateral fold closure

A

omphalocele, gastroschisis

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3
Q

rostral fold closure

A

sternal defects

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4
Q

macrolides

A

associated with hypertrophic pyloric stenosis

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5
Q

spleen

A

origin-mesoderm

foregut blood supply

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6
Q

retroperitoneal structure

A 
suprarenal glands
aorta and IVC
duodenum (2nd through 4th)
pancreas (except tail)
ureters
colon (descending and ascending)
kidneys
esophagus
rectum
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7
Q

falciform ligament

A

contains ligamentum teres hepatis (derivative of fetal umbilical vein)

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8
Q

hepatoduodenal ligament

A

portal triad (proper hepatic artery, portal vein, common bile duct)

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9
Q

omental foramen

A

connects greater and lesser sacs

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10
Q

gastrosplenic ligament

A

contains short gastrics and left gastroepiploic

separates greater and lesser sacs on left

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11
Q

submucosa

A

submucosal nerve plexus, secretes fluid

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12
Q

muscularis externa

A

myenteric plexus for motility

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13
Q

superior mesenteric artery syndrome

A

intermittent intestinal obstruction when transverse duodenum compressed between SMA and aorta

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14
Q

posterior duodenal ulcers

A

penetrate gastroduodenal artery causing hemorrhage

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15
Q

anterior duodenal ulcers

A

perforate into anterior abdominal cavity leading to pneumoperitoneum

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16
Q

esophagus anastomosis

A

left gastric to azygos

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17
Q

umbilicus anastomosis

A

paraumbilical and small epigastric veins of anterior abdominal wall

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18
Q

rectum anastomosis

A

superior rectal and middle and inferior rectal

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19
Q

treatment shunting

A

transjugular intrahepatic portosystemic shunt

can precipitate hepatic encephalopathy

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20
Q

location anal fissure

A

posterior (poorly perfused)

below pectinate line

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21
Q

zone 2 liver

A

yellow fever

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22
Q

femoral sheath

A

contains canal, vein, artery but not femoral nerve

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23
Q

spermatic cord

A

ICE tie
internal spermatic fascia (transversalis fascia)
cremasteric (internal oblique)
external spermatic fascia (external oblique)

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24
Q

indirect inguinal hernia

A

through internal (deep) inguinal ring and into scrotum
lateral to inferior epigastric
infants due to failure of processus vaginalis to close

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25
direct inguinal hernie
through inguinal triangle through parietal peritoneum medial to rectus abdominis, through external inguinal ring only, old men from weakness in transversalis fascia
26
pancreatic secretions
isotonic low-high Cl high-high HCO3
27
rate limiting step bile acid synthesis
7alpha hydroxylase
28
pleomorphic adenoma
mixed tumor, chrondromyxoid stroma and epithelium | recurs
29
Warthin tumor
cystic with germinal centers | found in smokers
30
cancer plummer vinson
squamous cell carcinoma
31
Menetrier disease
hyperplasia of gastric mucosa | excess mucus production with protein loss and parietal cell atrophy, decreased acid production
32
sister mary jospeh nodule
subcutaneous periumbilical mets
33
perforated ulcer
free air under diaphragm | referred pain to shoulder due to irritation of phrenic nerve
34
histology Celiac
villous atrophy | crypt hyperplasia and intraepithelial lymphocytes
35
D xylose test
blood and urine levels decrease with mucosal defects or bacterial overgrowth normal in pancreatic insufficiency
36
findings pancreatic insufficiency
decrease duodenal pH and fecal elastase | decrease KADE and B12
37
Whipple disease
PAS positive | cardiac, arthralgias, neuro symptoms
38
histology Crohn disease
transmural infalmmation cobblestone, creeping fat, bowel wall thickening noncaseating granulomas (T1 mediated)
39
histology ulcerative colitis
mucosal and submucosal inflammation only | crypt abscesses and ulcers (T2 mediated)
40
location of false diverticulum
vasa recta perforation of muscularis externa
41
location Zenker diverticulum
Killian triangle | between thyropharyngeal and cricopharyngeal parts of inferior pharyngeal constrictors
42
genetics Hirschsprung disease
RET | Down syndrome
43
locations of volvulus
midgut in children | sigmoid in adults
44
necrotizing enterocolitis
premature, formula fed infants with immature immune system | possible perforation-air in abdomen
45
serrated polyps
CpG hypermethylation microsatellite instability in BRAF sawtooth pattern
46
APC
tumor suppressor ch 5
47
Gardner
FAP and osseous and soft tissue tumors, hypertrophy of retinal pigment epithelium, impacted/supernumerary teeth
48
Turcot
FAP and malignant CNS tumor
49
Peutz-Jeghers
AD hamartomas throughout GI hyperpigmented mouth, lips, hands, genitalia increased risk GI and breast cancer
50
Lynch syndrome
AD DNA mismatch | proximal colon
51
histology cirrhosis
diffuse bridging fibrosis and regenerative nodules
52
spontaneous bacterial peritonitis
gram negative, aerobic paracentesis with ascitic fluid can worsen encephalopathy
53
decreased platelets in liver disease
decrease thrombopoietin, liver sequestration
54
mechanism Reye syndrome
decrease beta oxidation by reversible inhibition of mitochondrial enzymes
55
histology alcoholic hepatitis
``` swollen and necrotic hepatocytes with neutrophilic infiltation mallory bodies (damaged keratin) ```
56
triggers hepatic encephalopathy
increased production and absoprtion due to GI bleed, dietary, constipation, infection decreased removal due to renal failure, diuretics treat with lactulose, rifaximin, or neomycin
57
cavernous hemangioma
biopsy contraindicated due to hemorrhage risk
58
hepatic adenoma
OCP and anabolic steroid use
59
angiosarcoma association
arsenic and vinyl chloride
60
Budd Chiari
thombosis hepatic veins | associated with hypercoagulable states, polycythemia vera, postpartum, HCC
61
alpha1AT liver
aggregation in hepatocellular ER | PAS+
62
conjugated hyperbilirubinemia
biliary tract obstruction bilary tract disease-sclerosing or biliary cholangitis Dubin-Johnson and Rotor
63
location kernicterus
basal ganglia
64
treatment Crigler Najjar
phenobarbital-works in type II
65
genetics Wilson disease
ATP7B on chromosome 13
66
location Kayser-Fleischer rings
descemet membrane of cornea
67
genetics hemochromotosis
HFE C282Y>H63D on ch 6, HLA-A3
68
presentation hemochromatosis
restrictive or dilated cardiomyopathy (reversible) hypogonadism arthropathy-calcium pyrophosphate deposition at MCP
69
histology primary sclerosing cholangitis
onion skin duct fibrosis | strictures and dilation-beading
70
associations primary sclerosing cholangitis
UC, p-anca | risk of cholangiocarcinoma and gallbladder cancer
71
histology primary biliary sholangitis
lymphocytic infiltrate and granulomas destruction of intralobular bile ducts anti-mitochondrial Ab
72
histology secondary biliary cholangitis
extrahepatic bilary obstruction | increase pressure in intrahepatic ducts leading to fibrosis and bile stasis
73
associations cholesterol stones
obesity, Crohn, estrogen, advanced age, multiparity, rapid weight loss, Native American
74
associations pigment stones
crohn, hemolyis, alcoholic cirrhosis, advanced age, biliary infections, total parenteral nutrition
75
findings choledocholithiasis
gallstone in common bile duct | elevated ALP, GGT, direct bilirubin, AST/ALT
76
cause acalculous cholecystitis
CMV, stasis, hypoperfusion
77
symptoms ascending cholangitis
jaundice, fever, RUQ pain | altered mental status, hypotension (shock)
78
histology pseudocyst
granulation tissue, no epithelium
79
histology pancreatic adenocarcinoma
tumor from pancreatic ducts (disorganized glands)
80
H2 blockers and creatinine
cimetidine and ranitidine decrease excretion of creatinine
81
rebound acid increase
calcium carbonate
82
risk octreotide
increase risk of cholelithiasis due to CCK inhibition
83
side effects sulfasalazine
reversible oligospermia | sulfa toxicitiy

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