First Aid Gi

Front 1

Auerbach plexus
what?
where?

Back 1

Myenteric plexus
Coordinates Motility
Located between inner (circular) and outer (longtidinal) layer of smooth muscle

Front 2

Meissner's plexus
what?
where?

Back 2

Submucosal plexus
Regulates local Secretions, blood flow, absorption
Located between mucosa & inner layer of smooth muscle in GI tract wall

Front 3

What landmark separates the internal and external hemorrhoids?

Back 3

Pectinate Line
Formed where hindgut meets ectoderm

Front 4

VATER Syndrome

Back 4

Vertebral Abnormalities
Anal Atresia
Tracheoesophageal fistula
Esophageal Atresia
Renal Disease
absent Radius

also assoc. w/
Limb & Cardiac abnormalaties

Front 5

Parietal cells of stomach make?

Back 5

Intrinsic factor
Gastric Acid

Front 6

Chief cells of the stomach make?

Back 6

Pepsin

Front 7

How are pancreatic enzymes activated?

Back 7

Trypsinogen is (+) by enterokinase (brush border) and trypsin (+) other proenzymes and more trypsinogen

Front 8

Salivary amylase hydrolyzes which bonds?

Back 8

⍺-1,4 linkages
Yields disaccharides

Front 9

What is D-xylose used for?

Back 9

To differentiate malabsorption due to small bowel disease from pancreatic insufficiency.

Is a monosaccharide which does not require pancreatic enzymes to be absorbed

Front 10

SGLT-1 transporter

Back 10

Enterocyte Na-dependent transporter which takes up glucose & galactose

Front 11

Duodenal atresia is assoc. w/which genetic abnormality?

Back 11

Down Syndrome

Front 12

Primary & Secondary causes of achalasia?

Back 12

Primary: Loss of myenteric (Auerbach's) plexus & uncoordinated peristalsis

Secondary: Chagas' Disease (Trypanosoma cruzi neurotoxin destroys myenteric plexus)

Front 13

Non-bilious projectile vomiting around 2 weeks of age?

Back 13

Congenital pyloric stenosis

More common in 1st born males

Is not present at birth

Front 14

Celiac Disease is assoc w. which skin manifestation?

Back 14

Dermatitis herpetiformis
(papulovesicular lesions on extensor surfaces)

Front 15

Type A Chronic Gastritis

Back 15

Autoantibodies vs parietal cells
Get Pernicious Anemia & Achlorhydria

Affects Fundus & Body

pneumonic: AB pairing

Front 16

Type B Chronic Gastritis

Back 16

Caused by H. pylori

Affects Antrum

Front 17

H. pylori has highest assoc with which form of peptic ulcer disease?

Back 17

Almost 100% Duodenal Ulcers are caused by H. pylori

Front 18

Which peptic ulcer is precancerous?

Back 18

Gastric Ulcer

Front 19

Krukenberg's tumor

Back 19

bilateral hematogenous mets to ovaries from gastric adenocarcinoma

Many mucus-filled "signet-ring" cells

Front 20

Another name for diffuse, infiltrative gastric adenocarcinoma?

Back 20

Linitus plastica
Thickened, rigid appearance
Stomach does not peristalse
Not assoc. w/ H. pylori
See signet-ring cells

Front 21

Virchow's Node?

Back 21

involvement of Left supraclavicular node by mets from gastric adenocarcinoma

Front 22

Crohn's Diease effects which part of the GI tract?

Back 22

Can effect any part but usually effects the terminal ileum & colon

Front 23

Which inflammatory bowel diease has a higher assoc. w/ colorectal adenocarcinoma?

Back 23

Ulcerative Colitis

Front 24

Where are diverticula mostly found?

Back 24

Sigmoid colon

Front 25

Meckel's Diverticulum
Caused by?
Most common what?
Lined with what epithelia?

Back 25

Persistence of vitelline (omphalomestenteric) duct or yolk stalk.

Most common congenital anomaly of GI tract

May have gastric/pancreatic epithelia (aka Ectopy)

Can have persistent communication w/umbilicus and feces can come out.
Most common complication: bleeding from acid production (Can lead to iron deficiency)

Front 26

Rule of 2's

Back 26

Refers to characteristics of Meckel's Diverticulum

2" long
2' from ileocecal valve
2% population
Presents in first 2 years of life
Can have 2 types of epithelia (gastric/pancreatic)

Front 27

Zenker's Diverticulum

Back 27

False diverticulum
Weakness in cricopharyngeus muscle leads to herniation of tissue at pharynx/esophageal junction

Halitosis, dysphagia, obstruction, diverticulitis

Front 28

Hirschsprung's Disease is assoc w/ which genetic abnormality?

Back 28

Down Syndrome

Front 29

Hirschsprung's Disease
pathogenesis?
clinical presentation?

Back 29

Failure of neural crest migration
Absence of Auerbach & Myenteric Plexuses -> constricted aganglionic segment
Presents w/ chronic constipation early in life & dilated megacolon

Front 30

Brunner's glands are hypertrophied in what disease?

Back 30

Peptic Ulcer disease

Are found in Duodenal submucosa
(only GI submucosal glands)

Front 31

Signs of a tracheoesophageal fistula

Back 31

Air in stomach -> distension
Maternal polyhydramnios
Food regurgitation
Aspiration -> chemical pneumonia

Front 32

If a baby is born with an imperforate anus, you should look for other abnormalities in what place?

Back 32

Commonly associated w/ genitourinary tract malformations

*More common than an assoc. w/VATER Syndrome

Front 33

Source & action of gastrin?

Back 33

G cells in antrum of stomach

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

Front 34

Which 2 amino acids are potent (+) of gastrin secretion?

Back 34

Tryptophan
Phenylalanine

Front 35

Source & action of Cholecystokinin?

Back 35

I cells in duodenum & jejunum

↑ pancreatic secretion
↑ gallbladder contraction
↓ gastric emptying

Front 36

Source & function of Secretin?

Back 36

S cells in duodenum

↑ pancreatic bicarb secretion
↓ gastric acid secretion

Front 37

Source & function of Somatostatin?

Back 37

D cells in pancreatic islets & GI mucosa

↓ gastric acid & pepsinogen secretion
↓ pancreatic & SI fluid secretion
↓ gallbladder contraction
↓ insulin & glucagon release

Front 38

Clinical uses of ocreotide?
(5)

Back 38

Somatostatin analog

VIPoma
Carcinoid tumors
Acromegaly
Gastrinoma
Glucagonoma

Front 39

Source & function of Vasoactive Intestinal Peptide?

Back 39

Parasympathetic ganglia in sphincters, gall bladder, small intestine

↑ intestinal water & electrolyte secretion
↑ relaxation of intestinal smooth muscle & sphincters
↓ gastric acid secretion

Front 40

Systemic Mastocytosis
what is it?
clinical signs?

Back 40

Mast cell proliferation in BM & other organs
↑ histamine secretion
Leads to:
↑ gastric acid secretion → diarrhea → N/V, abd. cramps
syncope, flushing, hypotension, tachycardia, bronchospasm
pruritis, urticaria, dermatographism

Front 41

Acute gastritis:
What is it?
What is it caused by? (9)

Back 41

EROSIVE disruption of mucosal barrier (does not extend past muscularis mucosa). Leads to inflammation
Clinical signs: N/V, hematemesis, melena, Fe deficiency
Causes:
Stress, NSAIDs, alcohol, uricemia, burns (Curling's ulcer), brain injury (Cushing's ulcer), smoking, Anisakis infection, CMV (if have AIDS)

Front 42

Gastric Ulcers
Who?
Where?
Why?
How does eating affect pain?

Back 42

Older patients (50-60 yo)

Single ulcer on lesser curvature of stomach

H pylori infection in 70% or due to chronic NSAID use

Pain is worse w/meals -> weight loss

Front 43

Duodenal Ulcer:
Cause
When is it painful?

Back 43

Account for 75% peptic ulcer disease

Almost 100% due to H. pylori

Is painful a few hours after eating

Pain resolves w/ antacids (doesn't in gastric ulcers)