esophageal smc atrophy/fibrosis - low LES pressure - low/absent peristaltic ativ in esophageal body - abnml LES relaxation w/ swallowing

Random Flashcards by Alegra Mendez

scleroderma

esophageal smc atrophy/fibrosis

low LES pressure
low/absent peristaltic ativ in esophageal body
abnml LES relaxation w/ swallowing

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solids only + chronic heartburn –> progressive sx –>

peptic stricture

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solids and liquids + chronic heartburn –> progressive sx –>

scleroderma

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adjust these meds for renal insufficiency

histamine antagonists

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chronic gastritis
H. pylori + isolated in antrum
pH will be

low

H. pylori colonizes G cells –> hyperplasia –> inc gastrin –> inc acid –> dec pH

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in acute pancreatitis, hypo_____ is a poor prognostic marker

hypOcalcemia

suggests inc Ca flux into tissues, binding up peripancreatic fat

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temporary blockage of the exit of enzyme granules from acinar cells

Acute pancreatitis due to biliary sludge (early stones)

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osmotic diarrhea osmotic gap is

> 125

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which extra intestinal sx of UC is most likely to parallel disease course

peripheral arthritis

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thickened gallbladder wall

cholecystitis

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Effect of removing the gallbladder on lithogenic bile

Bile remains just as lithogenic after the gallbladder is removed

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brown pigment stones

stasis of bile and anaerobic bacterial infection within the biliary tree

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Most common site of gut carcinoids

terminal ileum

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carb absorption

absorbed in the proximal small intestine by a sodium-dependent carrier mechanism

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main stimulus for secretin stimulation

ACID

Secretin is released from intestinal mucosa into the splanchnic circulation when a higher acid load enters into the duodenum. This leads to increased bicarbonate secretion from the pancreas to help neutralize the acid and allow pancreatic enzymes (which require a more alkaline pH) to function.

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high LFTS >1000, negative viral hepatitis labs

acetaminophen OD

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secondary hemochromatosis

iron accumulation in kuppfer cells (macrophages)

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Sessile serrated adenomatous polyps

likely location

R colon

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tubular adenomas
tubulovillous
villous
sessile or pedunculated

likely location

L colon

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Cancers presenting with iron deficiency anemia and the lack of overt rectal bleeding

likely location

R colon

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Cancers presenting with blood

likely location

L colon

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Although the other disorders can cause intussusception, a ________ would be more common cause in this 4 y/o age group.

meckel’s diverticulum

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Air in the intestines is pneumatosis intestinalis and associated with ____________.

necrotizing enter colitis

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currant jelly stool

intussusception

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Omphalocele is always a defect in the

umbilical ring

Gastroschisis is a defect lateral to the

umbilicus

________(drug) has been shown to increase lower esophageal sphincter pressure

Metoclopramide

cystic fibrosis

chronic pancreatitis

hereditary hemochromatosis triad of sx

cirrhosis diabetes skin pigment (Fe+melanin=bronze)

small testes

hereditary hemochromatosis

Intense lymphocytic infiltration around the bile ducts in a portal triad

PBC

Intense staining of hepatocytes with Prussian blue

Hereditary hemochromatosis where the excess iron stains blue

most common salivary gland lesion

mucocele most comm at lower lip

dry eyes, dry mouth

Sjogren's (immune destroy of salivary and lacrimal glands) middle aged woman biopsy of the lower lip for dx

Sjorgren syndrome Abs

autoantibodies SS-A (Ro) and SS-B (La) antinuclear antibody test (ANA)

Sjorgren HLA

DR52

Both HPV + and - tumors are more common in male or female

male

which drugs worsen GERD

theophylline (dec LES P) | nifedipine (smc relaxant)

MRP2

Dubin Johnson inc conjugated bilirubin

Fe deficiency beefy red tongue esophageal web

Plummer-Vinson syndrome

chronic gastritis H. pylori + in entire stomach pH will be

high | H. pylori damages parietal cell via production of urease (urea --> ammonia + CO2

Abs to parietal cells

AI gastritis

high serum gastrin levels

chronic PPI use chronic atrophic gastritis ZE syndrome

___ gastritis (a type of chronic gastritis) induces ____ leading to risk of ____

AUTOIMMUNE gastritis (a type of chronic gastritis) induces INTESTINAL METAPLASIA leading to risk of GASTRIC ADENOCARCINOMA

NSAID induced ulcer may cause no sx except

bleeding

#1 MOA of NSAID --> ulcers

reduced mucosal BF via COX/prostaglandin inhibition

Which ulcers almost always involve H. pylori

duodenal ulcers | H. pylori --> inc gastrin acid prod

rapid gastric emptying

duodenal ulcers

which hormone increases pH in SI so pancreatic enzymes can function better

secretin

What stimulates CCK release and increasing the amount of digestive enzymes

partially digested fats and proteins

painless jaundice

head of pancreas neoplasm common bile duct obstruction

which intraductal papillary mutinous neoplasm is most likely to become malignant

IPMN - main duct

ER+

mucinous cystic neoplasm | pancreas, some malignancy

When do pseudopapillary tumors of the pancreas present

2nd-3rd decade

NOD2/CARD15

Crohns, ileal

IBD inflammatory mediators

``` Proinflammatory: TNFα IFNγ IL-1β IL-12 IL-18 IL-23 ```

cobblestoning

chron's

Which IBD has significant risk of adenocarcinoma when certain duration/extent characteristic occur?

UC >10 yr duration involvement of R colon or pancolitis

2 histo subtypes of microscopic colitis

lymphocytic (>20 intraepithelial lymphocytes) collagenous (still inc lymphocytes)

ischemic bowel disease phases

acute: hemorrhage in lamina propria, epithelial coagulative necrosis organizing (granulation, fibrosis) healed (atrophy, shortened crypts, branched glands)

ATP7B mutation

Wilson's

urosidol

tx for PBS, PBC

anti-mitochondrial Ab

PSC

SMAD4/DPC4

juvenile polyps

STK11

Peutz-Jeghers polyps

total colectomy indicated

FAP (familial adenomatous polyposis)

Lynch syndrome has inc risk of which cancers

colorectal endometrial stomach ovarian

pathologic stage T3

Tumor invades through muscularis propria | into subserosal fat

First degree relative with CRC or advanced adenoma < 60 | Two first degree relatives with CRC or adenoma at any age

Begin screening at age 40 or 10 years younger than age at first diagnosis, repeat every 5 years

One first degree relative with CRC or advanced adenoma > 60 | Two second degree relatives with CRC or adenoma

Begin age 40, repeat | every 10 years

Family or personal history of HNPCC

Colonoscopy at age 20-25

FAP

Flexible sigmoidoscopy age 12 – early total colectomy

pancolitis, when to begin annual colonoscopy?

8 years after diagnosis

PSC, when to begin annual colonoscopy?

at time of dx

reduce the risk of CRC

aspirin | post-menopausal hormone use (estrogen + progesterone)

reduce adenoma burden in FAP

celecoxib