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77 Cards in this Set
- Front
- Back
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what layer is the Meissner plexus located?
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submucosal
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what layer is the auerbach's plexus in
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muscularis externa
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histo of esophagus?
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nonkeratinized strat squam epithelium
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brunner's gland in what layer and what organ?
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in duodenal submucosa
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crypts of lieberkuhn found where?
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throughout SI
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Peyer's patches where?
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ileum
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this part has the largest number of goblet cells in the SI?
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jejunum
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myenteric nerve plexus (Auerbachs) for what?
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motility
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submucosal nerve plexus (Meissner) for what?
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secretion regulation
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around the stomach where are strong anastomoses at?
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between left and right gastrics
between left and right gastroepiploics |
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artery found just superior to the antrum of stomach?
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gastroduodenal
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artery that runs along inferior margin of stomach?
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from the left = L gastroepiploic (splenic origination)
from the right = right gastroepiploic (gastroduodenal origination) |
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caput medusae - from what?
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anastomoses of paraumbilical w/ superficial and inferior epigastric
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internal hemorrhoids from waht?
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anastomoses of superior rectal and middle/inferior rectal
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cancer above pectinate
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adenocarcinoma
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blood supply above pectinate line
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superior rectal artery from IMA
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blood supply below pectinate line
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inferior rectal artery from internal pudendal
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ultimate destination of venous drainage above pectinate line
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Inf. Mesneteric V = portal circulation
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ultimate destination of venous drainage below pectinate line
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IVC = systemic
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urachus becomes
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mediaN umbilical fold
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umbilical artery becomes
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mediaL umbilical foldS
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covers the epigastrics
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lateral umbilical fold
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coverings of the spermatic cord
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inside-->outside
internal spermatic fascia from trnasversalis fascia cremasteric muscle and fascia from the internal obliques external spertaic fascia from the external oblique |
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direct hernia by definition is where?
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medial to epigastrics
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indirect hernia by definition is where?
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lateral to epigastrics (through the inguinal canal)
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femoral hernia where?
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below inguinal ligament through femoral canal
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borders of hasselbach's triangle?
who cares? |
inferior epigastric artery
lateral rectus abdominus inguinal ligament I do, b/c this is where direct hernias protrude. |
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brunner's glands for what?
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to alkalinize the mucus and neutralize acid contents entering the duodenum from stomach
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hypertrophy of _________ seen in PUD.
Hint: in duodenum |
brunners glands in duodenal submucosa
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activates trypsinogen --> trypsin
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enterokinase/enteropeptidase and trypsin
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glucose adn galactose taken up into enterocytes by what?
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SGLT1 (Na dependent)
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enterocyte receptors for fructose uptake?
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GLUT5
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basolateral monosaccharide transporter in enterocytes?
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GLUT2
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immunglobulin from peyer's patches?
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IgA
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-idine MOA? (i.e. Famotidine)
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reversible block H2 receptors so decreases H+ secretion by parietal cells
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clinical use of Nizatidine?
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Peptic ulcer
gastritis mild esophageal reflux |
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Toxicities associated with Cimetidine?
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p450 Inhibitor
antiandrogenic crosses BBB and placenta decreased renal excretion (ranitidine also) |
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omeprazole MOA and use?
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irreversibly inhibit H/K ATPase in stomach parietal cells
Peptic ulcer, gastritis, esophageal reflux, Zollinger Ellison Syndrome |
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binds to ulcer base and provides physical protection allowing HCO3 to reestablish pH gradient
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bismuth and sucralfate
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clinical use of bismuth and sucralfate
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speed ulcer healing and for traveler's diarrhea
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H pylori therapy?
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metronidazole, amoxicillin or tetracycline, bismuth
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Misoprostol MOA?
Use? |
PGE1 analog that increases production and secretion of gastric mucous barrier, decreased acid production
used for NSAID induced ulcers, PDA maintenance, labor induction |
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abortifacient in women of childbearing potential
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misoprostol
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infliximab MOA?
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monoclonal antibody to TNF, proinflammatory cytokine
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clinical use of Infliximab?
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Crohn's
rheumatoid arthritis |
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respiratry infection, fever, hypotension from a Crohn's treatment: drug?
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infliximab
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Sulfasalazine MOA
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antibacterial and ASA combo that is activated by colonic bacteria
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sulfasalazine use?
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ulcerative colitis and crohn's
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sulfasalazine toxicity?
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malaise, nausea, sulfonamide toxicity, reversible oligospermia
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ondansetron MOA
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serotonin antagonist used as a central-acting antiemetic - powerful for it
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use of ondansetron
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central acting antiemetic used for postoperative vomit control and cancer chemo vomit control
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toxicity of ondansetron?
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HA, constipation
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Metoclopramide MOA?
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D2 receptor antagonist that increases resting tone, contractility, LES tone and motility
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what does motcloporamide not influence (many things, but what is important?)
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doesn't influence colon transport time
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use of metocloporamide
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diabetic and post surgery gastroparesis
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toxicity of metoclopramide
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increased parkinsonian effects
interacts w/ digoxin and diabetic agents |
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drug is contraindicated in patients w/ small bowel obstruction?
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metoclopramide
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chronic diarrhea, intermittent facial flushing, tricuspid stenosis murmur
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carcinoid syndrome
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fibrates contraindicated when? why?
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history of gallstones becasuse they can precipitate gall stones themselves
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cytokine found in high concentrations of Crohn's patients stool?
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TNF alpha
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bloody mucoid diarrhea, foreign country, hepatic abscess?
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amebiasis probably entamoeba histolytica. treat w/ metronidazole
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pegylated IFN use and possible side effects?
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treatment of hep B and C
episodic fever and chills, profound depression |
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loperamide in a child with diarrhea. good or bad?
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bad because it increases risk of toxic megacolon
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DM drugs that can cause a disulfiram like reaction with alcohol?
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sulfonylureas - first generation
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aortic valve replacement cholelithiasis etiology?
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hemolysis - pigment stones of unconjugated bilirubin
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post prandial non bilious vomiting in 4 week old boy
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congenital pyloric stenosis
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corkscrew on upper GI series
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midgut volvulus
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narrowed rectum on barium enema
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hirscsprungs
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double bubble on abdominal film
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air in duodenum and stomach - duodenal atresia
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identified diseases associated with Crohn's?
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anterior uveitis
iron deficiency anemia primary sclerosing chloangitis GI cancer |
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intermittent abdominal pain, diarrhea, fever w/o infectious cause?
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crohn's or ulcerative colitis
perianal fistula, ileum only, transmural inflammation = crohn's |
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how to diagnose c diff
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toxin assay
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acetaminophen OD causes what type of liver damage?
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centrilobular necrosis
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icteric sclera, palpebral xanthomas, pruritus....w/ elevated alk phos?
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primary biliary cirrhosis
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primary biliary cirrhosis characteristic liver injury?
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chronic, progressive and often fatal.
destruction of medium sized intrahepatic bile ducts --> eventual failure. tx: transplant |
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chronic schistosomiasis infection can lead to what serious outcomes?
how? |
portal hypertension and hepatosplenomegaly --> ascites --> cirrhosis
b/c the worm penetrates the skin, invades vasculature and settles in the portal or pelvic venous vasculature. |
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RUQ pain, fever, jaundice?
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ascending cholangitis - infected biliary tract
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