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73 Cards in this Set
- Front
- Back
(3) branches of the celiac trunk
|
Left Gastric A
Splenic A Common Hepatic A |
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(2) branches of the Common Hepatic Artery that supply the stomach
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Right Gastric A
Gastroduodenal A |
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trace the Gastroduodenal Artery to the spleen
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GDA -> R. Gastroepiploic A ->
L. Gastoepoploic A -> spleen (Gastroepiploic AA supply blood to Greater curvature of stomach - can also be called Gastro-omenal AA) |
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Name the Veins that you would see varices in w/ portal HTN
(3 sets) |
Esophageal:
Left gastric -> Azygos External hemorrhoids: Superior -> Inferior rectal Caput Medusae: Paraumbilical -> Inferior Epigastric |
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what does the Submucosa portion of the GI contain and control?
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Submucosa:
meiSSner's plexus control: Secretions, blood flow and absorption |
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what does the Muscularis portion of the GI contain and control?
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Muscularis:
Myenteric Auerbach's plexus control: Motility |
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what is the immunoglobulin of the gut?
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IgA
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Definiton:
Secrete alkaline mucous to neutralize acid contents entering the duodenum from the stomach |
Brunner's glands
|
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what is the name of the structure where the hindgut meets the ectoderm in development?
why is it significant? |
Pectinate line
Above line: Internal hemorrhoids Below line: External |
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Innervation, blood supply and pain level to Internal Hemorrhoids
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Nerves: Visceral innervation
Blood: Superior rectal A Pain: none |
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Innervation, blood supply and pain level to:
External Hemorrhoids |
Nerves: Somatic innervation
Blood: Inferior rectal (Pudendal branch) pain: Painful |
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what are the objects from lateral to medial in the Femoral Triangle?
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NAVEL:
Nerve Artery Vein (Empty) Lymphatics |
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what are the top, medial and lateral edges of the Femoral triangle?
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Top: Inguinal ligament
Medial: Adductor Longus m Lateral: Sartorius m |
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What is Hasselbach's triangle made of?
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Lateral: Inferior Epigastric A
Medial: Rectus Abdominis Bottom: Inguinal ligament |
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best landmark to determine of the inguinal hernia is Direct or Indirect
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Inferior Epigastric artery
[MDs don't LIe] Medial to artery = Direct Lateral to artery = Indirect |
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why is the Indirect hernia more common in infants?
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failure of Processus Vaginalis to close
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what is the primary cause of Achalasia?
secondary? |
Primary:
Failure of LES to relax due to loss of Auerbach's plexus Secondary: Chagas Dz |
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Dx:
"Olive" mass in epigastric region and projectile vomiting at 2 weeks of age |
Pyloric stenosis
|
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Dx:
Infecton of GI causing PAS-positive macros in intestinal lamina propria and mesenteric nodes |
Whipple's Dz
(T. Whippelii) |
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Definition:
epithelial tumor arising from precursor cells of the enamel origin |
Ameloblastoma
|
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MC Salivary gland tumor
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Pleomorphic Adenoma
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Dx:
newborn w/ copious salivation assoc w/ choking, coughing and cyanosis on attempts at eating |
Tracheoesophageal fistula
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Definiton:
Acute gastritis in assoc w/ severe burns |
Curling Ulcer
|
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Definiton:
Acute gastritis in assoc w/ brain injury |
Cushing ulcer
|
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Definition:
focal damage to the gastric mucosa w acute inflammation, necrosis and hemorrhage |
Acute (erosive) Gastritis
|
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Dx:
Autoimmune dz, pernicious Anemia, Achlorhydria where in stomach? |
Chronic (nonerosive) Gastritis Type A (3 As)
(Fundal) |
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MC form of Chronic Gastritis
where in stomach? |
Type B:
H. Pylori-assoc Gastritis [B = Bug] (Antrum) |
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Dx:
Pain greater w/ meals Ulcer cause? |
Gastric
[Gastric = Greater w/ meals] Cause: low mucosal protection vs. acid (H.pylori and NSAIDs) |
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Dx:
Pain Decreases w/ meals Ulcer cause? |
Duodenal ulcer
[Duodenal = Dec w/ meal] Cause: H.pylori |
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MC type of stomach cancer
(2) Extra-GI sites of involvement |
Adenocarcinoma
extra sites: Virchow node, Krukenberg tumor - signet-ring cells in bilateral Ovary |
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Definition:
Stomach cancer that is diffusely infiltrative (thickened, rigid appearance) |
Linitis Plastica
|
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Definition:
extreme enlargement of gastric rugae and possible loss of plasma proteins from altered mucosa |
Menetrier Dz
(giant hypertrophic gastritis) [MENE large Rugae] |
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Dx:
colon inflammation w/ crypt abscesses and pseudopolyps |
Ulcerative colitis
|
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Definition:
twisting of portion of bowel around its mesentary |
Volvulus
|
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remnant of Embryonic Vitelline duct
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Meckel's Diverticulum
|
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Dx:
inc serotonin, cutaneous flushing, diarrhea, bronchospasm, valvular lesions of right heart, RLQ mass |
Carcinoid tumor
(MC place = Appendix) |
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Definition:
dilation of the colon due to the absence of ganglion cells underlying cause? |
Hirschsprungs Dz
(colon SPRUNG open) cause: failure of neural crest cells to migrate |
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Dx:
trisomy 21 patient w/ chronic constipation early in life |
Hirschsprungs Dz
|
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MC place for ischemic bowel due to being poorly vascularized regions
(2) |
Splenic flexure
Rectosigmoid junction |
|
Dx:
Unexplained lower bowel bleeding |
Angiodysplasia
|
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Dx:
inflammation of the colon w/ flask-shaped ulcers |
Amebic colitis
(E. Histolytica infection) |
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Dx:
barrium swallow has "apple core" lesion in lower GI |
Colorectal cancer
|
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which polyp is benign?
which is most malignant? |
Benign: Tubular Adenoma
most malignant: Villous Adenoma |
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Dx:
polyps of the colon and small intestines and melanotic accumulations in the mouth, lips, hands and genitals |
Peutz-Jegher syndrome
|
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Dx:
adenomatous polyps w/ osteomas and soft tissue tumors |
Gardner syndrome
|
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Dx:
adenomatous polyps w/ tumors of the CNS |
Turcot syndrome
|
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Causes of Micronodular Cirrhosis
(3) |
Metabolic insult:
Wilsons Dz; Alcohol; Hemochromatosis |
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what type of shunt may releive portal HTN?
connecting what vessels? |
Portacaval shunt:
between Splenic vein and Lt Renal vein |
|
Another name for AST in lab
|
SGOT
|
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Dx:
swollen, necrotic hepatocytes, PMN infiltrates, intracytoplasmic eosinophilic inclusions, fatty change, sclerosis around central vein |
Alcoholic Hepatitis
|
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Definition:
intracytoplasmic eosinophilic inclusions what are they seen in? |
Mallory bodies
in: Alcoholic hepatitis |
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Dx:
high unconjugated bilirubin w/o hemolysis, decreased UDP-glucuronyl transferase, stress induced, no sx |
Gilbert's syndrome
|
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Dx:
high unconjugated bilirubin w/o hemolysis, absent UDP-glucuronyl transferase, jaundice, kernicterus, CNS damage |
Crigler-Najjar syndrome
|
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Dx:
Increased Conjugated bilirubin, brown to black discoloration of liver |
Dubin-Johnson syndrome
|
|
Dx:
hypergammaglobinemia and anti-smooth muscle Ab |
Autoimmune Hepatitis
|
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Dx:
severe obstructive jaundice, itching, hypercholesterolemia, xanthomas |
Primary Biliary cirrhosis
(Anti-mitochondrial Ab) |
|
Definition:
extrahepatic biliary obstruction causing increased pressure in intrahepatic ducts leading to injury and fibrosis; Inc Alk phos, Inc conjugated bilirubin |
Secondary Biliary Cirrhosis
|
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Dx:
tender hepatomegaly, ascites, polycythemia, hypoglycemia what is elevated in serum? |
Hepatocellular CA
(elevated alpha-fetoprotein) |
|
Definition:
Inadequate hepatic copper excretion and failure of copper to enter circulation, leading to copper accumulation in organs |
Wilson's Dz
(Auto Resessive) |
|
Dx:
asterixis, parkinsonian sx, cirrhosis, low ceruloplasmin, dementia |
Wilson's Dz
ABCD: Asterixis Basal ganglia sx Copper accumulation/low Ceru. Dementia |
|
Dx:
occlusion of IVC or hepatic veins w/ centrilobular congestion and necrosis; assoc w/ polycythemia, abd CA, or complication of pregnancy |
Budd-Chiari syndrome
|
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Hyperbilirubinemia type, urine bilirubin and urine urobilinogen changes for:
Hepatocellular jaundice |
Conjugated/Unconjugated
Inc Urine Bilirubin nml/Dec Urobilinogen |
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Hyperbilirubinemia type, urine bilirubin and urine urobilinogen changes for:
Obstructive jaundice |
Conjugated
Inc Urine Bilirubin Dec Urobilinogen |
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Hyperbilirubinemia type, urine bilirubin and urine urobilinogen changes for:
Hemolytic jaundice |
Unconjugated
Absent urine Bilirubin Inc Urobilinogen |
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Dx:
hepatoencephalopathy in young children w/ virus who are given aspirin |
Reye's syndrome
|
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what is chronic calcifying pancreatitis assoc with?
|
alcoholism
|
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what is chronic obstructive pancreatitis assoc with?
|
Gallstones
|
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Cause of Cholangiocarcinoma
|
Liver fluke
(C.sinensis) |
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Dx:
"Strawberry gallbladder" |
Cholesterolosis
|
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what causes the GB to become enlarged and distended?
|
Tumors (not stones)
|
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(3) changes in the pancreas w/ Acute Pancreatitis
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Hemorrhagic Fat Necrosis
Calcium soaps (leading to HypoC) Pseudocysts |
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Dx:
abdominal pain radiating to back, migratory thrombophlebitis, obstructive jaundice w/ palpable GB |
Pancreatic Adenocarcinoma
|
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Dx:
malabsorption problem w/ positive D-xylose test what CA can it lead to? |
Celiac Sprue
leads to: T-cell lymphoma |