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GI
| Question | Answer |
|---|---|
| Hepatitis A | Fecal-Oral. Acute only. |
| Hepatitis B | Parenteral/Sex/IV, 6mo+ HBs-> +/- Chronic->heptatocelluar Carcinoma. HBe & HBV DNA correlate w/viremia. |
| Hepatitis C | Parenteral, Transfusion. +/- Chronic ->Hepatocellular Carcinoma |
| Hepatitis D | Co-infx w/ HVB. +/- Chronic. |
| Hepatitis E | Fecal-oral. Pregnancy-> increased mortality |
| Gilbert Syndrome | Reduced UDP glucuronyl transferase. High unconjugated bilirubin. Asymptomatic |
| Crigler-Najjar Syndrome | No UDP glucuronyl transferase. Jaundice, kernicterus (depositin in brain), high unconj. bilirubin. Type1: Lethal. Type2: Tx w/ phenobarbital. |
| Dubin-Johnson & Rotor Syndromes | No bilirubin excretion from liver. D-J:->black liver. Both are benign. |
| Microvesicular Fatty Liver: | Reye's Syndrome: Microvesicular fatty liver, Encephalopathy & coma. Assoc. w/ Aspirin in kids w/ viral infx. Pregnancy: During 3rd trimester, High mortality. Tetracycline: Hypersensitivity Rx. |
| Hemachromatosis | DM, Cirrhosis, Skin pigmentation. HLA-A3 associated OR Achronic transfusions (beta thalassemia), chrom 6. Elevated serum FE |
| Wilson's Disease | Ceruloplasmin deficiency (a marker, not causal). Hepatitis/cirrhosis, Basal ganglia [parkinsonian]. Renal tubule) |
| Budd-Chiari Syndrome | Thrombosis of hepatic vein->jaundice, hepatomegaly, ascites. Assoc. w/poycythemia vera, hepatocellular carcinoma/other abdominal neoplasms, pregnancy. |
| Pancreatic Adenocarcinoma | #1:Head-> obstructive jaundice. #2:Tail->Secondary DM |
| Abdominal layers | Skin, Superficial fascia, External->internal Oblique,Transversus abdominus, Transversalis fascia, Extraperitoneal tissue, Peritoneum. |
| Celiac A. | Foregut. Vagus. T12/L1: Stomach, prox duodenum, liver & gallbladder, pancreas. |
| Superior Mesenteric A. | Midgut. Vagus. L1. Dist. Duodenum, Proximal 2/3 of Transverse colon |
| Inferior Mesenteric A. | Hindgut. Pelvic. L3. Distal 1/3 of Transverse verse colon, upper rectum. |
| Myenteric (Auerbach's) | Motility. Between inner(circular) & outer(longitudinal) smooth muscle layers. |
| Submucosal (Meissner's) | Secretion, blood flow, absorption. In submucosa between mucosa & inner smooth muscle layer of muscularis externa. |
| Cholecystokinin | I cells (Duodenum&Jejunum). Pancreatic & Gall secretions. Inhibits Gastric emptying. Fat & protein stimulates it-> Cholelithiasis exacerbated by fatty meal. |
| Gastrin | G Cells (Antrum). Increase Acid, motility, mucosa growth. Stimulated by stomach distention, protein (esp. phenylalanine & tryptophan), vagus. Inhibited by low pH. ZE syndrome. |
| Secretin | S Cells (Duodenum) Increase bicarb & bile, decrease H+. Increased by acid, fat. Higher pH permits pancreatic enzymes. |
| Somatostatin | D Cells. (Pancreas, Mucosa). Slows everything. Stimulated by acid, inhibited by vagus. Tx for VIPoma, carcinoid |
| GIP | K Cells. (Duodenum & Jejunum). Reduce acid, increase insulin. Stimulated by food. |
| VIP | Parasympathetics (sphincters, gallbladder, small intestine). Increase H2O, SM relaxation. Stimulated by distention, inhibited by sympathetics. VIPoma: pancreatic tumor-> diarrhea. |
| NO | SM relaxation. LOF-> achalasia. |
| Motilin | Small intestine. Migrating motor complexes. Stimulated by fasting state. |
| SGLT1 | Glucose/Galactoe-Na Co-transporter |
| GLUT-5 | Fructose transporter. |
| GLUT-2 | Nonspecific monosaccharide xporter to blood. |
| Boerhaave Syndrome | Esophageal rupture b/c retching (as opposed to mallory-weiss tear, which is painful lacerations to GE-jct) |
| Whipple'S Disease | Malabsorption, migratory arthritis, CNS, Cardiac. T. whipplei bacteria (G+ bacillus). PAS+ macrophages |
| Celiac Sprue | Blunted villi, lymphatic infiltrati. Jejunum. Assoc w/ Dermatitis Herpetiformis, T-Cell Lymphomas. |
| Menetrier's Disease | Gastric hypertrophy -> thick ruggae. Mucinous cells overrun parietal cells -> low H+ output -> protein malabsorption. |
| Ulcerative Colitis | Autoimmune. Rectum +. (Sub)Mucosa involvement. Always bloody. Assoc w/Pyoderma gangrenosum, colorectal carcinoma & primary sclerosing cholangitis. Tx: Sulfasalazine. |
| Crohn's Disease | Post-infx. Terminal ileum, Colon - rectum. Transmural inflammation, skips, cobblestone. Granulomatous. Tx: corticosteroids. |
| Diverticulosis v. Diverticulitis | Diverticulosis: Elderly, low-fiber diet, Sigmoid colon. Diverticulitis: Inflammation, LLQ pain, fever, leukocytosis -> peritonitis, abscess. |
| Meckel's Diverticulum | Ectopic gastric/pancreatic tissue. Terminal ileum. Assoc w/volvulus, intussusception, obstruction. |
| Turcot's Syndrome | FAP + Glioblastomas |
| Peutz-Jeghers Syndrome | Hamartomatous benign polyps on small intestine/colon. High risk of Colorectal cancer, others. |
| AST>ALT | Alcoholic hepatitis (>1.5) |
| ALT>AST | Viral hepatitis |
| Reye's Syndrome | ASA tx for pediatric viral infx. Microvesicular fatty liver, hypoglycemia, coma. |
| Mallory Bodies | Hyalination. Alcoholic hepatitis marker. |
| Hepatocellular Carcinoma | Hep B&C, Wilson's, Hemochromatosis, alpha1-antitrypsin, alcohol, aflatoxin. Alpha-fetoprotein. |
| Hyperbilirubinemia | HEPATOCELLULAR: Conj & Unconj, High urine bilirubin, normal urobilinogen. CHOLESTATIC/OBSTRUCTIVE: Conj, high urine bilirubin, low urobilinogen. HEMOLYTIC: Unconjugated. No urine bilirubin, elevated urine urobilinogen. |
| Acute Pancreatitis | GET SMASHeD: Gallstones, Ethanol, Trauma, Steroids, Mumps, Autoimmune dz, Scorpion sting, Hypercalcemia/Hyperlipidemia, Drugs (sulfa) |
| Retroperitoneal GI Structures | Distal duodenum, Ascending & Descending Colon, Pancreas |
| GI Collateral Circulation (Aorta Blocked) | Subclavian -> Internal Thoracic/Mammary -> Sup. Epigastric -> Inf. Epigastric -> Ext. Iliac -> Int. Iliac -> 1) Middle Rectal -> Inf. Mesenteric -> Sup. Mesenteric -> Thoracic Aorta 2) Common Iliac -> Thoracic Aorta. Then supplies Celiac, SMA, IMA |
| Portosystemic Vein Anastamoses | 1)Umbilicus (Inf & Sup Epigastric <-> Paraumbilical ). 2) Esophagus (L. Gastric <-> Esophageal Veins). 3) Rectum (Superior Rectal <-> Middle/Inferior Rectal Veins) 4)Surgical: Splenic <-> Renal |
| Brunner's Glands | Alkaline mucus secretions from duodenal submucosa. Hypertrophied in peptic ulcer disease. |
| Enteropeptidase/Enterokinase | Activates Trypsinogen -> Trypsin in duodenum. |
| Glut5, SGLT1 | Glut5: GI passive fructose absorption. SGLT1: Na-dependent Glucose & Galactose importer |
| Esophageal Cancer (Risk factors, Type) | ABCDEF: Alcohol/Achalasia, Barrett's, Cigarettes, Diverticuli, Esophageal Web (P-V Synd)/Esophagitis, Familial. SCC>Adeno. |
| Misoprostol | PGE1 Analog. Supports gastric mucous, inhibits acid secretion. NSAID-induced peptic ulcers, maintain PDAs, induce labor, abortion |
| H Pylori Tx | Metronidazole, Amoxocillin/Tetra, Bismuth, +/- PPI |
| Pirenzepine | M1, M3 Antagonist -> Lowers Acid & Histamine secretion. Tx: Peptic ulcers. SE: Tachycardia, dry mouth, blurry vision. |
| AlOH, MgOH,CaCO3 | HYPOKALEMIA Aluminum: Constipation, hypoPO4. Magnesium:Diarrhea, hyporeflexia, HypoTN & Cardiac arrest. Calcium:hyperCa, rebound acid. |
| Infliximab | Anti-TNF antibody. Tx: Crohn's Disease, Rheumatoid Arthritis. SE: Fever, Respiratory Infx, HypoTN |
| Sulfasalazine | Sulfapyridine(antibiotic) + Mesalamine(anti-inflammatory). Tx:UC, Crohn's. SE:Malaise, Nausea, Sulfa toxicity, oligospermia. |
| Onadestron | 5-HT3 antagonist. Tx: Anti-emetic. SE: Headache, constipation. |
Created by:
Kyle Tiemeier
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