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49 Cards in this Set
- Front
- Back
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Inhibitors of gastric acid
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Somatostatin, GIP, Prostaglandin, secretin
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What intracellular signaling molecule does Gastrin use?
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Gq --> IP3/Ca
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Most common location of salivary gland tumor
Most common tumor Most common malignant tumor |
parotid
Pleomorphic adenoma Mucoepidermoid carcinoma |
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Infections that cause esophagitis
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HSV-1
Candida CMV |
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Types of esophageal cancer and their location
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Sqamous - upper and middle 1/3
Adenocarcinoma - lower 1/3 |
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Menetriers disease
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Gastric hypertropy that leads to protein loss, atrophy of the parietal cells, and increased mucous cells
Hypoabluminemia & edema Precancerous Rugae look like brain gyri due to hypertrophy |
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Sister mary joseph's nodule
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SubQ periumbilical metastasis
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Ulcer with 100% association w/ H. pylori infection
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Duodenal
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Location of Crohn's Disease?
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Terminal ileum and colon most common
Rectal sparing |
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Location of ulcerative colitis?
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Colon
Always involves rectum |
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Most common location for a diverticulum?
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Sigmoid colon
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DDx for Pneumaturia
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Colovesical fistula (from diverticulitis)
Crohns |
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Zenker's diverticulum
Location and sx |
At Pharynx/Esophagus jxn
Halitosis, dysphagia, obsturction |
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Meckel's Diverticulum
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Persistence of the vitelline duct or yolk sac
2 inches long 2 feet from ileocecal valve 2% of population 2 types of tissue Presents in first 2 years of life |
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Meconium ileus
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CF patients
meconium plug obstructs intestine --> prevents stool passage at birth |
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Malignant risk of a polyp is associated with what factors?
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Size
Villious histology (the more villous, the worse off) Epithelial dysplasia |
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Gardner's Syndrome
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FAP + osseous and soft tissue tumors + retinal hyperplasia
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Turcot's syndrome
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FAP + CNS malignancies
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FAP always involves what part of the GI tract?
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Rectum
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HNPCC always involves what part of the GI tract?
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Proximal colon
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Presentation of a distal vs proximal colon cancer
esp differences in type of pain |
Distal: Colicky pain, hematochezia, obstruciton
Proximal: Dull pain, iron deficiency anemia, fatigue |
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Causes of micronodular cirrhosis
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metabolic insult, such as alcoholic hepatitis, hemochromatosis, Wilson's disease
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Causes of macronodular cirrhosis
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Significant liver injury leading to hepatic necrosis (post infectious or drug induced hepatitis)
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Reye's Syndrome
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HE following viral infection (VZV or influenza B) and administration of salicylates
Due to damage of mitochrondria, leading ot decreased beta-oxidation and inhibition of urea cycle Hepaticencephalopathy Hypoglycemia Increased transaminase Coma Microvesicular fatty change |
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Pathway for Alcohol metabolism + Pathway inhibitors
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Ethanol--> acetaldehyde (alcohol dehydrogenase; inhibited by fomepizole)
Acetaldehye --> Acetate (Acetaldehyde dehydrogenase; inhibited by disulfiram) |
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What is the defect in Dubin-Johnson syndrome?
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Defective liver excretion of conjugated bilirubin
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Sx of hemochromatosis
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Diabetes mellitus
Micronodular hepatitis Skin pigmentation (bronze) CHF and inc risk for HCC |
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Risk factors for HCC
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HBV/HCV
Hemochromatosis Wilson's disease Alcoholic hepatitis Aflatoxins PBC AAT deficiency Tyrosinemia |
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Presentation of biliary tract disease
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Jaundice
Pruritis Hepatomegaly Dark urine Light stools |
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Air in biliary tree means what?
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Gallstone ileus
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Charcot's triad of cholangitis
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Jaundice
RUQ pain Fever |
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Most common location of pancreatic adenocarcinoma?
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Pancreatic head
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Risk factors for pancreatic adenocarcinoma
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Smoking (most common cause)
Chronic pancreatitis NO association w/ EtOH |
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Clinical findings in pancreatic cancer
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Weight loss
Migrating thrombophlebitis - red & tender extremities on palpation Painless obstructive jaundice (w/ palpable gallbladder) Abdominal pain radiating to back |
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Causes of Acute Pancreatitis
Which are most common? |
GET SMASHED
Gallstones (most common) Ethanol (most common) Trauma Scorpion bite Mumps (infection) Autoimmune Steroids Hypercalcemia/Hyperlipidemia/Hypertriglyceridemia ERCP (3rd most common cause) Drugs (sulfa, azathioprine, furosemide, valproate) |
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Most common location for a colonic polyp?
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Rectosigmoid
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Prevalence of squamous cell carcinoma and adenocarcinoma of the esophagus?
Which is more common? |
Equal in western
Squamous most common worldwide |
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Only place that has GI submucosal glands?
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Brunners glands of the duodenum
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How does the body defend against candida?
What happens when it fails? |
T cell --> defend locally
Fail --> vulvovaginitis, esophagitis, etc Neutrophil --> prevent systemic Fail --> Right sided endocarditis, liver and kidney abscesses |
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Location of secretory IgA
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Tears, saliva, mucus, colostrum
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What causes kernicterus?
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Bilirubin deposition inthe brain
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Hereditary hyperbilirubinemia where you have a black liver + mechanism
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Dubin-Johnson syndrome
Defective liver excretion |
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On cross sectional CT, what is the relationship of IVC to Portal vein?
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IVC is posterior to the portal vein
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Wilson disease
pathogenesis Sx Diagnosis |
AR disease of impaired copper excretion from liver
Copper is pro-oxidant, and damages hepatic tissue Asterixis Basal ganglia degerneation (parkinsons) Ceruloplasmin dec, cirrhosis, Corneal deposits, Chorea Dementia hemolytic anemia Diagnosis: Liver biopsy is gold stanard Slit lamp to see Keiser-Fleisher rings |
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Histology of Acute Viral Hepatitis
(very important) |
Ballooning of hepatocytes
Lymphocytic, mononuclear cell infiltrates Councilman bodies (acidophilic, apoptosis) may have necrosis |
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Describe Prodrome of acute viral hepatitis
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Fever, malaise, lymphadenopahty, pruritis, painful hepatomegaly
Serum transaminases peak just before jaundice |
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Result of poor removal of an echinococcal cyst
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Anaphylaxis
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Ground glass appearance in hepatocytes due to...
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HepB infection
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Indications to test for A1AT deficiency
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Premature (<50) chronic bronchitis, emphysema, dyspnea
or Non-smokers w/ COPD |
