Gi

Front 1

Hepatic P450 Inducers

Back 1

Chronic alcohol use, St. John’s wort, Phenytoin, Phenobarbital, Nevirapine, Rifampin, Griseofulvin, Carbamazepine.

Chronic alcoholics StealPhen-Phen and NeverRefuse Greasy Carbs

Front 2

Hepatic P450 inhibitors

Back 2

Acute alcohol abuse, Ritonavir, Amiodarone, Cimetidine, Ketoconazole, Sulfonamides, Isoniazid (INH), Grapefruit juice, Quinidine, Macrolides (except azithromycin).

AAA RACKS IN GQ Magazine

Front 3

Developmental defects: failure of Rostral fold closure

Back 3

sternal defects

Front 4

Developmental defects: failure of Lateral fold closure

Back 4

omphalocele (sealed by peritoneum),

Front 5

Developmental defects: failure of Caudal fold closure

Back 5

bladder exstrophy

Front 6

Developmental defects: failure to recanalize

Back 6

Duodenal atresia (Trisomy 21)

Front 7

Developmental defects: vascular accident

Back 7

jejunal, ileal, colonic atresia

Front 8

ventral pancreatic bud forms:

Back 8

uncinate process and main pancreatic duct (gallbladder and common bile duct come off here)

Front 9

dorsal pancreatic bud forms:

Back 9

body, tail, isthmus, asccessory pancreatic duct, pancreatic head

Front 10

Falciform Ligament

Back 10

Liver to anterior abdominal wall; contains ligamentum teres

Front 11

Hepatoduodenal Ligament

Back 11

Liver to duodenum; contains Portal triad: proper hepatic artery, portal vein, common bile duct

Front 12

Gastrohepatic Ligament

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Liver to lesser curvature of stomach; contains gastric arteries, separates greater and lesser sacs on right

Front 13

Gastrocolic Ligament

Back 13

greater curvature and transverse colon; contains gastroepiploic arteries

Front 14

Gastrosplenic Ligament

Back 14

Greater curvature and spleen; contains Short gastrics, left gastroepiploic vessels- separates greater and lesser sacs on left

Front 15

Splenorenal Ligament

Back 15

Spleen to posterior abdominal wall; contains splenic artery and vein, tail of pancreas

Front 16

Layers of Gut Wall: inside to out

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(MSMS) mucosa (epithelium, lamina propria, muscularis mucosa)-- submucosa (meissner's plexus)-- musculars externa (auerbach plexus)-- serosa

Front 17

Branches of the Celiac trunk

Back 17

common hepatic, splenic, left gastric

Front 18

Anastomoses: superior epigastric (internal thoracic/ mammary)

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inferior epigastric (external iliac)

Front 19

Anastomoses: superior pancreaticduodenal (celiac trunk)

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inferior pancreatic duodenal (SMA)

Front 20

Anastomoses: middle colic (SMA)

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left colic (IMA)

Front 21

Anastomoses: superior rectal (IMA)

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middle and inferior rectal (internal iliac)

Front 22

Sliding hiatal hernia

Back 22

most common. Gastroesophageal junction is displaced upward; “hourglass stomach.”

Front 23

Paraesophageal hernia

Back 23

gastroesophageal junction is usually normal. Fundus protrudes into the thorax.

Front 24

Indirect inguinal hernia

Back 24

Goes through the internal (deep) inguinal ring, external (superficial) inguinal ring, and into the scrotum. Lateral to inferior epigastric artery. failure of processus vaginalis to close. Much more common in males.

Front 25

Direct inguinal hernia

Back 25

Protrudes through the inguinal (Hesselbach) triangle. Through abdominal wall medial to inferior epigastric artery. Goes through the external (superficial) inguinal ring only. Covered by external spermatic fascia. Usually in older men. (MD’s don’t LIe)

Front 26

Femoral hernia

Back 26

Protrudes below inguinal ligament through femoral canal below and lateral to pubic tubercle. More common in females.

Front 27

Absorbtion of Iron, Folate, B12

Back 27

Iron Fist, Bro- Iron (duodenum), folate (jejunum and ileum), B12 (terminal ileum)

Front 28

Liver Markers : Alkaline phosphatase (ALP)

Back 28

Cholestatic and obstructive hepatobiliary disease, HCC, infiltrative disorders, bone disease

Front 29

Liver Markers : Aminotransferases (AST and ALT)

Back 29

Viral hepatitis (ALT > AST). Alcoholic hepatitis (AST > ALT)

Front 30

Liver Markers : Amylase

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Acute pancreatitis, mumps

Front 31

Liver Markers : Ceruloplasmin

Back 31

decreased in Wilson disease

Front 32

Liver Markers : γ-glutamyl transpeptidase (GGT)

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increase in various liver and biliary diseases (just as ALP can), but not in bone disease; associated with alcohol use

Front 33

Liver Markers : Lipase

Back 33

Acute pancreatitis (most specific)

Front 34

Lymph node drainage of the esophagus

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upper 1/3- cervical lymph nodes; middle 1/3- mediastinal/ tracheobronchial; lower 1/3- celiac and gastric nodes

Front 35

duodenal ulcer

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better with food, caused by H. pylori. Rupture can cause gastroduodenal artery and acute pancreatitis

Front 36

gastric ulcer

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lesser curvature of the antrum. Worse with food. Caused by H. pylori mostly, but also NSAIDs and bile reflux. Rupture- left gastric artery

Front 37

Cholesterol stones

Back 37

radiolucent, can be due to bile acid sequestrants-- bile acids normally prevent gallstones or decreased phospholipids.

Front 38

Billirubin gallstones

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radioopaque. Risk factors: extravascular hemolysis, biliar tract infection (E. coli, Ascaris lymbricoides, Clonorchis sinensis).

Front 39

Serologic markers of HepB

Back 39

HBsAg= maker of infection-- first to rise, disappears after acute, persists if chronic; ABeAg= marks infectivity ability; HBcAB- IgM in acute and window, IgG rises in resolved/ chronic. HbsAB= IgG confers protectivity (in vaccines/ resolved Hep B)

Front 40

HepC Serologic markers

Back 40

HCV-RNA test confirms infection. Decreased RNA levels= recovery

Front 41

Hep D

Back 41

dependent on HBV. Superinfection upon existing HBV is more severe than coinfection.

Front 42

Gastrin

Back 42

Secreted by G cells (antrum of stomach). Causes increased H+ secretion, growth of gastric mucosa, increased gastric motility. Stimulate Parietal cells and ECL cells (which then release histamine onto parietal cells)

Front 43

Somatostatin

Back 43

Secreted by D cells of pancreatic islets and GI mucosa. Decreases gastric acid and pepsinogen secretion, decreases pancreatic and small intestine fluid secretion, decreases gallbladder contraction, decreases insulin and glucagon release. Decreased by vagal stimulation

Front 44

CCK

Back 44

Secreted by I cells (duodenum, jejunum). Increases pancreatic secretion, increases gallbladder contraction, decreases gastric emptying, increases sphincter of Oddi relaxation.

Front 45

Secretin

Back 45

Secreted by S cells (duodenum). Causes increased pancreatic HCO3- secretion, decreased gastric acid secretion, increased bile secretion. Triggered by acid, fatty acids.

Front 46

GIP

Back 46

Secreted by K cells (duodenum, jejunum). Causes decreased gastric H+ release and increased insulin release (triggered by fatty acids, amino acids, glucose. AKA gastric inhibitory peptide)

Front 47

Motilin

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Secrete by small intestine. Produces migrating motor complexes. Increased in fasting state

Front 48

VIP

Back 48

secreted by parasympathetic ganglia in sphincters, gallbladder, small intestine. Increases intestinal water and electrolyte secretion, increases relaxation of intestinal smooth muscle and sphincters. Caused by increased distention and vagal stimulation.

Front 49

Gastric acid secretion

Back 49

By parietal cells in stomach. Increased by: histamine, ACh, gastrin. Decreased by: somatostatin, GIP, prostaglandin, secretin.

Front 50

Pepsin

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Synthesized by chief cells in stomach. Protein digestion. Increased by vagal stimulation, activated from pepsinogen by H+

Front 51

D-xylose test

Back 51

looking at disruption of mucosal barrier. Decreased urinary excretion