Goljan Gi

Front 1

Oral manifestations of HIV

Back 1

Candidiasis, aphthous ulcers (stomatitis), hairy leukoplakia (EBV), Kaposi's sarcoma

Front 2

Noninfectious ulceration in oral cavity

Back 2

Pemphigus, membrane pemphigoid, eryhema multiforme or SJS (drugs or infection)

Front 3

Behcet Syndrome

Back 3

immune complex small vessel vasculitits, causes recurrent mouth and genitalulerations, erythema nodusum

HLA-B27 and B51

Front 4

Macroglossia causes

Back 4

Myxedmea, Down's, acromegaly, amyloidosis, mucosal neuromas

Front 5

Glossitis causes

Back 5

deficency of iron, B12, folate, vit C, niacin, scarlet fever, hairy leukoplakia

Front 6

Ameloblastoma

Back 6

benign tumor of ename organ epithelium, located in mandible, spreads locally but no metastases

Front 7

Lower esophageal dysphagia

Back 7

SMC dismotility associated with systemic sclerosis, CREST syndrome

Front 8

Plummer Vinson Syndrome

Back 8

d/t iron deficiency, leukoplakia in oral mucosa and esophagus, intermittent dysphagia for solids (obstructive lesion), d/t esophageal web or stricture

Front 9

Infectious esophagitis

Back 9

Complication of AIDS
- HSV- multinucleated squamous cell with inclusions
- CMV- basophillic intranuclear incluiosn
Candida- yeasts and pseudohyphae

Front 10

Octreotide

Back 10

somatostatin analog used in pancreatitis and esophageal varices, decreased GI blood flow and release of hormones

Front 11

Esophageal motor disorders

Back 11

Chagas, CREST, systemic sclerosis, diagnosed by barium swallow

Front 12

Esophageal Squamous cell carcinoma risk factors

Back 12

Smoking, alcohol, achalsia, more common in developng countries

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Paraneoplastic Syndrome

Back 13

Hormonal alterations and stuff d/t distal tumors, SIADH or hypercalcemia d/t PTH

Front 14

Gastroperesis

Back 14

Frcreased motility form autonomic neurppathy (DM) or vagotomy

Front 15

Chronic atrophic gastiritis

Back 15

Type A- pernicious anemia

Type B antrum and pylorus, H pylori usually

Menerier disease- hypertrophic giat rugal folds, atrophy of parietal cells

Front 16

Zollinger Ellison Syndrome

Back 16

malgnat pancreatic islt cell tumors, secrete gastrin -> acidity

elevated serum gastrin > 1000pg/mL

Front 17

Intestinal type gastric carcinoma

Back 17

most common, inestinal metaplasia d/t H pylori

Front 18

Gastric adenocarcinoma clinical findings

Back 18

weitght loss, epigastric pain, Virchow's node, paraneoplastic skin lesions, metastasis to umbilicus

Front 19

diarrhea ddx

Back 19

infection, malabsorption, ostmotic diarrhea

If bloody, dysentery, infarction, volvulus

Large bowel- infection laxatives, IBD

Front 20

Campylobacter Jejuni sequelae

Back 20

Guillan Barre d/t cross reactive antigen with neurons, HUS, HLA-B27 sponydloarthropathy

Front 21

Shiga toxin

Back 21

Inhibits protein synthesis by binding to ribosomes, leads to cell death

Front 22

Trichuris trichrum

Back 22

rectal prolapse in kids

Front 23

Ascaris lumbricoides

Back 23

larval phase passes through lones casuing cough and pneumonitis

Front 24

Strongyloides

Back 24

from feet to larval phase in lungs, eggs can hatch and larvae can migrate to lungs resulting in autoinfection

Front 25

Diphyllobothium latum

Back 25

from fish, diarrhea, preferentially uptake B12

Front 26

Pancreatic insufficiency

Back 26

d/t chronic pancreatitis, maldigestion of fat and proteins

Front 27

Serum immunoreactive trypsin

Back 27

Specific for the pancreas, decreased with chronic pancreatitis and increased in early CF

Front 28

Celiac Dz pathogeneisis

Back 28

transglutaminase in lamina propria deaminates gluten, and enhances immune response producing a T-cell and cytokine response

Front 29

Whipple's Dz

Back 29

caused by tropheryma whippelli, blunting of villi, PAS + macrophages in lamina propria -> fat malabsorption, fever, polyarthritis, hyperpigmentation

Front 30

Causes of small and large bowel obstruction

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adhesions, Crohn;s, duodenal atesia, gallstone ileus, Hirsprungs, Indirect and femoral hernia, intussuseption, meconium ileus, volvulus

Front 31

Small bowel infarction etiology

Back 31

transmural d/t occlusion of SMA (from left side of heart usually a fib)
or mesenteric vein thrombosis from hypercoagulable state

Mural- d/t hypoperfusion state

Front 32

Direct hernia

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hernia bulges through Hesselbach's triangele (medial rectus sheath, lateral inferior epigastric, inferior inguinal ligament), diappears with reclining

Front 33

Indirect Hernia

Back 33

Most common, into inguinal canal, may enter scrotum

Front 34

Femoral Hernia

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More common in women, bulge below inguinal ligament

Front 35

bowel infarction findings

Back 35

diffuse abd pain and distension, bloody diarrhea, no bowel sounds, no rebound tenderness early, Thumbprint sign on radiograph

Front 36

Ischemic colitis

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atherosclerotic narrowing of SMA causes mesenteric angina -> pain at splenic flexure, thumb printing on splenic flexure

Front 37

Angiodysplasia

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Dilatiion of mucosal venules in ascending colon, d/t increased wall stress ->hematochezia, assoicated with vWF and aortic stneosis

Front 38

Meckel Diverticulum

Back 38

Remnant vitelline duct, true diverticulum, bleeeding , fecsal material in vitelline duct, Contain pancreatic rests and hetertropic gastric mucosa (increase bleeding risk)

Front 39

Diverticulitis findings

Back 39

feverm diarrhea, LLQ pain, tender mass can be palpated sometimes, diagnosis via CT or water soluble barium study

Front 40

Ulcerative colitis

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chronic relapsing ulceroinflammatory diseases, continusous ulcerations limited to the mucosa and submucosa

Front 41

Crohn's Disease

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Chronic granulamtous disease, transmural inflammation, noncaseating granulomas and discontiiiounous spread

Front 42

small bowel tumors

Back 42

most common is neuroendocrine tumor, produce bioactive compounds -> portal vein -> usually metabolized unless metastasis, causes flushing, diarrhea, bronchospasm etc.

*urine 5-HIAA*

Front 43

Juvenile retention polyps

Back 43

most common polyp of kids, in rectum, sometimes prolapse, solitary polyp ot juvenile polyposis (AD)

Front 44

Cronkhite-Canada syndrome

Back 44

Nonhereditary polyposis syndrome, polyps plus ectodermal abnormalites of nails

Front 45

Peutz-Jeghers Polypois

Back 45

AD, hamartomatous polyps in small bowel, mucosal pigmentation, increased risk of some CA

Front 46

Tubular adenoma

Back 46

most common poylp, sgiomid coln is most common site, stalked polyps, less likely to be common

Front 47

Villlous adenoma

Back 47

may cause hypoproteiniemia and hypokalemia (secrete protein and potassium rich mucns), greatest risk of colon CA

Front 48

Familial polyposis

Back 48

APC gene, AD, all develop CA, prophylactic colectomy

Front 49

gardner syndrome

Back 49

FP, AD, colon cancer, osteomas and desmoid tumors

Front 50

Turcot's syndrome

Back 50

FP, AR, colon cancer and CNS tumrs

Front 51

Carcinogenesis of colon cancer

Back 51

APC -> RAS -> TP53, could also be DNA mismatch repair disease, colonoscopy is gold standard for detection

Front 52

Findings in colon cancers

Back 52

left sided- obstructs, get diarrhea or constipation strep bovis

right sided- tend to bleed, iron deficiency

Front 53

Findings in appedniciitis (in sequence)

Back 53

colicky periumbilical pain, fever, nausea, vomiting and fever AFTER pain, RLQ pain

Front 54

Rectal prolapse

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intussceoptoion of the retum through anus, in kids pertusisis, trichuriasis, and CF casue, in elderly straining with stool

Front 55

Pilonidal sinus/abscess

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painful mass in deep gluteal fold, incise and drain

Front 56

Causes of jaundice

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hemolytic anemias, Gilbert's syndrome, Crigler Nijar syndrome, physioligic jaundice of newborwn, breast milk jaundice, obstructive

Front 57

Dubin Johnson syndrome

Back 57

AR dsiorder in secretion into intrahepatic bile ducts, black pigment in hepatocytes

Front 58

Rotor's syndrome

Back 58

AR disorder similar to Dubin-Johnson, no black bigment

Front 59

Hyperbilrubinemias

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extravsacular hemolsyis increased UCB, viral hepatiits miced hyperbilrubinemia, obstructive diseae incrrease in conjugated bilirubin

Front 60

Liver cell necrosis tests

Back 60

ALT elevated in viral hepatitis, AST elevated in alcholic hepatitis, alk phos- cholestasis, GGYintra or extrahepatic obstruction to bile flow

Front 61

Ascending cholangitis

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Usually d/t E coli, inflammaiton of bile ducts leads to lifethreatening infection, fever, jaundice and RUQ pain

Front 62

Autoimmune hepatitis

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HLADR3 and DR4, young women, m fever, jaundice, hepatosplenomegaly, + ANA, anti-smooth muscle antibodies

Front 63

Reye syndrome

Back 63

Encephalapothy, microvesicular fatty change, transaminase elevation, associated with ASA, chickenpox and influeenza, mitochondria damage and accumulation of ammonia decrease in transaminases, and glucose

Front 64

Most common cause of heptic vein thromboisis

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Polycythemia vera, signs are enlarged painful liver, portal HTN, ascites, splenomegaly, high mortality rate

Front 65

Venoocclusive disease

Back 65

cause onbstruction of pportal blood flow, complication of bone marrow transplant, collagen develops around central veins

Front 66

Mallory bodies

Back 66

damaged cytokeratin intermediate filaments in hepatocytes, associated with alcoholic liver disease, also fatty chjange and neutrophil infiltration

Front 67

Primary sclerosing cholangitis

Back 67

onliterative fibrosis of intrahepatic and extrahepatic ducts, HLA-DR52 in 1005, males associated with IBD, can cause cholangfiocarcinoma, jaundice, pruritis, hepatosplenomegaly

Front 68

Cirrhosis

Back 68

irreversible diffuse fibrosis of the liver with formation of regenerative nodules, hepatocyte, lack of portal triads, surrounded by bands of finbrosis

Front 69

Pathogenesis of ascites

Back 69

Portal HTN, hypoalbuminiae and secondary hyperaldosterone d/t decreased CO and decreased liver metabolism of aldosterone

Front 70

Hepatorenal syndrome

Back 70

eversible renal failure without parenchymal disease, d/t decreased RBF

Front 71

Primary biliary cirrhosis pathogenesis

Back 71

environmetnal insult insult affecting mitochondrial proteins ttirggering CD* T cell destruction of intralobular bile duct epithlium, antimitochondirla antioides

Front 72

Hereditary hemochromatosis

Back 72

AR, HLA-A3 assoicated, unrestricted reabsorption of iron in the small intestine, excess iron stimulates production of free radiaclas leading to damage and cirrhosis

Front 73

Hereditary Hemochromatosis

Back 73

AR, HLA-A3 6q chromsome, Northern European, inrestricted reabosrption of iron in the small intestine
leads to cirrhosis, Bronze diabetes (destruction of B-islet cells) hyperpigmentation

Front 74

Wilson's disease

Back 74

AR, variable onset, liver diseasse from acute hepatitis to cirrhossis, gene mutation leads to defective transport of copper into bile for excretion, defective incorporation fo copper, increased copper in blood

Front 75

Wilson's disease CNS affects

Back 75

in over half of patients
deposits in putamen leading to parkinsonian type disorder
Subtha,mic nucleus leading to hemiballismus
Copper is toxic to neurons in the cerebral cortex -> dementia

Front 76

alpha1-antitrypsin defici ency

Back 76

AD, codominant inheritance, most severe in homzygous, leads to panacinar emphsema and cirhosis of liver from accumulation of AAT

Front 77

Lab tests in cirrhosis

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decreased serum BUN, increased ammonia, fasting hypoglycemia (defective gluconeogenesis), chronic resp alkalosis, lactic acidosis (not converting lactic acid to pyruvate), hyponatremia, hypoalbunemia

Front 78

Cavernous hemangioma

Back 78

most common benigng tumor of liver, best seen on CT, rarely bleeds

Front 79

Liver cell adenoma

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seen with OCPs, and anabolic roids, Von Gierke's glygogenosis. highly vascular dtendency to rupture

Front 80

Hepatocellular

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most common primary liver cancer, finding of bile in neoplastic cells, gross finding focal, multifocal or diffusely infiltrating CA, portal and hepatic vein invasion is common

Front 81

Caroli disease

Back 81

AD, segmental dilatation of bile ducts -> portal tract fibrosis, associated with polycystic kidney dissease, increased risk of cholaangiocarcinoma and cholelithaiasis

Front 82

Pathogenesisi of cholesterol stones in gall bladder

Back 82

supersaturation of bile with cholesterol with decreased bile salts, seen in women over 40, OTC use, obesity

Front 83

Lab findings in acute cholecystitis

Back 83

leukocytosis with left shift, increaset AST/ALP, best test is ultrasound

Front 84

Chronic cholecysitis

Back 84

repeated attacks of minor inflammation, clincial findings of severe persistent pain 12 hours post pradially in the evenings

Front 85

Gallbladder carcinoma

Back 85

porcelain callbladder from calcification, complication of cholelithiasis

Front 86

DIC in acute pancreatitis

Back 86

from activation of prothrombin by trypsin

Front 87

Sentinel Loop

Back 87

Plain x-ray in subadjacent duodenum or transverese colon, localized ileus where bowel does not edmonstrate peristalsis