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90 Cards in this Set

  • Front
  • Back
diaphragmatic hernias occur in infants as a result of what?
defective development of pleuroperitoneal membrane
hernia that goes through the internal (deep) inguinal ring aand external (superficial) inguinal ring and into the scrotum
indirect inguinal hernia
where dos an indirect hernia enter the internal inguinal ring?
lateral to inferior epigastric artery
where does a direct hernia bulge directly through abdominal wall?
medial to inferior epigastric artery
indirect hernias occur in infants owing to what?
failure of processus vaginalis to close - much more common in males
type of hernia that protrudes through the inguinal (Hesselbach's) triangle & goes through the external (superficial) inguinal ring only
direct inguinal hernia
contents of Hasselbach's triangle?
inferior epigastric artery
laterla border of rectus abdominis
inguinal ligament
achalasia results from loss of what?
myenteric (Auerbach's) plexus
achalasia is associated with an increase risk for what?
esophageal carcinoma
secondary achalasia may arise from what disease?
bird beak on barium swallow?
achalasia - dilated esophagus with an area of distal stenosis
persistence of the vitelline duct or yolk sac?
Meckel's diverticulum
cystic dilatation of vitelline duct?
omphalomesnteric cyst
serum enzyme elevated in MI?
serum enzyme elevated in acute pancreatitis, mumps?
serum enzyme decreased in Wilson's?
Barrett's esophagus?
glandular (columnar epithelial) metaplasia - replacement of nonkeratinizes squamous epithelium with gastric (columnar) epithelium in the distal esophagus; due to chronic acid reflux
esophageal cancer is usually what type?
squamous cell (Barrett's leads to adenocarcinoma)
what part of the GI tract does celiac sprue affect?
proximal part of small bowel
PAS-positive macrophages in intestinal lamina propria, mesenteric nodes
Whipple's disease
stress, NSAIDs, alcohol, uricemia, burns, and brain injury can all cause what?
acute gastritis (erosive)
autoimmune disorder characterized by autoantibodies to parietl cells, pernicious anemia, and achlorhydria
type A (fundal) chronic gastritis (nonerosive)
type B (antral) chronic gastritis
caused by H. pylori (B-Bug)
ulcer - pain greater with meals, weight loss?
gastric ulcer
ulcer - pain decreases with meals, weight gain?
duodenal ulcer
therapy for H. pylori infection?
triple therapy - metronidazole, bismuth salicylate, and either amoxicillin or tetracycline
incidence of peptic ulcer is twice as great in whom?
what is stomach cancer associated with?
dietary nitrosamines, achlorhydria, chronic gastritis - almost always adenocarcinoma
possible etiology of Crohn's disease?
possible etiology of ulcerative colitis?
what part of the GI tract is involved in Crohn's disease?
may involve any portion - but usually terminal ileum and colon; rectal sparing
creeping fat, bowel wall thickening, linear ulcers, fissures, fistulas?
friable pseudopolyps with freely hanging mesentery; crypt abscesses and ulcers, bleeding
ulcerative colitis
pyoderma gangrenosum and primary sclerosing cholangitis are extraintestinal manifestations of what?
ulcerative colitis
where are diverticula most often found?
sigmoid colon
true diverticulum?
all 3 layers - mucosa, muscularis, serosa
false diverticulum?
only mucosa and submucosa outpouch
where do diverticuli especially occur?
where vasa recta perforate muscularis externa
what causes diverticulosis?
increased intraluminal pressure and focal weakness in the colonic wall
what causes Hirschprung's?
failure of neural crest cell migration
3rd most common cancer?
colorectal cancer
risk factors for colorectal cancer?
colorectal villous adenomas, chronic IBD (esp. UC), high-fat and low-fiber diets, increased age, FAP, HNPCC, DCC gene deletion, personal and family Hx
apple core lesion on barium swallow?
colorectal cancer
chalky white deposits in acute hemorrhagic pancreatitis are what?
areas of fat necrosis
typical presentation of pancreatic cancer?
cholestatic jaundice; painless distention of gallbladder in about 50%
H. pylori infection in 70%, chronic NSAID use also implicated in this type of ulcer
gastric ulcer
almost 100% of people with this type of ulcer have H. pylori infection
nodules < 3 cm; uniform size
micronodular cirrhosis
type of cirrhosis due to etabolic insult, e.g. alcohol, hemochromatosis, Wilson's
nodules > 3cm, varied size
type of cirrhosis usually due to significant liver injury leading to hepatic necrosis, e.g postinfectious or drug-induced hepatitis
portacaval sunt between what 2 structures may relieve portal hypertension?
splenic vein and left renal vein
intracytoplasmic eosinophilic inclusions
Mallory bodies
findings in alcoholic hepatitis?
swollen and necrotic hepatocytes, neutrophil infiltration, Mallory bodies, fatty change, and sclerosis aroudn central vein
what is Budd-Chiari syndrome associated with?
polycythemia vera, pregnancy, hepatocellular carcinoma
occlusion of IVC or hepatic veins iwth centrilobular congestion and necrosis, leading to congestive liver disease (hepatomegaly, ascites, abdominal pain, and eventually liver failure)
Budd-Chiari syndrome
Rx for Wilson's
inheritance pattern of Wilson's?
autosomal recessive
esophageal diverticula above UES?
esophageal diverticula above LES?
classic triad in hemochromatosis?
micronodular cirrhosis, pancreatic fibrosis, skin pigmentation
lab findings in hemochromatosis?
increased ferritin, increased iron, decreased TIBC
treatment for hemochromatosis?
repeated phlebotomy, deferoxamine
defect in Gilbert's syndrome?
mildly decreased UDP-glucuronyl transferase; asymptomatic but unconjugated bilirubin is elevated without overt hemolysis
Crigler-Najjar syndrome, type I
severe disease - absent UDP glucuronyl transferase; presents early in life & patients die within a few years - jaundice, kernicterus, increased unconjugated bilirubin
Crigler-Najjar syndrome, type II responds to what?
treatment for Crigler-Najjar type I?
plasmapheresis and phototherapy
conjugated hyperbilirubinemia due to defective liver excretion; grossly black liver but benign
Dubin-Johnson syndrome
siilar to Dubin-Johnson but milder & without black liver?
Rotors syndrome
inflammation and fibrosis of bile ducts
primary sclerosing cholangitis
Chrarcot's triad of cholangitis?
jaundice, fever, RUQ pain
ERCP findings in primary sclerosis cholangitis?
alternating strictures and dilation with 'beading'
what is primary sclerosing cholangitis associated with?
ulcerative colitis
severe obstructive jaundice, steatorrhea, pruritis, hypercholesterolemia
primary biliary cirrhosis
labs in primary biliary cirrhosis?
increased alk phos, serum mitochondrial antibodies
this is due to extrahepatic biliary obstruction; increase in pressure in intrahepatic ducts leading to injury and fibrosis
secondary biliary cirrhosis
this is often complicated by ascending cholangitis, bile stasis, and bile 'lakes'
secondary biliary cirrhosis
labs in secondary biliary cirrhosis?
increased alk phos, increased conjugated bilirubin
presentation of hepatocellular carcinoma?
tender hepatomegaly, ascites, polycythemia, hypoglycemia
what level may be elevated in hepatocellular carcinoma?
alph fetoprotein
how does hepatocellular carcinoma spread?
hematogenous dissemination (like renal cell CA)
type of gall stones associated with obestity, Crohn's, CF, advanced age, clofibrate, estrogens, multiparity, rapid weight loss, and Native American origin
cholesterol stones - radiolucent with 10-20% opaque due to calcifications
most common type of gall stones?
mixed stones - radiolucent, have both cholesterol and pigment components
type of gallstones seen in patients with chronic RBC hemolysis, alcoholic cirrhosis, advanced age, and biliary infection
pigment stones
what elevated enzyme has a higher specificity for acute pancreatitis?
chronic calcifying pancreatitis is strongly associated with what?
obstructive pancreatitis is strongly associated with what?
tumor marker for colorectal cancer?
most common form of hiatal hernia?
sliding hiatal hernia
tumors from the penis, vagina, and analcanal can drain to the medial side of the horizontal chain of what lymph nodes?
superficial group of inguinal lymph nodes