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Gastrointestinal
FA Round 3
| Question | Answer |
|---|---|
| What does extremely elevated ALT and AST often indicate? | Drug-induced liver injury |
| Which pathologies can be identified by an elevated ALP? | Cholestasis (biliary obstruction), infiltrative disorders, and bone disease |
| What are two common proteins involved in stimulating appetite? | Ghrelin and Neuropeptide Y |
| What is the role of Ghrelin and Neuropeptide Y? | Stimulation of appetite |
| Is Ghrelin and Neuropeptide Y increased or decrease in a fed state? | Decreased |
| Which is the major hormone responsible for decreasing hunger? | Leptin |
| Is Leptin increased or decreased in a fed state? | Increased |
| What causes the bilateral pitting edema in Kwashiorkor malnutrition? | Decreased albumin and protein synthesis, which leads to decreased oncotic pressure and third spacing |
| What are common clinical features of Kwashiorkor disease? | Bilateral pitting edema, muscle atrophy, abdominal distension, hepatomegaly, dermatitis, hair loss, and an apathetic affect |
| What is the MCC of esophagitis in immunocompromised patients? | C. albicans infection |
| What are the endoscopy findings of C. albicans esophagitis? | White mucosal plaques |
| What is Zollinger-Ellison syndrome (ZES)? | Rare ulcer disease manifested by abdominal pain, resistance to treatment, ulcers distal to the typical gastric location, and high serum gastrin |
| What is the associated neoplasm of ZES? | Pancreas or duodenum, specifically a gastrin-secreting tumor |
| Where do perianal structures, including those in the anal canal below the pectinate line, drain? | Superficial inguinal nodes |
| What is Porcelain gallbladder? | Calcification of the gallbladder wall due to deposition of calcium salts |
| What are the most common clinical features of Alcoholic hepatitis? | Patients who heavily consume alcohol with fatigue, malaise, and RUQ pain |
| What type of hepatitis is associated with a 2:1 AST:ALT ratio? | Alcoholic hepatitis |
| Which antituberculotic medication are to be avoided in patients with liver disease? | Isoniazid, rifampin, and pyrimidine, as theses are known to cause drug-induced hepatitis |
| What is the structure of hepatitis E virus? | Nonenveloped, single-stranded RNA virus |
| What is the common underlying condition in some patients that develop Meconium ileus? | Cystic fibrosis |
| Which part of the embryological urinary development may be affected in cystic fibrosis? | Mesonephric duct |
| What are common parts derived by the Mesonephric duct? | Vas deferens, epididymis, seminal vesicles, and ejaculatory duct |
| How is ALP in PSC? | Elevated levels of ALP |
| How is PSC clinically presented? | Progressive fatigue, pruritus', icteric sclera, and fibrosis of intrahepatic and extrahepatic bile ducts |
| What is a common H2 blocker antihistamine? | Ranitidine |
| What is a common drug used to treat GERD? | Ranitidine |
| What is the advantage of Ranitidine over Cimetidine? | Ranitidine does not have the antiandrogenic effects of cimetidine |
| What are slow waves of the GI tract? | Rhythmic depolarization and repolarization of smooth muscle cells within the muscularis propria of the stomach and intestines |
| What are the CT findings of hepatic cirrhosis? | Nodular and shrunken liver |
| What are the hematologic abnormalities seen in hepatic cirrhosis? | Low platelet count (thrombocytopenia) from hypersplenism; prolonged PT and PTT caused by decreased clotting factors |
| What is the result of decreased clotting factors in cirrhosis? | Prolonged PT and PTT |
| What is a common histological association of Lynch syndrome? | Microsatellite instability |
| What malignancies are associated with Lynch syndrome? | Colon and endometrial carcinoma |
| What is a possible cause of painless rectal bleeding and young child? | Meckel diverticulum |
| What gives rise to a Meckel diverticulum? | Persistence of the Omphalomesenteric duct |
| What is the name for the persistence of the Omphalomesenteric duct? | Meckel diverticulum |
| What is a treatment option for Crohn disease? | Monoclonal antibodies directed against the inflammatory cytokine TNF-alpha |
| Which condition is treated with medication known to be monoclonal antibodies against TNF-a? | Crohn disease |
| What is the MCC of gastric ulcers? | H. pylori infection |
| Description of H-pylori gastric ulcers: | Punched-out lesion with scar tissue and chronic inflammatory cells in biopsy specimens |
| What is the most common drug used to treat diabetic gastroparesis? | Metoclopramide |
| What are associated adverse effects of Metoclopramide? | Extrapyramidal adverse effects, such as tremor, dystonia, and tardive dyskinesia |
| What the most characteristic GI manifestations of E. histolytica infection? | Bloody diarrhea and liver abscesses |
| What are the histological findings of E. histolytica infection? | Trophozoites containing phagocytosed RBCs in the stool |
| How is Diffuse Esophageal Spasm presented? | Episodic substernal chest pain accompanied by dysphagia |
| What are the effects on the esophagus physiology due to DES? | Periodic, uncoordinated, no peristatic contractions of the esophagus |
| What is the MCC of neonatal intestinal obstruction? | Intestinal atresia |
| What causes a duodenal atresia? | Failure of recanalization of the GI tract during embryogenesis |
| How is Duodenal atresia in neonate presented? | Quickly after birth with intractable emesis |
| What are two physicals symptomatic associations of Pancreatic cancer? | Jaundice and palpable nontender gallbladder |
| What are histological or tissue effects seen with duodenal ulcers? | Hyperplasia of Bruner glands |
| Which tissue or gland is hypertrophied in patients with chronic duodenal ulcers? | Brunner glands |
| A patient presents sudden RUQ pain, jaundice, and direct hyperbilirubinemia. Most likely diagnosis? | Obstruction of bile due to gallstones (choledocholithiasis) |
| Two common nonselective NSAIDs: | Naproxen and Ibuprofen |
| What are possible risks for taking nonselective NSAIDs? | Increase risk of gastritis, PUD, and upper GI bleeding |
| The blockage of which COX receptor leads to increase GI risk in nonselective NSAIDs? | COX-1 inhibiting or blockage |
| UC or Crohn disease involves the rectum? | Ulcerative colitis |
| What are some common histologic features of UC? | Superficial mucosal inflammation and crypt abscesses |
| Which pancreatic cells secrete Somatostatin? | D cells |
| What is secreted by pancreatic D cells? | Somatostatin |
| What hormone is secreted by I cells in the duodenum? | CCK |
| Which duodenal cells secrete CCK? | I cells |
| What part of the small intestine have I cells and K cells? | Duodenum and Jejunum |
| What GI hormone is secreted by K cells in the small intestine? | GIP |
| What cell secrete GIP in the doudenum and jejunum? | K cells |
| What hormone is secreted by S cell in the duodenum? | Secretin |
| What is the only marker + during the window period of Hepatitis B infection? | Hepatitis B core antibody |
| What is the most significant adverse effect of Cimetidine toxicity? | Antiandrogen effects (gynecomastia and decreased libido) |
| What are the tumor markers associated with Pancreatic adenocarcinoma? | CA 19 -9 and CEA |
Created by:
rakomi
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