Gi #1

Front 1

Histamine, ACh, and gastrin share what in common?

Back 1

They increase gastric acid secretion by parietal cells of stomach.

Front 2

Somatostain, GIP, prostaglandin, and secretin share what in common?

Back 2

They downregulate gastric acid secretion.

Front 3

Pepsin is released by what?

Back 3

Chief cells of the stomach

Front 4

Inactive pepsinogen is converted to pepsin by?

Back 4

H+

Front 5

HCO3- secretion by mucosal cells of stomach and duodenum increased by what?

Back 5

secretin (released by S cells of duodenum in response to acid)

Front 6

Phenylalanine and tryptophan are potent stimulators of what GI hormone?

Back 6

Gastrin

Front 7

What upregulates CCK secretion?

Back 7

Fatty acids and amino acids in duodenum .

Front 8

What are the three actions of CCK?

Back 8

1) inc. pancreatic secretion
2) inc. gallbladder contraction (bile needed to emulsify and absorb lipids in duodenum)
3) dec. gastric emptying

Front 9

What is implicated in loss of lower esophageal tone of achalasia?

Back 9

loss of NO secretion (NO -> increased SM relaxation)

Front 10

What are the two actions of GIP (Gastric Inhibitory Peptide)?

Back 10

1) Exocrine: dec. gastric H+ secretion
2) Endocrine: inc. insulin release

Front 11

Two actions of VIP (Vasoactive Intestinal Polypeptide)?

Back 11

1) inc. intestinal water and electrolyte secretion
2) inc. relaxation of intestinal SM and sphincters

Front 12

Name three upregulators of H+ secretion.

Back 12

1) Histamine
2) Ach
3) Gastrin

Front 13

Trypsinogen is converted to active trypsin enzyme by?

Back 13

enterokinase/enteropeptidase (enzyme secreted from duodenal mucosa)

Front 14

This enzyme activates other proenzymes and additional trypsinogen in a positive feedback loop.

Back 14

Trypsin (released by pancreas)

Front 15

This enzyme hydrolyzes alpha-1,4 linkages to yield disaccharides.

Back 15

salivary amylase

Front 16

What two substances inhibit gastric acid secretion?

Back 16

Somatostatin, prostaglandins

Front 17

What are the three monsaccharides absorbed by enterocytes?

Back 17

glucose, galactose, fructose

Front 18

Glucose and Galactose are taken up by enterocytes by what transporter?

Back 18

SGLT1 (Na+ dependent)

Front 19

Fructose is taken up by enterocytes by what transporter?

Back 19

Glut-5

Front 20

All monosaccharides transported to blood by what transporter?

Back 20

GLUT-2

Front 21

What does conjugating bile acids to glycine or taurine do?

Back 21

It makes them water soluble

Front 22

Secondary achalasia may result from what disease?

Back 22

Chagas' disease

Front 23

What syndrome is associated w/ esophageal dysmotility involving low pressure proximal to LES?

Back 23

Scleroderma (CREST syndrome)

Front 24

Painless mucosal lacerations at GE junction due to severe vomiting. Leads to hematamesis. Typically found in alcoholics and bulimics. Disease?

Back 24

Mallory-Weiss syndrome

Front 25

Transmural esophageal rupture due to violent retching. Syndrome?

Back 25

Boerhaave syndrome

Front 26

Associated with lye ingestion.

Back 26

Esophageal strictures

Front 27

Triad of: (1) dysphagia (due to esophageal webs), (2) glossitis, and (3) iron deficiency anemia. What syndrome?

Back 27

Plummer-Vinson syndrome

Front 28

Replacement of nonkeratinized (stratified) squamous epithelium with intestinal (columnar) epithelium in distal esophagus (glandular metaplasia) due to what? Called what?

Back 28

Due to chronic acid reflux (GERD) and called Barrett's esophagus.

Front 29

What can Barrett's esophagus become?

Back 29

Adenocarcinoma (BARRett's Becomes Adenocarcinoma, Results from Reflux)

Front 30

What three pathogens is esophagitis associated with?

Back 30

HSV-1, CMV, Candida

Front 31

What are the risk factors for esophageal cancer?

Back 31

Alcohol/Achalasia, Barrett's esophagus, Cigarettes, Diverticuli (e.g., Zenker's diverticulum), Esophageal web (e.g., P-V)/Esophagitis, Familial ("ABCDEF")

Front 32

Where does SCC of esophagus hit?

Back 32

Upper and middle 1/3

Front 33

Where does adenocarcinoma of esophagus hit?

Back 33

Lower 1/3

Front 34

Worldwide, which esophageal cancer is most common?

Back 34

SCC. In U.S. SCC and adenocarcinoma equal in incidence.

Front 35

What part of GI tract does celiac sprue affect?

Back 35

Proximal small bowel

Front 36

What part of GI tract does tropical sprue affect?

Back 36

Entire small bowel

Front 37

Etiology of Whipple's disease?

Back 37

Infection w/ Tropheryma whippelii (gram positive)

Front 38

What tumor marker is used to test for recurrences of CRC?

Back 38

CEA (Carcinoembryonic Antigen)

Front 39

FAP with osseous and soft tissue tumors, retinal hyperplasia. Disease?

Back 39

Gardner's syndrome

Front 40

FAP with possible brain involvement (gliobastoma). Disease?

Back 40

Turcot's syndrome

Front 41

Which part of the colon is always involved with HNPCC/Lynch syndrome?

Back 41

Proximal colon

Front 42

Benign polyposis syndrome that leads to hyperpigmented mouth, lips, hands, genitalia?

Back 42

Peutz-Jeghers syndrome

Front 43

Most common site for carcinoid tumors?

Back 43

SI

Front 44

"Nutmeg" appearance of liver due to what disease process?

Back 44

Chronic passive biliary congestion

Front 45

Rare fatal syndrome associated with viral infection (VZV and influenza B) that has been treated with salycilates (Aspirin).

Back 45

Reye's syndrome

Front 46

What's the relationship of AST and ALT in alcoholic hepatitis?

Back 46

AST > ALT (ratio usually > 1.5). Mnemonic: You're toASTed with alcoholic hepatitis.

Front 47

What's the relationship of AST and ALT in viral hepatitis?

Back 47

ALT > AST.

Front 48

What lab finding is associated with hepatocellular carcinoma?

Back 48

alpha-fetoprotein

Front 49

Most common metastatic site of hepatocellular carcinoma?

Back 49

Lung

Front 50

What syndrome is associated with polycythemia vera, pregnancy, and HCC?

Back 50

Budd-Chiari syndrome

Front 51

Hereditary hyperbilirubinemia due to dec. bilirubin uptake.

Back 51

Gilbert's Syndrome

Front 52

Hereditary hyperbilirubinemia due to decreased or absent UGT.

Back 52

Gilbert's syndrome (asymptomatic) or Crigler-Najjar syndrome, type I (fatal, absent UGT). C-N syndrome type II is less severe and responds to phenobarbital which inc. liver enzyme synthesis.

Front 53

Hereditary hyperbilirubinemia due to defective liver excretion of bilirubin.

Back 53

Dubin-Johnson syndrome. Rotor's syndrome simiilar but even milder and does not cause black liver.

Front 54

Increased antimitochondrial antibodies and IgM. Disease?

Back 54

Primary sclerosing cholangitis

Front 55

What disease is highly associated with tumor marker CA-19-9?

Back 55

Pancreatic adenocarcinoma (also associated with CEA)

Front 56

This drug is used for:
1) prevention of NSAID-induced petic ulcers
2) maintenance of PDA
3) used to induce labor

Back 56

Misoprostol (PGE-1 analog). Increased production of gastric mucous barrier and decreases acid production. Toxicity = diarrhea, and contraindicated in women of childbearing potential (arbotifacient).

Front 57

Common side effect of aluminium hydroxide antacid?

Back 57

Constipation (aluMINIMUM amount of feces). Also hypophosphatemia due to antacids binding phosphate.

Front 58

Common side effect of Magnesium hydroxide?

Back 58

Diarrhea (Must Go to the bathroom)

Front 59

Common side effect of Calcium carbonate?

Back 59

Hypercalcemia

Front 60

What prokinetic drug used for diabetic and post-surgery gastroparesis works via D2-receptor antagonism?

Back 60

Metoclopramide (also used for N/V due to D2 blocking activity in CTZ).

Front 61

What mAb to TNF-alpha cytokine used to treat RA and Crohn's disease?

Back 61

Infliximab

Front 62

30 yo w/ diarrhea, blood per rectum; intestinal biopsy shows transmural inflammation. Dx?

Back 62

Crohn's disease

Front 63

Most common cause of idiopathic hyperbilirubinemia?

Back 63

Gilbert's syndrome

Front 64

55 yo w/ chronic GERD presents w/ esophageal cancer. Most likely histologic subtype?

Back 64

Adenocarcinoma

Front 65

Woman presents w/ alternating bouts of painful diarrhea and constipation. Normal colonoscopy. Most likely Dx?

Back 65

Irritable Bowel Syndrome.

Front 66

Name abdominal layers going from outside to inside.

Back 66

Skin
Superficial fascia
External oblique
Internal oblique
Transversus abdominis
Transversalis fascia
Extraperitoneal tissue
Peritoneum
(Menmonic: Sally Struthers Eats Indian Toddlers To Enlarge Peritoneum)

Front 67

Falciform Ligament (connections and structures contained)

Back 67

Connects: liver to anterior abdominal wall
Contains: Ligamentum teres
Note: derivative of fetal umbilical vein

Front 68

Hepatoduodenal ligament (connections and structures contained)

Back 68

Connects liver to duodeum
Contains portal triad
Note: May be compressed b/w thum and index finger placed in epiploic foramen (of Winslow) to control bleeding. Connects greater and lesser sacs.

Front 69

Gastrohepatic Ligament (connections and structures contained)

Back 69

Connects Liver to lessure curvature of stomach.
Contains gastric arteries
Note: Separtes right greater and lesser sacs. May be cut during surgery to access lesser sac.

Front 70

Gastrocolic Ligament (connections and structures contained)

Back 70

Connects greater curvature and transverse colon.
Contains gastroepiploic arteries
Note: Part of greater omentum.

Front 71

Gastrosplenic Ligament (connections and structures contained)

Back 71

Connects greater curvature and spleen.
Contains short gastrics
Note: Separates left greater and lesser sacs.

Front 72

Splenorenal ligament (connections and structures contained)

Back 72

Connects spleen to posterior abdominal wall.
Contains splenic artery and vein

Front 73

Femoral Region general organization?

Back 73

Lateral to medial:
Nerve
Artery
Vein
Empty space
Lymphatics
("NAVEL")

Front 74

Femoral triangle contents?

Back 74

Femoral vein, artery, and nerve

Front 75

What does the femoral sheath contain?

Back 75

The femoral vein, artery, and canal (deep inguinal lymph nodes) but NOT femoral nerve.