Gi

Front 1

muscarinic antagonists
clinical use in GI?
mechanism?
names?
toxicity?

Back 1

peptic ulcer
block M1 receptors on ECL cells (decrease histamine secretion) and block M3 receptors on parietal cells (decreases H+)
pirenzepine, propantheline
toxicity = bradycardia

Front 2

inflixamab
mechanism
clinical use
toxicity

Back 2

antibody to TNF-alpha
crohn's disease, RA
respiratory infection, fever, hypotension

Front 3

sulfasalazine
mechanism
clinical use
toxicity

Back 3

combo anti-inflammatory (mesalamine) and anti-biotic (sulfapyradine)
used in crohns and UC
reversible oligospermia

Front 4

epithelium type in:
esophagus?
stomach?

Back 4

non-keratinized squamous
non-ciliated columnar

Front 5

mekel's diverticulum

Back 5

failure of obliteration of the vitello-intestinal duct, located in the distal ileum, it is a true diverticulum with mucosa, submucosa and muscularis propria. Common – 2% of population. Can cause bleeding, obstruction

Front 6

- Part 2 of duodenum -

Back 6

marks embryologic meeting of fore and midgut. And where outpuching of liver and pancreas

Front 7

- Hirschprung’s disease –

Back 7

absence of ganglion cells (neural crest doesnt migrate) in the wall of the colon. congenital - presents in first few days of life.

Front 8

hepatoduodenal ligament

Back 8

part of the lesser omentum and separates the greater peritoneal sac from the right lesser peritoneal sac, it contains the common bile duct, the proper hepatic artery, and the portal vein

Front 9

- Splenorenal ligament

Back 9

the portion of the dorsal mesentery between the posterior abdominal wall and the spleen – it transmits the splenic artery and vein

Front 10

- Heterotopic rests

Back 10

small areas of normal tissue in abnormal sites

Front 11

- Lipoprotein lipase

Back 11

releases TGs from chylomicron cores. LPL is located on the external surface of the vascular endothelium

Front 12

- Motilin

Back 12

is a hormone released by the SI during fasting. It initiates migratory motor complexes (MMCs)

Front 13

- Coronary ligament –

Back 13

reflection of peritoneum – found on top and r posterior side of liver

Front 14

- Esophagus muscle in muscularis propria layer

Back 14

o Upper 1/3 – skeletal
o Middle 1/3 – skeletal and smooth
o Lower 1/3 – only smooth muscle

Front 15

which salivary gland produces the most serous saliva? the most mucus?

Back 15

- As you proceed from the midline laterally acini in the sublingual gland are almost pure mucous cells, while acini in the submandible gland contain a mix of mucous and serous cells, and acini in the parotid gland are mostly pure serous cells

Front 16

- Reye syndrome-

Back 16

fatty liver with encephalopathy. An acquired mitochondrial abnormality
kids VZV, asprin

Front 17

- Omphalocele –

Back 17

herniation of abdominal viscera through the abdominal wall near the umbilicus

Front 18

- Meconium ileus

Back 18

a manifestation of CF due to viscid pancreatic secretion which get stuck in the small bowel

Front 19

- Bile pigment stones (calcium bilirubinate)
what are they derived from?
who gets them?

Back 19

are derived from degradation of heme, seen in patients with chronic hemolytic disorders (such as sickle cell) and alcoholic cirrhosis

Front 20

- Zollinger-ellison syndrome –

Back 20

a gastrinoma. From ectopic gastric tissue (usually in pancreas or duodenum)

Front 21

the most important predictors of metastatic potential of carcinoid tumors?

Back 21

location and size

Front 22

- Primary billiary cirrhosis –

Back 22

autoimmune disorder, distruction of medium sized intrahepatic bile ducts. Cholestatic picture develops. Itching is due to elevated levels of circulating bile salts. Most progress to cirrhosis. 90% have anti-mitochondrial autoantibodies

Front 23

- Chagas disease –
GI finding?
other findings?
cause?

Back 23

achalasia, heart failure, due to protozoan parasite – trypanosome cruzi found in south America

Front 24

- Mallory-weiss tears
cause?
prognosis?

Back 24

occur as a complication of repeated vomiting – is a tear of the esophagus that results in bleeding – usually will heal on their own

Front 25

- Esophageal rings
what are they?
names based on location?

Back 25

are mucosal folds in the esophagus. They are called:
o Webs in the upper esophagus
o Schatzki rings in the lower esophagus (at the gastro-esoph junction)

Front 26

- Menetrier’s disease –
aka?
associated symptoms?

Back 26

also known as protein-losing gastroenteropathy. Increased mucus production leads to protein losses, may cause hypoalbuminemia and edema

Front 27

- Obstructive jaundice
lab findings?

Back 27

leads to a back up of conjugated (direct) bilirubin --> increased conjugated bilirubin in blood and urine

Front 28

- Plummer-vinson syndrome triad?

Back 28

atrophic glossitis, esophageal webs, and iron deficiency anemia. Have increased risk of squamous cell carcinoma of the esophagus

Front 29

Cisapride
function?
toxicity?

Back 29

prokinetic with association with serious cardiac arrhythmias, including torsade de pointes, especially when given with erythromycin

Front 30

jaundice in cystic duct blockage? common bile duct blockage?

Back 30

no and yes

Front 31

side effect of cimetidine that is unique from other H2 blockers?

Back 31

cimetidine has the effect of hepatic enzyme inhibitor, decreases the metabolism of other hepatically metabolized meds such as phenobarbitol

Front 32

metochlopramide
mechanism
clinical use
toxicity

Back 32

prokinetic
GERD
is a dopamine antagonist so will exacerbate parkinsons symptoms

Front 33

esophageal diverticula from mouth caudally?

Back 33

zenkers - presents with regurgitation of food
traction - asymptomatic, mid-esophagus
epiphrenic - tx - heller myotomy

Front 34

autoimmune esophageal dysfunction

Back 34

scleroderma (aka systemic sclerosis)
loss of peristalsis and hypotensive LES
also has thickening of the skin

Front 35

- The liver can be divided into 3 zones.

Back 35

Zone 1 is periportal, zone 3 is associated with the central vein
Zone 3 contains the P450 oxidase enzymes system and is most sensitive to injury

Front 36

somatic efferent inputs to internal and external anal sphincters

Back 36

pudendal nerve

Front 37

caries the sensory afferent info from the rectum

Back 37

pelvic nerve

Front 38

- Tumors from the penis, vagina, and anal canal can drain into what lymph nodes?

Back 38

superficial inguinal lymph nodes – easily palpable

Front 39

-Tumors from the stomach can metastasize to what lymph nodes

Back 39

the easily palpable superclavicular nodes (virchow’s nodes)

Front 40

-Mallory bodies are what?
found when?

Back 40

eosinophillic cytoplasmic inclusions (“alcoholic hyaline”) that are found in the largest numbers in alcoholic hepatitis

Front 41

-Metronidazole + alcohol causes what side effect?

Back 41

can cause a disulfiram reaction of nausea, tachycardia

Front 42

-Budd-chiari syndrome –

Back 42

hepatic vein obstruction. May occur as a complication of thrombogenic and myeloproliferative disorders, including polycythemia vera

Front 43

marker of colorectal cancer?

Back 43

CEA
also high in cirrhosis and pancreatitis