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Flashcards in USMLE GI Deck (68):
1

Liver to anterior abdominal wall

Falciform

2

Liver to duodenum

Hepatoduodenal, portal triad: hepatic artery, portal vein, common bile duct

3

Liver to lesser curvature of stomach

Gastrohepatic, gastric arteries

4

Greater curvature and transverse colon

Gastrocolic, gastroepiploic arteries

5

Greater curvature and spleen

Gastrosplenic, small gastric arteries, left gastroepiploic vessels

6

Spleen to posterior abdominal wall

Splenorenal, splenic artery and vein

7

Octreotide is a _____ analog used to treat what 4 conditions?

Somatostatin
Acromegaly
Insulinoma
Carcinoid syndrome
Variceal bleeding

8

Gastrin - source

G cells

9

Gastrin - action (3)

Increase H+ secretion
Increase growth of gastric mucosa
Increase gastric motility

10

Gastrin - regulation (6)

Increased by:
stomach distention,
alkalinization,
amino acids,
peptides,
vagal stimulation
Decreased by pH

11

Somatostatin - source

D cells in pancreatic islets and GI mucosa

12

Somatostatin - action (4)

Decrease gastric acid and pepsinogen secretion
Decrease pancreatic and SI secretion
Decrease gallbladder contraction
Decrease insulin and glucagon secretion

13

Somatostatin - regulation (2)

Increased by acid
Decreased by vagal stimulation

14

CCK - source

I cells in duodenum, jejunum

15

CCK - action

Increase pancreatic secretion
Relax Sphincter of Oddi
Increase gallbladder contractions
Decrease gastric emptying

16

CCK - regulation

Increased by fatty acids and amino acids

17

Secretin - source

S cells (duodenum)

18

Secretin - action (3)

Increase pancreatic HCO3 secretion
Increase bile secretion
Decrease gastric acid secretion

19

Secretin - regulation

Increased by acid, fatty acids in lumen of duodenum

20

GIP (Gastric inhibitory peptide) - source

K cells (duodenum, jejunum)

21

GIP (Gastric inhibitory peptide) - action

Decrease H+ secretion
Increase insulin release

22

GIP (Gastric inhibitory peptide) - regulation

Increased by fatty acids, amino acids, oral glucose

23

Motilin - source

Small intestine

24

Motilin - action

Produces migrating motor complexes to stimulate intestinal peristalsis

25

Motilin - reg

Increased in fasting state

26

What structure lies lateral to a femoral hernia?

Femoral vein

27

What artery is located posterior to the duodenal bulb?

Gastroduodenal artery

28

1 g of protein yields how many calories of energy?

4 cal

29

What vitamins do you need supplement a purely breastfed baby?

Vit D & K

30

Carcinoid tumour and other neuroendocrine tumours will be positive for what?

Chromogranin

31

Under what conditions will you see carcinoid syndrome from a carcinoid tumour

Metastases to liver due to first pass metabolism of serotonin

32

What is the histologic hallmark of ulcerative colitis?

Crypt abscesses with neutrophils

33

Risk of carcinoma in UC depends on what factors?

Extent (more = worse) and duration (>10 years) of involvement

34

What is the histologic hallmark of Crohn's disease?

Noncaseating granulomas with lymphoid aggregates

35

What test do you need to dx Hirschsprung's?

Rectal suction biopsy

36

What condition is Hirschprung's classically associated with?

Down Syndrome

37

What are the complications of a diverticulum?

Rectal bleeding (hematochezia)
Diverticulitis
Fistula

38

Where in the colonic wall is particularly susceptible to diverticulum formation?

Where vasa recta perforate the muscularis propria

39

What protects against the Adenoma-carcinoma sequence?

Aspirin, by blocking COX

40

What increases the risk of progression from colonic adenoma to carcinoma?

1. > 2cm
2. Sessile growth (flat)
3. Villous histology

41

What cancers are colorectal carcinomas associated with?

Endometrial
Ovarian
Skin

42

What is CEA useful for in Colon CA?

Treatment response and recurrence; NOT screening

43

What is the first enzyme that is activated in acute pancreatitis?

Trypsin

44

What is a complication of an annular pancreas?

Duodenal obstruction

45

What do you think of when you see a thin elderly person with new onset T2DM?

Pancreatic cancer in the body/tail.

46

What biomarker is associated with pancreatic cancer?

CA 19-9 (more specific than CEA)

47

What do you think of when you see an elderly woman with new onset cholecystitis?

Gallbladder carcinoma

48

What causes dark urine in gallbladder problems?

Excessive urubilinogen

49

What is the mechanism by which phototx resolves physiologic neonatal jaundice?

Converts unconjugated bilirubin to a water-soluble form

50

A surgeon is operating and finds a pitch black liver. What condition does this patient have?

Dubin Johnson Syndrome

51

What do you worry about in a pregnant woman with Hep E?

Fulminant hepatitis

52

What cell mediates fibrosis in cirrhosis?

Stellate cell

53

In what condition will you find Mallory bodies and what do they contain?

Alcoholic hepatitis, contain damaged keratin filaments

54

What is the mechanism of injury in hemochromatosis?

Free radical generation

55

What marker do you look for in primary biliary cirrhosis?

Anti-mitochondrial antibody

56

What is damaged in Reye syndrome?

Hepatic mitochondria

57

Hepatic adenomas are related to what drug use?

OCP, will go away with cessation

58

What tumour marker is used in hepatocellular carcinoma?

Alpha-fetoprotein

59

Bloody diarrhea from E. Coli produces a substance that inhibits protein synthesis. What is this substance and what is it most similar to?

Shiga-like toxins, shigella.

60

Prolonged cholestasis can lead to poor absorption of fat soluble vitamins, leading to what condition?

Osteomalacia

61

Direct vs indirect inguinal hernia?

Medial and lateral to inferior epigastric artery

62

What organ is derived from mesoderm but supplied by foregut vessel?

Spleen

63

What hematologic side effect do you see with alcoholism?

Macrocytosis

64

Cecum stuck to RUQ. What happened?

Midgut failed to rotate around SMA

65

What is another name for lactose?

Galactosyl B-1,4-glucose

66

PAS = stain for what?

Glycoprotein

67

Recurrent pseudomonas infections =?

CF

68

Cancer in 3rd part of duodenum invades what structure?

SMA