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Flashcards in UWorld Deck (34)
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Classic glactosemia

Autosomal recessive absence of galactos-1-phosphate uridyltransferase. Accumulation of toxic substances causes problems. Failure to thrive, jaundice, hepatomegaly, infantile cataracts, intellectual disability

1

Mallory-Weiss tear

Tear of the gastric mucosa near the gastroesophageal junction caused by forceful vomiting. Presents with vomiting and retching, hematemesis, and epigastric pain.

2

Boerhaave Syndrome

Esophageal transmural tear caused by forceful vomiting (often from Mallory-Weiss tear). Results in air escaping into the mediastinum and pleura --> chest and upper abdominal pain, fever, dyspnea, shock.

3

Mallory-weiss syndrome acid-base disturbance?

Vomiting --> metabolic alkalosis

4

What does a 99mTc-pertechnetate scan detect?

Presence of gastric mucosa

5

Accumulation of 99mTc-pertechnetate in R lower abdomen is diagnostic of

Meckel diverticulum

6

What causes Meckel diverticulum, and how does it manifest?

Failure of obliteration of the emphalomesenteric duct.
Lower GI bleed due to acid secretion by ectopic gastric mucosa

7

Congenital defect in Hirschsprung disease

Failure of neural crest cell migration

8

What gets blood supply from the foregut even though it isn't part of the foregut?

Spleen

9

How many calories of energy does 1g of protein yield?

4

10

Imperforate anus is associated with what other congenital malformations?

Urogenital tract anomalies

11

Annular pancreas

Pancreas encircles duodenum, can cause obstruction

Abnormal migration of ventral pancreatic buds

12

What embryonic cells give rise to Meissner and Auerbach plexi?

Neural crest cells

13

When do the neural crest cells reach the proximal colon? The rectum?

8th week, 12th week

14

Where are lipids digested? Where are they absorbed?

Digested in duodenum (bile salts), absorbed in the jejunum

15

What is the difference between a true and false diverticulum?

True: contains all 3 layers of intestinal wall (mucosa, submucosa, muscularis)

False: contains only mucosa and submucosa.

16

What does bilious vomiting after first 24 hours of life indicate?

Intestinal obstruction below second part of duodenum.

17

Enlargement of what heart chamber can cause dysphagia?

Left atrium

18

Total gastrectomy - what needs to be supplemented?

B12, because of intrinsic factor deficiency

19

Linkage disequilibrium

Pair of alleles are inherited together in the same gamete (haplotype) more or less often than would be expected by random chance. Can occur even if genes are on different chromosomes.

20

Which organ is impaired in a pt with weight loss, pain, excessive excretion of neutral fat?

Exocrine pancreas, seen in alcoholics

21

What structure lies underneath the angle of the SMA/aorta?

transverse duodenum

22

What organs/structures are retroperitoneal?

SAD PUCKER

Suprarenals (adrenals), aorta (IVC), duodenum (2nd-4th part), pancreas (except tail), ureters, colon (ascending and descending), kidneys, esophagus, rectum

23

What hormone stimulates exocrine pancreas to release bicarb?

Secretin, from S cells in the duodenum. Most potent stimulus is HCl.

24

Name the 3 poral-systemic anastomoses and their clinical manifestations.

1) Esophagus: left gastric - esophageal arteries --> esophageal varices
2) Umbilicus: Paraumbilical - small epigastric --> caput medusae
3) Rectum: superior rectal - middle and inferior rectal --> anorectal varices

25

Where does a ruptured gastric ulcer from lesser curvature bleed?

Left gastric artery

26

Where does a ruptured duodenal ulcer on posterior wall bleed?

gastroduodenal artery

27

What is pancreas divisum

Failure of the dorsal and ventral pancreatic buds to fuse. Ends up with two ducts, one for each part.

28

Crohn's disease: gross appearance and histology

Linear ulcers and normal mucosa interspersed --> cobblestone appearance. Creeping fat.

Histo: non-caseating granulomas, lymphoid inflammatory infiltrate (Th1 mediated)

29

What cell type mediates Crohn's disease?

Th1