Shit - GIT UWorld Flashcards Preview

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Flashcards in Shit - GIT UWorld Deck (42):
1

Niacin main role and toxicity

Raises HDL (also lowers VLDL and TG synthesis)
Toxicity = flushing, hyperuricemia (ppt gout), hyperglycemia (acanthosis nigracans), hepatitis

2

Mechanism of base exception repair

Glycosylase recognizes deaminated base and removes it
Endonuclease and lyase remove the remaining sugar-Phosphate part
Polymerase puts new base in
ligase seals it

3

Gastrin on parietal cells

Secrete acid
also TROPHIC = parietal cell hyperplasia (seen in ZE)

4

PPT factors of SMA syndrome

Anything that causes decreased mesenteric fat (drops the angle) i.e. catabolism, bed rest
Also scoliosis correction

5

Superficial inguinal nodes drain:

all skin below bellybutton except posterior calf (popliteal)

6

Arsenic poisoning s/s and Rx

s/s = stomach pain, vomiting, delerium, GARLIC breath

Rx = Dimercaprol (which is nephrotoxic and hypertensive)

7

Cholestyramine AE

increased TAG and VLDL synthesis
Increased cholesterol content of bile so cholesterol stones
Decreases statin absorption (give 4 hrs apart)

8

Oxyphil histo

Eosinophils in upper glandular area of mucosa

9

Signs of poor prognosis in liver failure

Prolonged PT, low albumin, high bilirubin
[indicate liver function]

10

CREST esophagus shit

replace muscle with fibrosis --> dilated LES --> reflux -> barretts --> ACA

Esophageal hypomotility

11

TZDs mechanism

binds nuclear receptor PPAR-g to increase adiponektin levels to decrease insulin resistance

12

Pancreatic pseudocyst lined by; found where

granulation tissue and fibroblasts [real cysts = epithelium]

MC in lesser sac; boarders are stomach (ant), transverse colon, and duodenum

13

NFKB role in inflammation

cytokine production

14

Types of esophagitis and appearance

Eosinophilic = eosinophils, strictures
Reflux = metaplasia
Candida = plaques
CMV = linear ulcers
HSV = punched-out ulcers
Chemical ingestion

15

colonic diverticula = what kind of diverticulum

pulsion

16

Causes of acute pancreatitis

GET SHMASHED
[gallstones, ethanol, trauma, surgery, hypertriglyceridemia, mumps (coxsakie B and myco pneumo), Autoimmune, Scorpion sting, Hypercalcemia, ERCP, Drugs (sulfa, azathioprine, furosemide, valproic acid)

17

COX-2 and colon cancer

INCREASES the risk of adenomatous polyps

18

Arteries that run being posterior duodenum

Gastroduodenal
Branches = superior pancreaticoduodenal and right gastroepiploic

19

Malrotation of midgut: GI positioning, s/s

Cecum fixed to duodenum in URQ via Ladd bands.
Whole midgut fixed to SMA

s/s =
volvulus
Duodenal obstruction (bilious vomiting)

20

Acute opioids on the GIT

Contraction of smooth muscle of sphincter of Oddi --> increase biliary pressure --> biliary colic

21

Which has more acute s/s; hep B or hep C?

Hep B - serum-sickness-like: fever, malaise, rash, pruritis, LAD, joint pain

Acute Hep C usually asymptomatic

22

APC gene role:

Intracellular adhesion and inhibition of proliferation

23

Boarders of femoral hernias

Medial = inguinal ligament
Lateral = Femoral vein

24

GIT condition mimicking unstable angina

Diffuse Esophageal Spasms
- chest pain not relieved by rest and intermittent dysphagia

25

Carcinoid cells

Neuroendocrine: APUD/enterochromaffin

26

Drugs to slow down gastric motility

Loperamide and diphenoxylate - mu opioid agonists

27

Ribavirin MOA

interferes with duplication of viral genetic material

28

Causes of granulomatous bile duct destruction and lymphocyte-rich portal tract infiltrate

Primary biliary cirrhosis
Graft vs. host disease

29

Balloon degeneration vs bridging necrosis

Balloon = hepatocyte injury
Bridging necrosis = hepatocyte death

30

Increased estrogens in liver failure. mechanism and s/s

Decreased estrogen metabolism
Increase SHBG production (binds T more, increase E:T ratio)

Gynecomastia
Spider angiomas
Testicular atrophy
Decreased body hair

31

Ground-Glade hepatocytes =

HepB; full of HBsAg

32

MC watershed areas of the bowel

Splenic flexure
Distal sigmoid colon

33

Bioavailability (F) =

AUC oral / AUC IV

34

NAC mechanism

1) Glutathione substitute to detoxify NAPQI
2) Donates sulfhydryl to enhance non-toxic sulfaton elimination of acetaminophen (normal mechanisms @ low doses = sulfation and glucuronide conjugation)

35

Treatments for different types of nausea:

Visceral (chemo, GI bug, anesthesia) = 5HT3 antagonist
Vestibular = antimuscarinic and H1G1
Migraine = dopamine antagonists

*all are antagonists*

36

Secretin test

Normally secretin (from duodenum, in response to low pH) causes HCO3- from pancreas and inhibits gastrin release from G-cells

In ZE, secretin stimulation INCREASES gastrin levels
(ZE = ulcers past duodenal bulb

37

Hepatic steatosis mechanism:

1) inhibition of FA oxidation by increase NADH form alcohol metabolism
2) decrease lipoprotein synthesis and secretion
3) increased peripheral fat catabolism

38

Enzyme that's inhibition leads to cholesterol stones

7a-hydroxylase

39

Abetalipoproteinemia s/s

Malabsorption stuff
SI with foamy cytoplasm
Acanthocytes
Neurological: progressive ataxia and retinitis pigmentosa

40

UC CRC vs. sporatic

- younger
- early p53 and late APC
- come form flat lesions (not polypoid)
- mucinous/signet ring
- proximal colon
- multifocal
- higher grade

41

cause of direct inguinal hernias; covering

Weakness of transversals fascia

Covering = only external spermatic fascia

42

Calculating calories

protein = 4
carbs = 4
fat = 9
ethanol = 7