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54 Cards in this Set
- Front
- Back
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What type of cells are ONLY found in the antrum of the stomach?
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G cells - secrete gastrin
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What is the most potent stimulus for meal stimulated HCl acid secretion?
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Gastrin
Located in the antrum |
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What neurotransmitter is ONLY released during meals?
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Gastrin
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Via what second messenger pathway does H2 receptor activation cause release in HCl?
What cell releases histamine? |
cAMP
Enterochromaffin-like (ECL) cell |
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What is the most important regulator of HCl acid secretion?
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Vagal ACh release
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True or False
A vagotomy will completely abolish acid secretion during gastric distention? |
False
It only completely abolishes acid secretion during the cephalic phase (acid secreted by sight, smell, taste, or though of food) |
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What type of the cells that secrete somatostatin are NOT in direct contact with the stomach lumen?
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D cells in the corpus/body of stomach
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What is the most common of H. pylori infection phenotype?
What may it ultimately lead to? |
Pangastric gastritis
MALT lymphoma |
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What is the least common of H. pylori infection phenotype?
What may it ultimately lead to? |
Corpus-predominant gastritis
Gastric ulcer or Gastric adenocarcinoma |
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Patients with a duodenal ulcer have an H. pylori infection limited to what part of the stomach?
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Gastric antrum
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In a duodenal ulcer, what protects H. pylori from being destroyed by neutrophils?
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Catalase - neutralizes H202
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What 3 H. pylori virulence factors cause a disruption of tight junctions?
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CagA antigen
VacA cytotoxin Urease |
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What are 2 major differences in distinguishing H. pylori induced duodenal ulcers vs. NSAID induced duodenal ulcers?
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H. pylori = increased parietal cell # = high HCl
NSAIDs = normal parietal cell # = normal HCl |
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What is the most common site of cervical cancers to develop?
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Squamocolumnar Junction
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What is the most common way by which cervical squamous cell carcinomas spread?
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Via lymphatics
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If doing a pap smear to screen of cervical neoplasia, where should you swab?
If doing a pap smear to screen for hormone replacement effects on the vagina, where should you swab? |
Sqaumo-columnar junction
Lateral vaginal wall |
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What kind of ulcer gets worse while eating food?
What kind of ulcer gets worse after eating food? |
While eating = Gastric Ulcer
After eating = Peptic Ulcer |
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What kind of H. pylori gastritis most often causes gastric ulcers?
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Corpus-predominant gastritis
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True or False
In Gastric ulcers you have DECREASED gastrin secretion? |
False
You have increased gastrin secretion |
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In gastric ulcers, what is the mechanism by which H. pylori causes the ulcers to occur?
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Inflammation of gastric mucosa
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What are 3 functions of COX-1?
What is the normal function of COX-2? |
Mucus & Bicarb Secretion, and increased mucosal blood flow
Inhibition of leukocyte adherence |
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What is one of the main ways you can tell the difference b/w a malignant gastric ulcer and a non-malignant one?
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If the ulcer fails to decrease in size by 50% after 4 wks of therapy = cancer ulcer
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What kind of ulcer has very high acid output?
What kind of ulcer has very low acid output? What kind of ulcer can occur in the presence of no acid output? |
Duodenal Ulcer
Gastric Ulcer Malignant Ulcer |
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In what kind of ulcer disease do you have too few parietal cells?
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Corpus predominant H. pylori infection -> Gastric Ulcer
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What is the cause for the increased gastrin production in duodenal ulcers?
What is the cause for the increased gastrin production in gastric ulcers? |
Decreased somatostatin b/c decreased D cells
Hypochlorhydria |
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Perforation of a duodenal ulcer usually goes into where?
Perforation of a gastric ulcer usually goes into where? |
Anterior wall of duodenum = air under diaphragm
Perforate to the lesser curvature |
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What is the major and minor mechanism by which giving a patient with Cl sensitive metabolic alkalosis helps?
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Major - Na increases volume = decreased RAAS
Minor - Cl decreases HCO3 levels |
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What is the basic cause of chloride resistant metabolic alkalosis?
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Increased Mineralcorticoid
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What HPV infections are generally associated with exophytic warts?
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HPV 6 & 11
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What HPV infections are assoicated w/ precancerous lesions of the vulva?
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HPV 16, 18, 31
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What HPV infection is associated with cervical adenocarcinoma?
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HPV 18
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What is the classical triad found in Stein-Leventhal syndrome?
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Obesity
Hirsutism Secondary Amenorrhea |
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What kind of ovarian tumor is associated with pseudomyxoma peritonei?
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Surface epithelial Mucinous Borderline tumor
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What kind of ovarian tumor would you associate with a patient who has a triad of: ovarian fibroma, ascites, and right sided pleural effusion (Mieg’s syndrome)?
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Thecoma-fibroma Sex Cord Stromal Tumor
Especially the fibroma part |
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What kind of tumor has “sheets” of germ cells separated by bands of fibrosis that contain lymphocytes?
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Dysgerminoma
(Seminoma in males) |
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What ovarian tumor produces alpha-fetoprotein?
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Endodermal sinus tumor
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What is the triad of toxemia of pregnancy (pre-eclampsia)?
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HTN
Proteinuria Edema |
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What is the initiating event of pre-eclampsia?
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Placental Ischemia
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What kind of intestinal cells predominately function for absorption?
What kind of intestinal cells predominately function for secretion? |
Villous cells
Crypt cells |
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What are the 2 major secretory ions in stool?
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Cl & HCO
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What is the normal stool osmolality?
What is the normal [Na] in stool? What is the normal [K] in stool? |
280-310 mosm [from 2 x (Na + K)]
20-30 55-75 |
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What kind of intestinal cells use a single ion exchanger to absorb Na?
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Jejunal villus cells
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Electrogenic Na absorption in the jejunum and ileum is coupled to what?
Electrogenic Na absorption in the colon is coupled to what? |
Glucose, amino acids, or phosphate
NOTHING, it is stimulated by Aldosterone (carries the Na in by itself) |
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An increase in what second messenger causes increased Cl secretion through the CFTR channel?
Where does this occur? |
cAMP
Ileum & Colon |
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What is the predominant anion in the lumen of the distal small intestine and colon?
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HCO3
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Where does K secretion mostly occur in the GI system?
How? |
In the distal colon
Via transcellular aldosterone mediated channels |
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As fluid moves distally through the small intestine, what happens to Cl & HCO3 concentration?
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Cl decreases
HCO3 increases |
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What are the 4 required things when ordering for a cytology requisition?
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Pertinent clinical information
Name of requesting clinician and contact information Sample site and collection method Date and time of collection |
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What is the direct and indirect method by which vibrio cholera toxin causes increased anion secretion?
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Direct - increasing cAMP in crypt cells = increased CFTR
Indirect - activating enterochromaffin cells -> increased 5HT -> increased ACh/substance P -> cAMP mediated anion secretion in crypt cell |
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In what kind of diarrhea is the stool osmotic gap < 50 mosmols?
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Secretory diarrhea
It is >100 in osmotic diarrhea |
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True or False
In secretory diarrhea the urine will be maximally ACIDIFIED? |
True
HCO3 loss causes non anion-gap metabolic acidosis |
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Where are bile salts normally reabsorbed?
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Distal ileum
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What is the best fluid replacement to give a pt w/ osmotic diarrhea?
What is the best fluid replacement to give a pt w/ secretory diarrhea? |
Hypotonic fluid
Isotonic fluid |
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Why do diabetics have increased risk of a severe, sudden, explosive diarrhea that is frequently worse at night?
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Decreased peristalsis = bacterial overgrowth in sm. intestine
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