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Gastrointestinal
Round 3 UWORLD Part I
Question | Answer |
---|---|
Which lymph nodes drain the rectum PROXIMAL to the anal dentate line? | Interior mesenteric and Internal iliac lymph nodes |
What part, proximal or distal to the anal dentate line, of the rectum is drained by the Inferior mesenteric and Internal Iliac lymph nodes? | Proximal recturm to the anal dentate line |
Which lymph node receives lymph for the rectum distal to the anal dentate line? | Inguinal nodes |
Which part of the rectum with respect to the anal dentate line, lymph is drained via the inguinal nodes? | Distal rectum to the anal dentate line |
Pain description of appendicitis? | Dull visceral pain at the umbilicus due to afferent pain fibers entering at the T10 level in the spinal cord |
Early pain in Appendicitis is located at which level of the Spinal cord? | T10 |
Initial pain due to appendicitis is located at the: | Umbilicus |
Do afferent or efferent fibres cause pain in appendicitis? | Afferent pian fibers |
What causes the shift of localized pain in Appendicitis from the umbilicus to the LRQ? | Appendix irritates the Parietal peritoneum and abdominal wall causes more severe somatic pain |
What is the name of the area to which late appendicitis pain shifts from the umbilical area? | McBurney's point |
Pain at McBurney's point is often associated with which condition? | Appendicitis |
Where is the McBurney's point? | 2/3 f the distance from the umbilicus to the anterior superior iliac spine |
What is Anorexia nervosa? | Eating disorder characterised by a low body weight, intense fear of becoming fat, and distorted body image |
Is Anorexia nervosa associated with a low or normal/high body weight? | Low body weight |
What are the complications of Anorexia nervosa due to starvation practices? | Bradycardia, hypotension, osteoporosis, and amenorrhea |
What is a less common complication of Anorexia nervosa that involves gland hypertrophy? | Parotid hypertrophy |
What is the cause of Duodenal atresia? | Vascular accidents in utero |
What is the intestinal atresia associated with vascular accidents while in utero? | Duodenal atresia |
When do "apple-tree" atresias occur? | As the superior mesenteric artery is obstructed |
Which arterial vessel is obstructed in "apple-tree" atresias? | Superior Mesenteric artery |
What is the result of a duodenal atresia? | Blind-ending pouch proximal to the jejunum |
What is the deficits of the Ileum in duodenal atresia? | Terminal ileum spiraled around an ileocolic vessel |
What are common situations or events that increase chances of C. difficile infection? | Hospitalization and prolonged antibiotic use |
What are the most common symptoms of C. difficile infection? | Diarrhea, abdominal pain, and pseudomembranous in the intestinal mucosa |
What is the best test or lab technique to confirm C. difficile infection dx? | Nucleic acid amplification test |
What diarrheal condition is often diagnosed bia Nucleic acid amplification test? | C. difficile infection |
What is Schistosomiasis? | A parasitic fluke infection, that is common in rural population of the Sub-Saharan Africa |
Which part of the world is seen with high incidence of Schistosomiasis? | Sub-Saharan Africa |
While mostly asymptomatic, what are the main categories of symptoms seen with Schistosomiasis? | 1. Hepatosplenic (portal hypertension, hepatosplenomegaly, esophageal varices) 2. Urinary (bladder cancer) |
What lab (hematologic) value is important in dx of Schistosomiasis? | Eosinophilia |
What are some complication or possible results of Atrophic gastritis? | Profound hypochlorhydria, inadequate intrinsic factor production, vitamin B12 deficiency and elevated methylmalonic acid levels |
What water soluble vitamin is often deficient in patient with Atrophic gastritis? | Vitamin B12 |
What condition can be associated with megaloblastic anemia due to Cobalamin deficiency, elevated methylmalonic acid, and low IF production? | Atrophic gastritis |
What increases the reticulocyte count in a patient with Pernicious anemia? | Vitamin B12 replacement therapy |
What is the rate of effect on hemoglobin, erythrocyte count, and reticulocyte count upon Vitamin B12 replacement therapy? | Reticulocyte count immediately increases while, Hb and Erythrocyte count rise gradually and take up to 8 weeks |
What is the main cause of Gallstone formation? | Supersaturation of cholesterol |
What is the common composition of gallstone due to supersaturation of cholesterol? | Precipitates out of bile with mucin and calcium salts to form white or yellow-cholesterol stones |
What are factors that promote the formation of cholesterol stones? | 1. Increased cholesterol synthesis 2. Gallbladder hypomotility 3. Increased calcium or mucin concentration 4. Decreased bile acid synthesis or recirculation |