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65 Cards in this Set
- Front
- Back
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At what vertebrae level is the bifurcation of the aorta?
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L4
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At what vertebrae level is the celiac trunk?
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T12
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What are the three branches of that celiac trunk?
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Spenic, left gastric, and common hepatic arteries
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What vessels are anastomosing in esophageal varices?
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Left gastric vein (portal) and esophageal vein (systemic)
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What vessels are anastomosing in caput medusae?
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Paraumbilical veins (portal) and the superficial and inferior epigastric veins (systemic)
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What vessels are anastomosing in internal hemroids?
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Superior rectal vein (portal) and middle and inferior rectal vein (systemic)
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What molecules stimulate the secretion of gastrin?
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Phenylalanine, tryptophan, and Ca2+
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What hormone is responsible for pancreatic secretion and gallbladder secretion?
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CCK
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In cholelithiasis, pain worsens after fatty food ingestion due to?
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CCK production
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What stomach illnesses is somatostatin given to treat?
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VIPoma, carcinoid tumors, and Zollinger Ellison syndrome
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What is a VIPoma?
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Non-alpha, non-beta islet cell pancreatic tumor that secretes VIP. Copious diarrhea.
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What are the actions of ghrelin?
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Increases growth hormone, ACTH, cortisol, and prolactin secretion.
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What nerve runs through the parotid gland?
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CN VII facial nerve
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What activates trypsinogen to trypsin?
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Enterokinase/enterpeptidase, an enzyme secreted from the duodenal mucosa
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What is the rate limiting step in carbohydrate digestion?
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Oligosaccharide hydrolase at the brush border of intestine producing monosaccharides from olgio- and disaccharides.
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Which transporter takes up glucose and galactose?
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SGLT1 (Na+ dependent) and GLUT-2
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Which transporter takes up fructose?
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GLUT-5 (facilitated diffusion) and GLUT-2
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M cells
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Specialized cells that take up antigen in the Peyer's patches of the small intestine.
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What is the only significant mechanism for cholesterol excretion?
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Bile
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What are the components of bile?
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Bile salts, phospholipids, cholestrol, bilirubin, water, ions, and copper (except in Wilson's disease)
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What is bilirubin conjugated with and by what?
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Bilirubin is conjugated with gluconuronate by glucuronyl transferase.
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What does bilirubin travel with in the blood?
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Albumin
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What is bilirubin secreted into the gut as?
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Urobilinogen
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What gives stool its characteristic color?
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Stercobilin, which is how bilirubin is excreted in feces.
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What is the most common salivary gland tumor?
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Pleomorphic adenoma - most common tumor, painless, movable mass, benign with a high rate of recurrence.
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Warthin's tumor
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Benign salivary gland tumor; heterotopic salivary gland tissue trapped in a lymph node, surrounded by lymphatic tissue.
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What is the most common malignant salivary gland tumor?
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Mucoepidermoid carcinoma
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Boerhaave syndrome
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Transmural esophageal rupture due to violent retching.
Worse than Mallory-Weiss syndrome (which is NOT transmural). |
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Ingestion of what toxin is associated with esophageal strictures?
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Lye
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Plummer-Vinson syndrome
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Dysphagia (due to esophageal webs), glossitis, and iron deficiency anemia
Increases the chances of squamous cell cancer of the esophagus. |
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What deficiency is tropical sprue associated with?
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Folate
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What are the symptoms of Whipple's disease? What is the treatment?
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PAS-positive macrophages in intestinal lamina propria, mesenteric nodes. Arthralgias, cardiac and neurologic symptoms are common. Most often occurs in older men.
Treatment is IV antibiotics for 10 days then TMP-SMX for a year. |
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What can cause pancreatic insufficiency?
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Cystic fibrosis, obstructing cancer, or chronic pancreatitis
Causes malabsorption of fat and fat-soluble vitamins (A, D, E, K). |
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Abetalipoproteinemia
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Decreased synthesis of apo B; inability to generate chylomicrons; decreased secretion of cholestrol,VLDL into bloodstream, fat accumulation in enterocytes. Presents in early childhood with malabsorption and neurologic manifestations.
Vitamin E supplementation can help. |
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What antibodies are present in celiac sprue?
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Antibodies against gliadin, tissue transglutaminase, and endomysial
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What skin condition is celiac sprue associated with?
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Dermatitis herpetiformis
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Curling's ulcer
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Decrease in plasma volume due to a burn; causes a sloughing of gastric mucosa.
"Burned by a CURLING iron" |
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Cushing's ulcer
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Brain injury causes increased vagal stimulation, increased ACh, and increased H+ secretion, leading to ulcer development.
"Always CUSHIon the brain" |
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Menetrier's disease
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Gastric hypertrophy with protein loss, parietal cell atrophy, and increased mucous cells. Precancerous. Rugae of the stomach are so hypertrophied that they look like brain gyri.
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What histology is present with adenocarinoma of the stomach?
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Signet ring cells
Can metastasize to the ovaries, which would be a Krukenberg tumor. |
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Where are diverticula most often found?
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Sigmoid colon
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Zanker's diverticulum
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False diverticulum. Herniation of mucosal tissue at the junction of the pharynx and esophagus. Presenting symptoms: halitosis (due to trapped food particles), dysphagia, obstruction.
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What is the most common congenital anomaly of the GI tract?
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Meckel's diverticulum
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What is the tumor marker for colorectal cancer?
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CEA
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What type of lesion is seen on barium enema x-ray for
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"Apple core" lesion
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What are the symptoms of a carcinoid tymor?
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Be FDR - Bronchospasm, Flushing, Diarrhea, and Right sided heart murmurs
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What is the treatment for esophageal varices?
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Beta-blockers - either propanolol or nadolol
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What is the treatment for ascites?
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Thiazide diuretic and loop diuretic; possibly pericentisis
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ALT > AST
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Viral hepatitis
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AST > ALT
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Alcoholic hepatitis
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GGT
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Increased with various liver diseases; increased with heavy alcohol consumption
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Alkaline phosphatase
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Increased with obstructive liver disease (hepatocellular carcinoma), bone disease, or bile duct disease
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Amylase
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Increased in acute pancreatitis and mumps
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Lipase
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Increased in acute pancreatitis
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Decreased ceruloplasmin
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Wilson's disease
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What is the mechanism behind Reye's syndrome?
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Aspirin metabolites decrease beta-oxidation by reversible inhibition of mitochondrial enzyme.
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Mallory bodies
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Intracytoplasmic eosinophilic inclusions, present in alcoholic hepatitis.
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Would there be a JVP in Budd-Chiari syndrome?
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No, it only involves the IVC.
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What converts conjugated bilirubin into urobilinogen?
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Gut bacteria; some unconjugated bilirubin is converted directly into urobilinogen during heme metabolism, however.
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What two liver conditions is phenobarbital used to treat?
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Gilbert's syndrome and Crigler-Najjar type II; phenobarbital in these cases increases liver enzyme synthesis.
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What hereditary hyperbilirubinemia causes a grossly black liver?
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Dubin-Johnson syndrome
Rotor's syndrome, also a conjugated bilirubinemia, does not cause the glossy black liver; it is a milder form of Dubin-Johnson |
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What part of the brain shows degeneration in Wilson's disease?
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Basal ganglia
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What is the treatment for Wilson's disease?
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Penicillamine
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What is the treatment for iron accumulation?
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Deferoxamine
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What is the classic triad of hemochromatosis?
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Micronodular cirrhosis, diabetes mellitus, and skin pigmentation
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