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120 Cards in this Set
- Front
- Back
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falciform ligament is remnant of what fetal structure?
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fetal umbilical vein
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where are Brunner's glands?
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submucosa of duodenum
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where are Peyer's patches?
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lamina propria and submucosa of ileum
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at what vertebral level is celiac trunk?
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T12
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at what vertebral level is SMA?
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L1
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at what vertebral level is IMA?
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L3
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at what vertebral level is bifurcation of abdominal aorta?
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L4
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parasympathetic innervation of gut?
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Vagus: foregut and midgut
Pelvic: hindgut |
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strong anastamoses within celiac trunk?
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Left and right gastroepiploic
Left and right gastrics |
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arterial supply of internal hemorrhoids?
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superior rectal artery (branch of IMA)
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arterial supply of external hemorrhoids?
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inferior rectal artery (branch of internal pudendal artery)
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venous drainage of internal hemorrhoids?
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superior rectal vein -> IMV -> portal system
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venous drainage of external hemorrhoids?
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inferior rectal vein -> internal pudendal -> internal iliac -> IVC
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organization of structures in femoral region?
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lateral to medial:
Nerve-Artery-Vein-Empty space-Lymphatics |
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what cells secrete gastrin?
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G cells in the antrum of the stomach
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what cells secrete cholecystokinin?
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I cells (duodenum and jejunum)
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what cells secrete secretin?
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S cells (duodenum)
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what cells secrete somatostatin?
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D cells (pancreatic islets, GI mucosa)
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what cells secrete GIP?
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(glucose-dependent insulinotropic peptide or gastric inhibitory peptide)
K cells (duodenum and jejunum) |
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what cells secrete VIP?
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(vasoactive intestinal polypeptide)
parasympathetic ganglia in sphincters, gallbladder, small intestine |
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what cells secrete intrinsic factor?
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parietal cells (stomach)
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what cells secrete gastric acid?
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parietal cells (stomach)
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what cells secrete pepsin?
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chief cells (stomach)
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what cells secrete bicarb?
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mucosal cells (stomach, duodenum, salivary glands, pancreas) and Brunner's glands (duodenum)
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action of gastrin?
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increases gastric H+ secretion
increases gastric motility |
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action of cholecystokinin?
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acts on neural muscarinic pathways to trigger pancreatic secretion and increase gallbladder contraction
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action of secretin?
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increases pancreatic bicarb secretion, decreases gastric acid secretion
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action of somatostatin?
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decreases gastric acid, pancreatic, and small intestine secretions
decreases gallbladder contractions decreases insulin and glucagon release |
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action of GIP?
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exocrine: decreases gastric H+ secretion
endocrine: increases insulin release (triggered by oral glucose load) |
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action of VIP?
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increases intestinal water and electrolyte secretion and relaxation of intestinal smooth muscle
*VIPoma causes copius diarrhea |
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action of intrinsic factor?
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vitamin B12 binding protein (required for vitamin B12 uptake in terminal ileum)
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action of gastric acid?
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decreases stomach pH
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action of pepsin?
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protein digestion (activated from pepsinogen by H+)
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what nerve runs through the parotid gland?
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CN VII
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vagus innervation in GI secretions?
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stimulates parietal cells (ACh) and G cells (GRP)
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effect of atropine on GI secretions?
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blocks vagal stimulation of parietal cells; does not affect vagal stimulation of G cells
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pathway of histamine on H2 receptors in gastric parietal cells?
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activation of H2 receptor causes increase in cAMP, leading to activation of ATPase proton pump (H+/K+ exchanger)
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hypertrophy of brunners glands?
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peptic ulcer disease
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what activates trypsinogen?
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duodenal enzyme (enterokinase/enteropeptidase); allows activated trypsin to activate other pancreatic enzymes
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where are oligo- and di-saccharides broken down into monosaccharides?
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at brush border of intestine by oligosaccharide hydrolase
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rate limiting step in carbohydrate digestion?
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breakdown into monosaccharides at brush border (by oligosaccharide hydrolase)
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transporters involved in carbohydrate absorption by enterocytes?
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SGLT1: sodium dependent transporter for glucose and galactose
GLUT-5: facilitated diffusion of fructose GLUT-2: transportation of all monosaccharides into blood |
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Warthin's tumor?
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benign salivary gland tumor; heterotopic salivary gland tissue trapped in a lymph node
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most common malignant salivary gland tumor?
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mucoepidermoid carcinoma
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pathophysiology of Achalasia?
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failure of relaxation of LES due to loss of myenteric (Auerbach's) plexus
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infectious disease that may lead to achalasia?
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Chagas' disease
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Boerhaave syndrome?
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transmural esophageal rupture due to violent retching
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causes of esophageal strictures?
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lye ingestion
acid reflux |
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metaplasia in Barrett's esophagus?
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replacement of squamous epithelium with intestinal columnar epithelium (distal esophagus)
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most common type of esophageal cancer?
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worldwide: squamous (upper and middle thirds)
in USA: adenocarcinoma (lower third of esophagus) |
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Whipple's disease?
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infection with tropheryma whippelii (gram positive bacteria); symptoms include malabsorption, arthralgias, cardiac, and neurologic sxs; most often seen in older men
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antibodies in celiac sprue?
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anti-gliadin and transglutaminase
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cause of Cushing's ulcer?
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increased vagal stimulation causing increased H+ production
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type A gastritis?
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Autoimmune disorder with
Autoantibodies to parietal cells, pernicious Anemia, Achlorhydria; occurs in Body of stomach |
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type B gastritis?
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Bacteria-associated (H. pylori);
occurs in Antrum of stomach +increased risk of MALT lymphoma |
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type of gastritis with increased risk of MALT lymphoma?
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type B (H. pylori associated; in Antrum)
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signet ring cells in gastric biopsy?
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adenocarcinoma
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Virchow's node?
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left supraclavicular node with mets from stomach cancer
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Krukenberg's tumor?
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bilateral mets to ovaries from stomach cancer
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Sister Mary Joseph's nodule?
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subcutaneous periumbilical metastasis from stomach cancer
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increased gastric acid secretion causes what type of peptic ulcer disease?
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duodenal ulcers
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IBD with skip lesions?
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Crohn's disease
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IBD with cobblestoning?
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Crohn's disease
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IBD with creeping fat?
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Crohn's disease
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IBD with linear ulcers, fissures, fistulas?
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Crohn's disease
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IBD with non-caseating granulomas?
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Crohn's disease
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IBD associated with migratory polyarthritis?
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Crohn's disease
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treatment for Crohn's disease?
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corticosteroids, infliximab
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IBD with rectal involvement?
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UC must have rectal involvement; Crohn's is rectal sparing
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IBD transmural vs. mucosal/submucosal?
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transmural: Crohn's
mucosal: UC |
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IBD with loss of haustra, "lead pipe" appearance?
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Ulcerative Colitis
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IBD with crypt abscesses and bleeding?
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Ulcerative Colitis
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IBD associated with pyoderma gangrenosum?
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Ulcerative Colitis
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IBD associated with primary sclerosing cholangitis?
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Ulcerative Colitis
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IBD with pseudopolyps?
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Ulcerative Colitis
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treatment for ulcerative colitis?
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ASA preparations (sulfalazine),
6-mercaptopurine, infliximab |
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embryologic cause of Meckel's diverticulum?
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persistant vitelline duct or yolk stalk
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location and size of Meckel's diverticulum?
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2 inches long
2 feet from ileocecal valve (also… 2% of population, presents in first 2 yrs of life, 2 possible types of ectopic epithelia present [gastric/pancreatic]) |
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study used to diagnose Meckel's diverticulum?
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pertechnetate study, looking for ectopic uptake
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"double bubble" associated with Down syndrome?
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duodenal atresia
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meconium ileus?
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failure to pass meconium at birth; caused by cystic fibrosis
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histologic type of colonic polyp associated with malignancy?
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villous
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Peutz-Jeghers syndrome?
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autosomal-dominant syndrome featuring multiple non-malignant hamartomas in GI tract, hyperpigmented hands/junk/mucosa
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FAP gene?
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APC gene on chromosome 5
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FAP + osseous and soft tissue tumors, retinal hyperplasia?
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Gardner's syndrome
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FAP + malignant CNS tumors?
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Turcot's syndrome
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gene mutation associated with HNPCC?
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autosomal dominant mutation of DNA mismatch repair genes; proximal colon
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tumor marker associated with colorectal cancer?
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CEA
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most common molecular mutation pathway that leads to colorectal cancer?
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(chromosomal instability)
loss of APC gene -> k-RAS mutation -> loss of p53 |
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ALT elevated more than AST?
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viral hepatitis
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AST elevated more than ALT?
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alcoholic hepatitis
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isolated elevated AST?
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possible MI
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infectious disease that causes elevated amylase?
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mumps
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fatty liver, hypoglycemia, coma (in child)
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Reye's syndrome following ASA administration
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histology of alcoholic hepatitis?
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swollen and necrotic hepatocytes with neutrophilic infiltration and Mallory bodies (intracytoplasmic eosinophilic inclusions)
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Mallory bodies?
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intracytoplasmic eosinophilic inclusions seen in alcoholic hepatitis
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tumor marker associated with hepatocellular carcinoma?
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alpha-fetoprotein
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liver findings in alpha-1 antitrypsin deficiency?
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PAS-positive globules (accumulation of misfolded gene product protein)
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neurological symptoms of Wilson's disease?
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Asterixis
Basal ganglia degenration -> parkinsonian Choreiform movements Dementia |
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treatment for wilson's disease?
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penicillamine
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Wilson's disease inheritance?
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autosomal-recessive
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cirrhosis, diabetes, bronzing?
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Hemochromatosis
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serum iron studies in hemochromatosis?
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decreased TIBC, increased transferrin saturation
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treatment of hereditary hemochromatosis?
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repeated phlebotomy, deferoxamine
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HLA associated with hereditary hemochromatosis?
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HLA-A3
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antibodies in primary biliary cirrhosis?
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anti-mitochondrial antibody
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"beading" of intra- and extra-hepatic bile ducts on ERCP?
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primary sclerosing cholangitis
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jaundice, fever, RUQ pain?
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cholangitis
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causes of acute pancreatitis?
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Gallstones
Ethanol Trauma Steroids Mumps Autoimmune disease Scorpion sting Hypercalcemia/Hyperlipidemia ERCP Drugs |
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tumor markers for pancreatic adenocarcinoma?
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CEA and CA-19-9
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toxicity of cimetidine?
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(H2 blocker)
P-450 inhibitor antiandrogen (gynecomastia, etc) crosses blood-brain barrier and placenta decreases renal excretion of creatinine |
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muscarinic antagonists used in peptic ulcer disease (rarely used now)
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pirenzepine, propantheline
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electrolyte abnormality associated with all antacids?
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hypokalemia
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MOA of infliximab?
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monoclonal antibody to TNF, used in Crohn's disease and rheumatoid arthritis
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MOA of metoclopramide?
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D2 receptor antagonist used in diabetic and post-surgery gastroparesis
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major risk factor for gallbladder cancer?
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chronic gallstones
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migratory thrombophlebitis?
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Trousseau's sign -- presenting symptom in 10% of pancreatic adenocarcinoma
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combination therapy for acute Hep B infection?
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lamivudine and interferon-alpha
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most common cause of microcytic anemia?
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iron deficiency
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where is iron absorbed?
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duodenum
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