6-05 Cardio/gi

Front 1

functions of thenar/hypothenar mm

Back 1

OAF: oppose, aBduct, flex

Front 2

changes in bloodflow / vascular resistance in compensated coarctation of aorta

Back 2

decreased lower body SVR and increased upper body SVR (autoregulation --> vasodilation), allows blood flow to be normal in both upper and lower body

Front 3

ostium primum vs ostium secundum

Back 3

ASDs; primum is lower (septum primum grows cranial --> caudal), secundum is higher (represents the 'hole' formed in the septum primum to allow R-->L shunt during fetal life)

Front 4

blood supply to head of femur

Back 4

medial femoral circumflex (implicated in Legg-Calve-Perthes disease, aseptic necrosis if femur head)

Front 5

progressively increasing chest pain

Back 5

"crescendo" or unstable angina

Front 6

monckeberg arteriosclerosis

Back 6

"medial calcific sclerosis" -- dz of ELDERY, ring-like calcifications in MEDIA of MEDIUM-sized MUSCULAR arteries; no change in luminal diameter --> not clinically relevent

Front 7

3 features of NF1

Back 7

1) multiple neural tumors; 2) café-au-lait spots; 3) iris hamartomas (Lisch nodules)

Front 8

course of common peroneal nerve, common site of injury

Back 8

peroneal nerve courses by nec of the fibula (remember, fibula is lateral and superficial peroneal nerve innervates the lateral aspect of the foot -- SPooning from the side; also makes sense because peroneal nerve EVERTS the foot, so it must be lateral); neck of the fibula --> peroneal damage --> dropPED foot

Front 9

bullous pemphigoid vs Staph scalded skin syndrome

Back 9

staph in kids / infents; bullous pemphigoid is a dz of ELDERLY

Front 10

cardiac tamponade vs constrictive pericarditis

Back 10

both have: decreased CO, increased venous pressure (JVD); TAMPONADE: no kussmaul, yes pulsus paradoxus; PERICARDITIS: is opposite (yes kussmaul, no pulsus paradoxus - pressure not transmitted through rigid pericadrdial shell, but instead goes to jugular veins?? --> inc JVD with inspiration)

Front 11

classic signs of tamponade

Back 11

1) decreased arterial pressure (dec CO), 2) increased venous pressure (JVD), 3) small quiet heart

Front 12

contents of carotid sheath

Back 12

1) internal jugular vein; 2) common carotid artery; 3) vagus nerve

Front 13

blood supply to inerventicular septum

Back 13

anterior: LAD; posterior: posteriod descending artery (80% of time comes off of RCA, 20% off of L circumflex)

Front 14

blood supply of SA and AV nodes

Back 14

RCA

Front 15

changes in cardiac function during exercise

Back 15

1) increased CO because of inc stroke volume; 2) (later) increased heart rate --> inc CO

Front 16

O2 and pH effects on contractility (and therefore stroke volume)

Back 16

acidosis and hypoxia --> decreased contractility --> decreased SV

Front 17

causes of increased blood volume

Back 17

overtransfusion, sympathetic excitement

Front 18

resistance as f(viscosity, length, and radius)

Back 18

resistance = k * (viscosity * length / r^4)

Front 19

what changes viscosity

Back 19

viscosity ~= f(HCT); inc viscosity in: 1) polycythemia; 2) hyperproteinemic states, eg multiple myeloma; 3) hereditary spherocytosis (HS)

Front 20

wenckebach block

Back 20

mobitz type I; progressively increasing PR interval until dropped QRS, then reset

Front 21

pulsus pardoxus

Back 21

indicates cardiac tamponade; normally, decrease of thoracic pressure during inspiration --> increased venous return --> shift of septum --> slightly decreased L filling --> decreased pressure; in tamponade, fixed volume --> L ventricle compromised more --> exaggerated drop in BP

Hint 21

None

Front 22

SA/AV node action potential

Back 22

phase 4: slow Na leak current (no fast channels -- helps slow AV conduction), slope determines HR; phase 0: upstroke, mediated by Ca++ influx (no fast Na+ channels)

Front 23

p wave represents

Back 23

atrial depolarization

Front 24

pr interval represents

Back 24

conduction thru av node

Front 25

qrs represents

Back 25

ventricular depolarization

Front 26

qt interval represents

Back 26

mechanical contraction of ventricles

Front 27

delta wave

Back 27

wolff-parkinson-white syndrome; accessory pathway (bundle of kent) allows early depolarization of part of ventricles; can lead to reentry SVT

Front 28

mobitz I vs mobitz II

Back 28

mobitz I = wenckebach block, progressive lengthening of PR interval, asymptomatic; mobitz II: often n:1 block, can progress to 3rd degree --> BAD

Front 29

peripheral chemoreceptors

Back 29

aortic and carotid (~same loc as baroreceptors); respond to PO2 < 60, inc PCO2, and dec pH

Front 30

central chemoreceptors

Back 30

respond to CO2 and pH, NOT O2; cause CUSHING reaction (increased intracranial pressure --> hypertension, bradycardia, and irregular respirations)

Front 31

cushing reaction

Back 31

increased intracranial pressure --> cerebral hypoxia (vessels compressed) --> chemoreceptors --> inc BP until vessels patent --> hypoxia reversed, but inc BP detected by baroreceptors --> bradycardia

Front 32

organ that gets largest share of cardiac output

Back 32

liver

Front 33

nl pressures:

Back 33

RA: <5; RV: <25/5; PA: <25/10; LA: < 12; LV: <130/10; Ao: <130/90

Front 34

3 congenital R-L shunts

Back 34

early cyanosis, "blue babies" -- 1) Tetralogy of Fallot; 2) Transposition of the Great Vessels; 3) Truncus Arteriosus

Front 35

3 congenital L-R shungs

Back 35

late cyanosis (eisenmenger's), "blue kids" -- 1) VSD (harsh holosystolic murmur); 2) ASD (loud S1, wide fixed split S2); 3) PDA (close with indomethacin)

Front 36

location of shunt in PDA

Back 36

left pulmonary artery to aorta, derivative of branchial arch 6

Front 37

eisenmenger syndrome

Back 37

uncorrected L->R shunt --> PulmHTN --> shunt reverses --> late cyanosis, clubbing, polycythemia

Front 38

defects in tetralogy of Fallot

Back 38

PROVe: 1) Pulm Stenosis --> 2) RVH; 3) Overriding Aorta; 4) VSD; all caused by anterosuperior displacement of infundibular septum (unequal splitting of pulm trunk and AO

Front 39

congenital cardiac defects a/w 22q11

Back 39

Truncus arteriosus, Tetralogy of Fallot

Front 40

congenital cardiac defects a/w Down syndrome

Back 40

ASD (primum), VSD (endocardial cushion defect)

Front 41

congenital cardiac defects a/w congenital rubella

Back 41

Septal defects, PDA

Front 42

congenital cardiac defects a/w Turner Syndrome

Back 42

Infantile coarctation of the aorta (proximal to L. subclavian)

Front 43

congenital cardiac defects a/w Marfan's Syndrome

Back 43

AR

Front 44

congenital cardiac defects a/w Child of diabetic mother

Back 44

Transposition of the great vessels

Front 45

progression of atherosclerosis

Back 45

fatty streaks --> proliferative plaque --> complex atheroma

Front 46

angina types and assoc pain

Back 46

1) STABLE (pain with exertion); 2) PRINZMETAL'S (coronary spasm --> pain at rest); 3) UNSTABLE/CRESCENDO (worsening chest pain)

Front 47

red infarcts

Back 47

occur in organs with dual blood supply (eg lung, liver, intestines), or following reperfusion

Front 48

most common coronary artery occluded

Back 48

LAD > RCA > circumflex

Front 49

ECG changes following MI

Back 49

transmural: Q waves, ST elev; subendocardial: ST depression

Front 50

dressler's syndrome

Back 50

fibrinous pericarditis several weeks after MI (autoimmune)

Front 51

causes of dilated (congestive) cardiomyopathy

Back 51

(ABCCCDD): Alcohol, Beriberi, CoxsackiB, chronic Cocaine, Chagas, Doxorubicin tox, Diphtheria (exotoxin rockets); others: peripartum cardiomyopathy, hemochromatosis

Front 52

types of ASD

Back 52

ostium PRIMUM (5%): defect in lower atrial septum, can involve AV valves; ostium SECUNDUM (90%): center of atrial septum at foramen ovale, from abn of either setpum primum or secundum, AV valves nl;

Front 53

effects of nitro on angina

Back 53

helps with stable, doesn't help with prinzmetal or unstable

Front 54

cardiac rhabdomyoma

Back 54

most common primary cardiac tumor in KIDS; a/w TUBEROUS SCLEROSIS;

Front 55

equilibration of pressures in all 4 heart chambers

Back 55

seen in cardiac tamponade

Front 56

electrical alternans

Back 56

cardiac tamponade (heart axis shifts within fluid-filled pericardium from beat to beat)

Front 57

signs of bacterial endocarditis

Back 57

JANEWAY lesions (nontender, palms and soles); OSLER nodes (tender, fingers and toes); ROTH spots (retinal hemorrhages surrounding white spots); SPLINTER hemorrhages (nail bed)

Front 58

vegetations on both sides of valve

Back 58

libman-sacks endocarditis (a/w SLE); mitral stenosis, no embolic risk

Front 59

findings in rheumatic fever

Back 59

FEVERSS (Fever, Erythema marginatum, Valvular damage, Elevated ESR, Red-hot joints (polyarthritis), Subq nodules, Sydenham chorea)

Front 60

causes of serious pericarditis

Back 60

SLE, RA, infection, uremia (clear, straw colored exudate)

Front 61

causes of fibrinous pericarditis

Back 61

uremia, MI (dressler's), RF (fibrin-rich exudate)

Front 62

causes of hemorrhagic pericarditis

Back 62

TB, malignancy

Front 63

findings in pericarditis

Back 63

friction rub, ST elevations in all leads, "distant" heart sounds

Front 64

near absence of muscle tone and peristalsis of esophagus

Back 64

scleroderma -- replacement of muscle by dense connective tissue

Front 65

hourglass-shaped stomach on barium swallow

Back 65

hiatal hernia

Front 66

tx for severe crohn's dz

Back 66

corticosteroids (hydrocortisone suppositories for UC)

Front 67

most imp predictor of Carcinoid tumor metastatic potential

Back 67

site and size (carcinoid tumors in appendix / cecum, although most frequent, rarely met to liver; stomach/ileum/colon carcinoid tumors have high metastatic potential, esp if >2cm)

Hint 67

None

Front 68

relevence of architecture / cell pleomorphism in neuroendocrine tumors

Back 68

minimal

Front 69

most common course of Hep B infection

Back 69

60-65%: sublinical dz --> complete recovery; 20-25% acute hep (99% of these recover)

Front 70

meconium ileus

Back 70

retention of meconium in GI tract; often a manifestation of CYSTIC FIBROSIS (abormally visci pancreatic secretions --> gets stuck in small bowel);

Front 71

1' presentation of diffuse esophageal spasm

Back 71

midsternal pain, sometimes mis-dx as cardiac; caused by prolonged contraction of entier esophagus;

Front 72

scleroderma vs achalasia

Back 72

scleroderma has significant acid reflux with resultant esophagitis; achalasia has regurgitant food and heartburn

Front 73

3 main components of free edge of lesser omentum

Back 73

common bile duct, hepatic artery, portal vein (portal triad?)

Front 74

connection between greater and lesser sacs

Back 74

foarmen of winslow -- bounded by common bile duct, duodenum, stomach

Front 75

time of presentation of ostium secundum ASD

Back 75

late childhood -> 20s; systolic ejection murmur (increased RV volume) and wide fixed splitting of 2nd heart sound

Front 76

embryo: what causes separation of the atria from ventricles

Back 76

fusion of endocardial cushions

Front 77

type of gallstones found in chronic hemolytic disorders

Back 77

pigment (calcium bilirubinate)

Front 78

white oral lesion with risk of malignancy

Back 78

leukoplakia

Front 79

bile duct obstruction a/w UC

Back 79

PSC (primary sclerosing cholangitis), characterized by "beading" on ERCP

Front 80

types of chronic gastritis

Back 80

antral (Type B): a/w h.pylori; fundal (type A): a/w pernicious anemia

Front 81

causes of hematemesis

Back 81

duodenal ulcer, gastric ulcer, esophageal varices

Front 82

common sites of ischemic bowel infarction

Back 82

1) transverse colon near splenic flexure (switch from SMA to IMA); 2) rectosigmoidal junction (switch from IMA to Internal Iliac A.)

Front 83

consequence of SMA aneurysm

Back 83

compression of L. renal vein (passes anterior to aorta, just inferior to origin of SMA) --> can cause varicocele on the left along with renal and adrenal hypertension on the left

Front 84

contents of saliva

Back 84

mucin (lubricates food); alpha-amylase / ptyalin (breaks down starch); HCO3- (neutralizes oral bacterial acids, maintains dental health)

Front 85

muscle of the esophagus

Back 85

proximal 1/3 is skeletal, distal 1/3 is smooth (incl LES), middle 1/3 is mixed

Front 86

dysphagia: diffulcty with solids vs liquids

Back 86

just solids suggests mechanical disturbance, solids + liquids suggests motility disorder

Front 87

odynophagia vs heartburn

Back 87

odynophagia suggests esophageal spasm, heartburn suggests GERD

Front 88

manifestation of congenital GI problems

Back 88

manifest during neonatal period except for meckel diverticulum (can remain asymptomatic)

Front 89

sharp stabbing pain vs burning epigastric pain

Back 89

sharp stabbing usu pancreatitis, burning epigastric usu gastric/duodenal ulcer

Front 90

precursor lesion to oral cancer

Back 90

leukoplakia

Front 91

virchow node

Back 91

enlarged left-sided suprclavicular lymph node a/w gastric carcinoma

Front 92

krukenberg tumor

Back 92

metastatic dz to the ovaries from stomach; mucinous signet rign cells

Front 93

achalsia

Back 93

motility disorder, impaired relaxation of LES --> no liquids / solids can get through; tx w/ CCBs and nitrates

Front 94

secretin

Back 94

produced by duodenum in response to H+ --> increases pH by inhibiting gastric H+ secretion and increasing HCO3- secretion by pancreas, liver, gallbladder

Front 95

duodenal vs gastric ulcer

Back 95

DUODENAL: decreased pain after meals/antacids, a/w inc acid production; GASTRIC: pain persists, dec/nl acid production;

Front 96

hiatal hernia

Back 96

stomach thru diaphragm; can be caused by smoking or obesity; can cause GERD

Front 97

small bowel vs large bowel obstructions

Back 97

small bowel usu from adhesions; large bowel usu from neoplasms

Front 98

rota vs norwalk vs adeno

Back 98

rota usu in infants, adeno in kids, norwalk in older kids and adults

Front 99

diverticulosis vs diverticulitis

Back 99

diverticuLOSIS (MCC lower GI bleeding): bleeding, no pain; diverticuLITIS: PAIN (diverticuL-AIEEE-tis), bright red rectal bleeding, serious: perforation, peritonitis, abscess formation

Front 100

protozoal causes of diarrhea

Back 100

entamoeba (bloody), giardia (watery, foul-smelling), cryptosporidium (watery, large fluid loss, I/C pts)

Front 101

pear-shaped trophozoite with four pairs of flagella and two nuclei resembling eyes

Back 101

Giardia

Front 102

which IBD a/w sclerosing cholangitis (PSC)

Back 102

UC

Front 103

abdominal pain disproportionate to physical findings (no guarding, distention, tenderness)

Back 103

suggestive of mesenteric ischemia

Front 104

abetalipoprotienemia

Back 104

AR dz, lack of ApoB --> defective chylomicron formation, enterocytes stuffed with lipids; a/w acanthocytes ("burr" cells)

Front 105

charcot triad

Back 105

a/w acute cholangitis: 1) fever; 2) RUQ pain; 3) jaundice (obstructive --> conjugated bilirubinemia)

Front 106

amylase/lipase levels in gallstone vs EtOH pancreatitis

Back 106

much higher in gallstone-induced (thousands) vs hundreds in alcoholic pancreatitis

Hint 106

None

Front 107

posterior duodenal ulcer -- what artery affected?

Back 107

gastroduodenal

Front 108

snRNPs

Back 108

form spliceosomes in conjunction with proteins -- involved in removal of introns (RNA splicing)

Front 109

killed vs live attenuated polio vaccines

Back 109

killed (SalK) is given IM --> no GI IgA; live attenuated (Sabin) is given PO --> IgA

Front 110

AZT (ziduvudine) mech

Back 110

nucleoside RTI

Front 111

gastrin

Back 111

"food in stomach" hormone: secreted by G cells in antrum of stomach in response to distention, AA, peptides, or ACh; EFFECTS: increased HCl secretion by parietal cells in fundus of stomach, increased gastric motility, increased gastric mucosal growth (eg Zollinger-Ellison syndrome)

Front 112

CCK

Back 112

"fat in duod" hormone: secreted by I cells in duodenum in response to FA/AA; EFFECTS: decreased gastric motility, increased pancreatic enzyme secretion, increased gallbladder contraction, relaxtion of sphincter of oddi

Front 113

Secretin

Back 113

"acid in duod" hormone: secreted by S cells in duodenum in response to acid; EFFECTS: inhibits gastric HCl secretion, promotes pancreatic HCO3- secretion;

Front 114

Somatostatin

Back 114

"inhibitory hormone": secreted by delta cells of pancreas; EFFECTS: inhibits {GH, insulin, glucagon, CCK, gastrin} --> decreases acid and pepsinogen secretion, decreases pancreatic and intestinal fluid secretion, decreases gallbladder contraction

Front 115

GIP

Back 115

"gastric inhibitory peptide / glucose-dependent insulin peptide": secreted by K cells of duodenum in response to all three nutrient classes; EFFECTS: increased insulin release, decreased gastric H+ secretion;

Front 116

trypsinogen

Back 116

pro-protease secreted by pancreas into duodenum, acitvated to trypsin by enterokinase on duodenal brush border

Front 117

trypsin

Back 117

serine protease; activates other proenzymes (including trypsinogen)

Front 118

age group affected by indirect hernias + anatomy

Back 118

INfants, goes IN to INguinal canal (lateral to inferior epigastric vessels); occurs because of failure of processus vaginalis to close

Front 119

anatomy of direct inguinal hernia

Back 119

protrudes through Hesselbach's triangle (rectus m., inguinal ligament, inferior epigastric vessels)

Front 120

palpable "olive mass" epigastrically

Back 120

hypertrophic pylroic sphincter -- a/w vom, regurg in older kids (projectil vom at 2 weeks)

Front 121

AST:ALT ratio

Back 121

AST > ALT: alcoholic hep; ALT > AST: viral hep; AST only: MI

Front 122

GERD

Back 122

a/w hiatal hernia/incompetent LES, tobacco/EtOH; recumbent position increases discomfort

Front 123

esophageal webs

Back 123

mucosal folds above the aortic arch, a/w Plummer Vinson syndrome (Fe deficiency)

Front 124

Esophageal Rings (Schatzki)

Back 124

mucosal *rings* (vs folds) below aortic arch, near squamocolumnar junction; causes intermittent dysphagia

Front 125

risk factors for esophageal cancer

Back 125

ABCDEF (Alcohol, Barrett's, Cigarettes, Diverticuli (eg zenker's), Esophageal webs/Esophagitis, Familial)

Front 126

celiac vs tropical sprue

Back 126

celiac is AI, affects small bowel only; tropical is infectious, can affect entire small bowel

Front 127

chronic gastritis TWO TYPES

Back 127

Type A: fundal, Auto-antibodies to parietal cells --> pernicious Anemia, Achlorydia; Type B: antral, H.Pylori (type B = Bug); both inc risk of gastric carcinoma

Front 128

menetriere's disease

Back 128

enlarged gastric rugae --> loss of plasma proteins from altered mucosa --> protein losing enteropathy; inc risk of stomach cancer; gut looks like brain gyri

Front 129

PUD and cancer

Back 129

PUD does NOT predispose to cancer;

Front 130

UC vs Crohns presentation

Back 130

UC presents w/ bloody stool, a/w colon cancer, no fistulas; Crohns presents w/ nonbloody diarrhea and fistulae

Front 131

acute necrotic pancreatitis vs bacterial peritonitis, grossly

Back 131

acute necrotic pancreatitis can present w/ hemorrhage into necrotic areas, areas of white chalky fat necrosis on pancreas and other parts of abd cavity; bacterial peritonitis is characterized by a dull-appearing peritoneal surface w/ white-yellow supporative exudate

Front 132

VIP

Back 132

hormone produced by islet cells and neurons in GI mucosa; EFFECTS: relaxation of GI smooth muscle, dec H+ secretion, and stim of pancreatic HCO3- and Cl secretion

Front 133

VIPoma

Back 133

islet tumor --> PANCREATIC CHOLERA (WDHA: Watery Diarrhea, Hypokalemia, Achlorhydia); tx w/ somatostatin (octreotide)

Front 134

histo presentation of Crohns vs UC

Back 134

Crohns: intestinal inflam w/ scattered noncaseating granulomas; UC: collections of neutrophils within crypt lumina

Front 135

characteristics of colonic diverticula

Back 135

mech: pulsion (); structure: "false" -- only 2 layers;

Front 136

adult vs fetal diverticula

Back 136

diverticula acquired during adult life (eg Zenker) are usu false, while diverticula from fetal dev (eg Meckel) are true

Front 137

traction vs pulsion diverticulum

Back 137

TRACTION: due to inflam --> scarring; "true" structure; PULSION: pushed out by pressure (eg constipation --> straining); "false" structure

Front 138

plemorphic adenoma

Back 138

MC salivary gland tumor (usu parotid); BENIGN; contains myxoid/cartilage like elements + epithelial cells

Front 139

adeno vs squamous cell carcinoma of esophagus

Back 139

BOTH: dysphagia, anorexia, hematemesis; SQUAMOUS CELL: smoking, EtOH, upper and middle thirds of esoph; ADENO: barrett's, lower third

Front 140

crohns vs UC epi

Back 140

crohns: young jews;

Front 141

complications of meckel diverticulum

Back 141

intussusception (kids), volvulus (older)

Front 142

PAS positive macrophages

Back 142

Whipple disease (1' causes malabsorption; can affect any organ, a/w arthralgias, cardiac, and neuro sx)

Front 143

carcinoid tumor

Back 143

usu in appendix or SI; if met to liver, can become carcinoid syndrome --> vasoactive peptides --> flushing (5HT), watery diarrhea (VIP), right sided heart lesions (5-HT)

Front 144

types of polyps

Back 144

tubular (small, pedunculated MC, least malig potential) --> villous (large, sessile, velvety, many villi, HIGH malig protential)

Hint 144

None

Front 145

congenital unconjugated hyperbilirubinemias

Back 145

caused by defect in glucornyl-transferase; 1) GILBERT: 5% pop, usu asx; 2) CRIGLER-NAJJAR: Type I (dangerous, death/kernicterus), Type II (milder, tx w/ phenobarbital)

Front 146

congenital conjugated hyperbilirubinemias

Back 146

defect in bilirubin uptake; 1) DUBIN JOHNSON: black liver; 2) ROTOR: like DJ, but no liver discoloration

Front 147

leptospirosis

Back 147

Weil disease/ icterohemorrhagic fever: jaundice, renal failure, hemorrhage

Front 148

alcoholic hepatitis: histo

Back 148

fatty change, focal liver necrosis, neutrophilic infiltrates, and mallory bodies (intracytoplastmic eosinophilic hyaline inclusions)

Front 149

alcoholic cirrhosis findings

Back 149

micronodular hepatocelular damage, jaundice, hypoalbumin, coag factor deficiencies, Hyperestrinism

Front 150

primary vs secondary biliary cirrhosis

Back 150

BOTH: severe obstructive jaundice --> elev alk phos; PRIMARY: intrahepatic, autoimmune (AMA), mid aged women; SECONDARY: extrahepatic obstruction --> inflammation --> fibrous tissue formation, can lead to ascending cholangitis, histo: bile lakes

Front 151

primary sclerosing cholangitis

Back 151

PSC includes intra and extra hepatic bile ducts, is a/w UC, seen as "beading" on ERCP (alternating strictures and dilation; can lead to secondary biliary cirrhosis and cholangiocarcinoma; Charcot's triad of cholangitis: RUQ pain, fever, jaundice;

Front 152

budd chiari syndrome

Back 152

thrombotic occlusion of heptaic veins --> jaundice, hepatomegaly, liver failure; a/w polycythemia vera, HCC, abd neoplasms

Front 153

hemangiosarcoma (angiosarcoma)

Back 153

rare hepatic vascular tumor, a/w PVC, thorotrast, arsenic

Front 154

cholangiosarcoma

Back 154

bile duct carcinoma, a/w Clonorchis sinensis (liver fluke) and Thorotrast, NOT HBV/cirrhosis

Front 155

types of gallstones

Back 155

1) CHOLESTEROL: solitary, large, yellow; 2) PIGMENT: bilirubin, a/w HA and bacterial infection; 3) MIXED: MCC, cholesterol + calcium

Front 156

clinical manifestations of pancreatic cancer

Back 156

abd pain radiating to back, migratory thrombophlebitis (Trousseuau sign), obstructuve jaundice --> distended palpale gall bladder (Courvoisier law)

Front 157

infiltrative gastric cancer

Back 157

Linitis plastica (infiltration --> fibrosis --> thickened, rigid appearance)

Front 158

most common location of diverticula (esp in elderly)

Back 158

sigmoid colon, a/w low fiber diets

Front 159

which part of bowel most likely to have volvulus

Back 159

sigmoid colon (has redundant mesentary; ascending and descending are retroperitoneal, and transverse is stretched tight)

Front 160

"apple core lesion"

Back 160

CRC; left sided: obstructive, right sided: nonobstructive, but a/w anemia

Front 161

micro vs macronodular cirrhosis

Back 161

MICRO: metabolic insult (EtOH, hemochromatosis, wilson's); MACRO: significant liver injury (post-infec, drug-induced)

Front 162

estrogen effects of cirrhosis

Back 162

hyperestrinism (liver metabolizes estrogen)

Front 163

alpha-1-antitrypsin deficiency

Back 163

A1AT produced in liver, protects lungs from elastase; defienciency causes panacinar emphysema + liver cirrhosis (improperly secreted A1AT accumulates in liver)

Front 164

cholesterol stones

Back 164

big yellow gallstones; a/w obesity, Crohn disease, CF, old ppl, clofibrate, native americans