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72 Cards in this Set
- Front
- Back
celiac disease involvement
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PROXIMAL small bowel
(tropical sprue = entire small bowel) |
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most likely location for a volvulus
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sigmoid colon
(most other parts of the colon are held in place by the posterior peritoneal membrane) |
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Z-E syndrome
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food in the gastric lumen does NOT have an effect on serum gastrin
(remains at the same elevated level) |
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symptoms of choledocolithiasis
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=stone in common bile duct
colicky RUQ pain jaundice and conjugated hyperbilirubinemia can lead to cholangitis (life threatening) |
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normal mucosa of distal esophagus
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non-keratinized stratified squamous
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treatment of congenital pyloric stenosis
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presents at 3-6 weeks
Tx: pyloromyotomy (pyloric muscle is partially cut to relieve the obstruction) |
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Menetrier's disease
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=protein losing gastroenteropathy (and deficient gastric acid)
increased mucus production leads to PROTEIN loss from excessive gastric secretions can lead to hypoalbuminemia and peripheral edema |
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Plummer-Vinson syndrome
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atrophic glossitis
esophageal webs IDA *increasd risk of esophageal squamous cell carcinoma |
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innervation (p-sympathetic) to internal anal sphincter
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pelvic nerve
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innervation (p-sympathetic) to external anal sphincter
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pudendal nerve
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Budd-Chiari syndrome
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=hepatic vein obstruction
complication of thrombogenic/myeloproliferative disorders (PV), also of hepatitis presentation -> progressive severe ascites and tender hepatomegaly over months **LFTs are near normal Dx = hepatic venography (definitive = liver Bx) |
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tracheoesophageal fistula
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most common type = C
-proximal esophagus ending in a blind loop -usually discovered with the 1st meal [respiratory distress and cyanosis due to aspirated milk] |
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inferior pancreatoduodenal artery is a branch from which larger artery?
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SMA
(superior pancreatoduodenal is a branch of common hepatic from the celiac trunk) *these two can form anastomoses when celiac trunk is occluded by a clot |
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most common location of Meckel's diverticulum
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distal ileum within 12 inches of the ileocecal valve
can contain pancreatic tissue or gastric mucosa |
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is alcoholic fatty change of the liver reversible?
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yes, if alcohol is stopped
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a patient with Crohn's disease' family members are at increased risk for
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Ulcerative colitis [suggests that these two diseases are ends of the same spectrum]
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necrotizing enterocolitis
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most commonly presents around when infant has first oral foods
gangrene of terminal ileum and ascending colon |
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histo of Reye syndrome
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extensive microvesicular steatosis
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histo of alkaholic hepatitis
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AST/ALT ratio >1.5
swollen and necrotic hepatocytes, neutrophil infiltration, mallory bodies [hyaline], fatty change, fibrosis around central vein |
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histo of chronic active hepatitis
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chronic inflammation with continuing necrosis of hepatocytes surrounding the portal tract [limiting plate]*
also see piecemeal necrosis |
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histo of active hepatitis
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lymphocyte infiltrates and ballooning degeneration of hepatocytes
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S-100 marker
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melanoma, neural tumors and astrocytomas
(can help determine the origin of metastatic lesions) |
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chylomicrons are produced by____
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enterocytes (intestinal epithelial cells)
LPL is released from external surface of vascular endothelium of many tissues |
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angiosarcoma
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highly aggressive multinodular tumor that arises from blood vessels
vinyl chloride is a risk factor for liver angiosarcoma |
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veins anastomosed in a portal-caval shunt
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left renal vein (drains directly into the IVC)
splenic vein (drains directly into portal vein) |
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metronidazole can have a reaction like which other drug?
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disulfuram (when taken w/alcohol)
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curling ulcer
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acute gastric ulcer in association with severe burns
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cushing ulcer
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acute gastric ulcer in association with brain injury
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Krukenberg tumor
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bilateral involvement of the ovaries by metastatic stomach carcinoma
*signet ring cells |
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Virchow node
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involvement of supraclavicular lymph node by metastatic stomach carcinoma
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ischemic bowel disease most often affects these two areas of the colon
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splenic flexure
rectosigmoid junction [these are 'watershed' areas btwn the SMA, IMA and internal iliac arteries] |
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tetracycline toxicity
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unpredictable hypersensitivity-like reaction with MICROvesicular fatty change in liver
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perivenular sclerosis
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associated with alcoholic hepatitis
surrounds central veins can lead to cirrhosis |
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primary biliary cirrhosis
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anti-mitochondrial antibodies
leads to severe obstructive jaundice intrahepatic setatorrhea, pruritis, hypercholesterolemia (xanthomas) high alk phos levels |
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primary sclerosing cholangitis
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both intra and extrahepatic
inflammation and fibrosis of bile ducts 'beading' on ERCP associated with ulcerative colitis can lead to secondary biliary cirrhosis *charcot's triad -jaundice + fever + RUQ pain |
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aflatoxin B1
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associated with hepatocellular carcinoma
thought to cause specific point pmutations in p53 gene |
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narcotic of choice for acute cholecystitis
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meperidine
-> least likely to cause a spasm of the sphincter of Oddi (b/c it has anti-muscarinic properties) |
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hyperplastic polyp
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small, rounded
glands and sawtooth crypts composed of goblet and columnar epithelial cells no atypia *90% of colonic polyps NO MALIGNANT POTENTIAL |
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locations of oral cancers
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floor of mouth > tip of tongue > hard palate > base of the tongue
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which zone of the liver contains the P450 system?
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Zone 3: is very sensitive to ischemic injury
(zone 1 is the most sensitive to toxic injury. this area shows infiltration in hepatitis) |
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arteries supplying the greater curvature of the stomach
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proximal: short gastric (arises from splenic artery)
distal: right gastroeploic (the left gastroeploic can alternatively supply if the right is damaged) |
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arteries supplying the lesser curvature of the stomach
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proximal: left gastric (arises from celiac artery)
distal: right gastric (arises from hepatic artery before the gastroduodenal) |
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Zenker's diverticulum
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false diverticulum formed by herniation of the mucosa at a point of weakness at jxn of pharynx and esophagus
ass'd with halitosis and can cause dysphagia if it fills w/food |
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plummer-vinson syndrome
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triad of
-dysphagia due to upper esophageal webs -atrophic glossitis -IDA |
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schatzki rings
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mucosal rings found in distal esophagus at squamocolumnar jxn
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type of meals to eat post-gastric bypass
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frequent, small, high fat meals
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drug rxn btwn erythromycin and cisapride
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arrhythmias: torsades des pointes, prolonged QT interval
v-tach, v-fib also *also watch ketoconazole, fluconazole, clarithromycin, nefadazone and idinavir |
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splenic artery and vein are found in the ____
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splenorenal ligament
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meconium ileus
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manifestation of cystic fibrosis
(meconium gets 'stuck' in the small bowel) can cause gut perforation or fistulas |
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manifestations of stone in the common bile duct
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bile backs up and goes into circulation
-> CONJUGATED hyperbilirubinemia -> tea colored urine |
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free edge of the lesser omentum contains 3 structures
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common bile duct
hepatic artery portal vein |
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connection btwn the greater and lesser omentum
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foramen of Winslow
-bounded by the common bile duct, duodenum and stomach |
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chronic administration of PPIs can lead to
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hypergastrinemia (due to decreased negative feedback)
this may increase risk of developing gastric carcinoid tumors |
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misoprostol
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PGE1 analog
stimulates gastric secretion of mucus used to treat NSAID-induced gastritis |
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sulcralfate
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selectivey bids to necrotic peptic ulcer tissue and acts as a barrier to acid, pepsin and bile
requires presence of acid for maximal effect -> don't give with H2 blocker or PPI! |
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lactulose
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used to treat hepatic encephalopathy
-acidifies the stool and prevents diffusion of ammonia from colon to the blood |
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sulfsalazine
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sulfpyridine + 5-ASA
-absorbed inthe colon (bacteria break the azo bond) used to treat ulcerative colitis (more than crohns) |
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mesalamine
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unconjugated 5-ASA (less SEs than sulfsalazine)
has many formulations -asacol: delayed release to ileum and beyond -pentasa: released throught GI tract -rowasa: rectal suspension enema (rectum and distal colon) |
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predisposing factors for gastric carcinoma
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pernicious anemia, chronic gastritis, achlorhydria, bacterial overgrowth, neoplastic polyps
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foregut derivatives
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mouth, esophagus, stomach, duodenum, oral cavity, pharynx, tongue, tonsils, salivary glands, LRT, liver, gallbladder, pancreas
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most important predictor of metastatic potential of carcinoid tumors
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size and location
(stomach, ileum and cecum have high metastatic potential, esp if >2 cm) |
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atrophic gastritis
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associated with pernicious anemia
gastric epithelium replaces gastric and cheif cells with goblet cells |
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Reye syndrome is a acquired abnormality of which organelle?
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mitochondria [mechanism is unknown]
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which anaesthetic can cause idiosyncratic hepatic failure?
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halothane
ranges from hepatitis to focal massive hepatic necrosis |
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femoral hernias
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more common in women
loop of bowel passes into saphenous opening of fascia lata and through cribiform fascia |
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gastroschisis
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incomplete fusion of lateral body folds during 4th week of development
causes abdominal viscera to protrude through abdominal cavity |
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sliding hiatal hernia
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most common form
frequently associated with GERD |
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annular pancreas results from
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abnormality in rotation of ventral pancreatic bud around second part of duodenum
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high risk of colon cancer is associated with
(nutrition related) |
a low fiber diet
(smoking also, but to a less extent) |
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hepatoduodenal ligament
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connects liver to 1st part of duodenum
proper hepatic artery (cystic artery is a branch) common bile duct portal vein |
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drug of choice for acute flare ups of Crohn's disease
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prednisone
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treatment for Wilson's disease
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penicillamine
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