Small Bowel

Question 1

retroperitoneal portions of the duodenum

Answer 1

descending and transverse

Question 2

transition point between the third and fourth portions of the duodenum

Answer 2

acute angle between the aorta and SMA

Question 3

site of B12 absorption

Answer 3

terminal ileum

Question 4

site of iron absorption

Answer 4

duodenum

Question 5

90 % of water absorption

Answer 5

jejunum

Question 6

vascular supply of jejunum

Answer 6

SMA

Question 7

intestinal brush border

Answer 7

maltase sucrase, limit dextrinase, lactase

Question 8

M cells

Answer 8

antigen presenting cells in the intestinal wall

Question 9

Peyers patches

Answer 9

lymphoid tissue, incureased in the ileum

Question 10

absorption of bile salts

Answer 10

45 % ileum, 5 % colon passive

50% active in terminal ileum

Question 11

conjugation of bile

Answer 11

to taurine and glycine

Question 12

primary bile acids

Answer 12

cholic and chenodeoxycholic acid

Question 13

secondary biles acids

Answer 13

deoxycholic and lithocholic

Question 14

short gut syndrome

Answer 14

diarrhea, steatorrhea, weight loss, nutritional deficiency

Question 15

check for fecal fat

Answer 15

sudan red stain

Question 16

schilling test

Answer 16

tests for B12 absorption (radiolabeled B 12 in urine)

Question 17

causes of steatorrhea

Answer 17

gastric acid hypersecretion of acid

interruption of bile salt reorption

Question 18

non healing fistulas

Answer 18

FRIENDS

foreign body, radiation, inflammatory bowel disease, epitheliazation, neoplasm,, distal obstruction, sepsis/ infection

Question 19

air in the biliary tree

Answer 19

gallstone ileus

Question 20

gallstone ileus

Answer 20

SBO fro gallstone in terminal ileum

fistula between gallbladder ans second protion of duodenum

Question 21

meckels diverticulum

Answer 21

2 ft from ileocecal valve, 2 % of population, 2 yr of life at presentation
2 types of tissue - pancreas and gastric

Question 22

failure of closure of the omphalomesenteric duct

Answer 22

meckels diverticulum

Question 23

most common tissue found in meckels diverticulum

Answer 23

pancreas tissue

Question 24

most likely tissue in meckels to be symptomatic

Answer 24

gastric mucosa

Question 25

breakdown product of serotonin

Answer 25

5-HIAA - can be measured in urine

Question 26

precursor of serotonin

Answer 26

tryptophan

Question 27

produces serotonin

Answer 27

kulchitsky cells (enterochromaffin cell)

Question 28

carcinoid syndrome

Answer 28

intermittent flushing and diarrhea

Question 29

most common site for carcinoid tumor

Answer 29

appendix

Question 30

carcinoid in appendix < 2 cm

Answer 30

appendectomy

Question 31

carcinoid in appendix > 2cm or involving base

Answer 31

right hemicolectomy

Question 32

Peutz jeghers syndrome

Answer 32

jejunal and ileal hamartomas, mucocutaneous melanotic skin pigmentation

Question 33

most common cause of appendicitis in children

Answer 33

hyperplasia

Question 34

most common cause of appendicitis in adults

Answer 34

fecalith

Question 35

most likely spot of appendix to perforate

Answer 35

midpoint of antimesenteric border