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Step 1 GI
| Question | Answer |
|---|---|
| What is contained in the hepatoduodenal ligament? | hepatic artery, portal vein, common bile duct |
| The falciform ligament carries a remnant of what structure? | fetal umbilical vein (adult = ligamentum teres) |
| Where are the splenic artery and vein located? | splenorenal ligament (spleen to post abd wall) |
| What does Meissner's submucosal complex regulate? | secretions, blood flow, absorption |
| At what level does the bifurcation of the abdominal aorta occur? | L4 |
| What venous structures are involved in internal hemorrhoids? | superior rectal vein (IMV, portal) <--> middle and inferior rectal (IVC, systemic) |
| What arterial collateral circulation exists around the area of the duodenum? | sup pancreaticoduodenal (celiac trunK) <--> inf pancreaticoduodenal (SMA) |
| What defect can lead to a diaphragmatic hernia? | defective pleuroperitoneal membrane |
| Which inguinal ring(s) does a DIRECT inguinal hernia pass through? | only through SUPERFICIAL (defect in ext oblique aponeurosis) |
| What border's create Hesselbach's triangle? | MEDIAL: lateral border of rectus abdominis, LATERAL: inf epidgastric artery, INFERIOR: inguinal ligament |
| Persistence of what structure contributes to an indirect inguinal hernia? | processus vaginalis |
| What is the function of Vasoactive Intestinal Peptide? | incr intestinal water and electrolyte secretion; incr relaxation of intestinal smooth muscle and sphincters |
| What cells release CCK? What is the stimulus? | I cells (dudodenum and jejunum); incr FA or AA |
| What mediator stimulates G cells to release gastrin? | vagus nerve --> gastrin-releasing peptide (thus, atropine can't block this) |
| How does gastrin incr the release of gastric acid? | stimulates ECL cells to release Histamine (H2) receptor --> incr cAMP and activation of H/K ATPase |
| In what disease do you see hypertrophy of Brunner's glands? | PUD |
| Where does salivary amylase cleave carbohydrates? | alpha-1,4 linkages --> disaccharides |
| Where is folate absorbed? | jejunum |
| what does bile consist of? | bile salts (conj bile acids), phsopholipids, cholesterol, bilirubin, water, and ions |
| Describe the histology of a pleomorphic adenoma. | epithelial cells intermixed w/ myxomatous and cartilaginous stroma; facial n. invovlement is sign of malignancy; high-rate of recurrence |
| What is the pathogenesis of a Cushing's ulcer? | trauma to brain --> incr vagal stimulation and incr H production |
| What is a potential GU complication of diverticulitis? | colovesical fistula --> pneumaturia |
| What small intestine tumor shows "dense core bodies" on EM? | carcinoid tumor (most commonly in appendix) |
| What is the pathogenesis of Reye's syndrome? | after viral infection and tx w/ salicylates, aspirin metabolites decr beta-oxidation by reversible inhibition of mitochondrial enzyme |
| What is Budd-Chiari syndrome? | occlusion of IVC or hepatic veins w/ centrilobular congestion and necrosis; associated w/ polycythemia vera, pregnancy, HCC |
| In Wilson's disease, where does Cu accumulate? | cornea, putamen (parkinsonism), STN (hemiballismus), cerebral cortex (dementia) |
| What is the MOA of Metoclopromaide? | D2 receptor antagonist; incr resting tone, contractility, LES tone, and motility |
| Why are pt with Menetrier's disease at incr risk of stomach carcinoma? | achlorhydria |
| Which HLAs is Celiac disease associated with? | HLA-B8 and HLA-DW3 |
| What Ab is found in autoimmune hepatitis? | anti-smooth muscle |
| What causes mallory bodies to form in alcoholic hepatitis? | damaged cytokeratin intermediate filaments in hepatocytes |
| What are the characteristic findings of Primary sclerosing cholangitis on ERCP? | narrowing and dilation of bile ducts = "beading" |
| What is the pathogenesis of hepatic encephalopathy? | inr in aromatic AAs are converted to false NTs; incr in serum NH3 |
| What is the pathogenesis of primary biliary cirrhosis? | insult affects mitochondrial proteins and triggers CD8 T cell destruction of intralobular bile duct epithelium |
| What are the gross findings of focal nodular hyperplasia of the liver? | central depressed stellate scar with radiating fibrous septae; contains large blood vessels |
| What is Caroli disease? What other disease is it associated with? | segmental dilation of intrahepatic bile ducts with portal tract fibrosis; ADPKD |
| What causes ARDS in acute pancreatitis? | pancreatic phospholipases destroy surfactant |
| What is suggested of a pancreatic psuedocyst after acute pancreatitis? | persistent amylase >7 days (collection of digested pancreatic tissue around pancreas) |
| What causes perivenular fibrosis in alcoholic hepatitis? | acetaldehyde |
Created by:
ash0403
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