SUBJECTS
|
BROWSE
|
CAREER CENTER
|
POPULAR
|
JOIN
|
LOGIN
Business Skills
|
Soft Skills
|
Basic Literacy
|
Certifications
About
|
Help
|
Privacy
|
Terms
|
Email
Search
Test your basic knowledge |
USMLE GI
Start Test
Study First
Subjects
:
health-sciences
,
usmle
Instructions:
Answer 50 questions in 15 minutes.
If you are not ready to take this test, you can
study here
.
Match each statement with the correct term.
Don't refresh. All questions and answers are randomly picked and ordered every time you load a test.
This is a study tool. The 3 wrong answers for each question are randomly chosen from answers to other questions. So, you might find at times the answers obvious, but you will see it re-enforces your understanding as you take the test each time.
1. Why does volvulus occur more at cecum and sigmoid colon
Largest nimber of goblet cells in the small intestine - plicae circulares and crypts of lieberkuhn
Pyoderma gangrenosum - primary sclerosing cholangitis
Redundant mesentary
Hydrocele
2. involvement of left supraclavicular node by mets from stomach
Warning
: Invalid argument supplied for foreach() in
/var/www/html/basicversity.com/show_quiz.php
on line
183
3. What are causes of extrahepatic biliary obstruction
Gallstone - biliary stricture - chronic pancreatitis - carcinoma of the pancreatic head
Older patients
Distal colon - obstruction - colicky pain - hematochezia - proximal colon - dull pain - iron deficiency anemia - fatigue
Hyrdolyzes alpha 1-4 linkages to yield disaccharides
4. What is diverticulosis
Many diverticula - associated with low fiber diets - caused by inc intraluminal pressure and focal weakness in colonic wall
Around the central vein (zone III)
Gardner's syndrome
Inc pressure in the intrahepatic ducts leading to injury/fibrosis and bile stasis
5. What structures feed into the common bile duct
HBV - HCV - wilsons dz - hemochromatosis - alpha1- antitrypsin def - alcoholic cirrhosis
5HT - wheezing - right sided heart murmurs - diarrhea - flushing -
Cystic duct and common hepatic duct
Positive urease test
6. What is the frequency of basal electric rhythm of the ilieum
8-9 waves/min
Begins starch digestion - inactivated by low pH upon reaching the stomach
H pylori (70%) - NSAIDS - dec mucosal protection against gastric acid
Pertechnetate - study for uptake
7. What factors increase risk of malignancy of adenomatous polyps
Inc size - villous histology - inc epithelial dysplasia - precursor to CRC
Turcot
Superior rectal
Tropheryma whippelii - gram positive and PAS- positive MACS in intestinal lamina proporia and mesenteric nodes
8. What separates the right greater and lesser sacs
Gastrohepatic ligament
>3mm nodules - significant liver injury leading to hepatic necrosis - postinfectious - drug induced hepatitis with inc risk of HCC
Stimulate intestinal persistalsis
Distal 1/3 of transverse colon to supper portion of rectum - IMA - and PANS
9. What are esophageal strictures associated with
EtOH
Lye ingestion and acid reflux
Stimulate the H/K ATPase
GLUT 2
10. mostly sporadic lesions in children < 5 - 80% in rectum - When is there no risk of malignant potential
FAP
Serum mitochondrial antibodies including IgM - associated with CREST - RA and celiac dz
Fasting and stress
Juvenille polyps - no risk if single
11. In which portion of the esophagus is it sqamous cell cancer and in which portion is adenocarcinoma
Squamous - upper 1/3 - adeno - lower 1/3
Below
Esophageal varices
Source - S cells (duod) - action - inc pancreatic bicarb secretion - dec gastric acid secretin - inc bile secretion - regulation - inc by acid - fatty acids in lumen of duod
12. Bilirubin is the product of what?
Heme metabolism
Splenic flexure
Coma - scleral icterus - fetor hepaticus - spider nevi - gynecomastia - jaundice - testicular atrophy - hand tremor - bleeding - anemia - ankle edema
Alpha amylase
13. What is the prognosis of adenocarcinoma
Low pressure proximal to LES
Averages 6 months - very aggressive - usually already metastasized at presentation
Hiatal hernia - sliding - hourglass shape - and paraesophageal hernia where stomach chomes up through the hiatus
Diverticulum
14. What carcinogens are associated with HCC
Alfatoxin in peanuts
Fe2+ in the duod
Dubin johnson
Splenic flexure
15. Where is the pectinate line
L2
External - receive somatic innervation - internal receive visceral innervation - not painful but sign of portal HTN
Where hindgut meets ectoderm
Budd chiari syndrome
16. conjugated hyperbilirubinemia due to defective liver excretion
Striated
Primary sclerosing cholangitis
Dubin johnson
Cigarettes and chronic pancreatitis - not EtOH
17. Where and How is iron absorbed
Achalasia due to loss of myenteric plexus (auberach)
Fe2+ in the duod
When diffusely infiltrative - thickened rigid appearance like a leather bottle
IgA receives protective secretory component and is then transported across the epithelium to gut lumen
18. How is the diagonsis of CRC made
Iron def anemia in older pts - screening of pts >50 with stool occult blood test and colonscopy - apple core lesion on barium enema xray - CEA tumor marker
Copious diarrhea - non alpha - non beta cell pancreatic tumor
Inc pressure in the intrahepatic ducts leading to injury/fibrosis and bile stasis
Stimulate intestinal persistalsis
19. What complication can arise from indirect inguinal hernias
Pain associated with cholecystitis and galls stones - diabetics may not present with pain
Villi and microvilli inc absorptive surface - brunner's glands and crypts of lieberkuhn
Jaundice - tender hepatomegaly - ascites - polycythemia - hypoglycemia
Hydrocele
20. What is the risk with peutz jehgers
Inc risk of CRC and other visceral malignancies
ASA preparations (sulfasalazine) 6- mercaptopurine - infliximab - colectomy
So hypertrophied they look like brain gyri
No
21. Where does type B chronic gastritis occur and What causes it
Repeated phlebotomy - deferoxamine - HLA- A3
H pylori (almost 100%)
Antrum - H.pylori - inc risk of MALT lymphoma
Lamina propora and submucosa
22. What is the leading cause of bowel incarceration
US and cholecystectomy
EtOH
Femoral hernia
Muscularis mucosae
23. A protrusion of peritoneum through an opening - usually a site of weakness
Pancreatic insuff - steatorrhea - fat soluble vitamin def - DM
Hernia
Splenic flexure
Dermatitis herpetiformis
24. What kind of digestion is bile needed for
Bleeding - intussusception - volvulus - obstruction near terminal ileum
Dubin johnson
HSV-1 - CMV - Candida
Triglycerides and micelle formation - required for absorption of of non polar nutrients in small intestine
25. Which is used more quickly - an oral glucose load - or that by IV
Source - K cells (duod - jej) - action - exocrine - dec gastric H+ secretion - endocrine - inc insulin release - regulation - inc by fatty acids - amino acids - oral glucose
Hernia
Oral glucose
L/R renal artery around L1
26. What is the cause of physiologic neonatal jaundice
Immature UDP- glucuronyl transferase to unconjugated hyperbilirubinemia - jaundice kernicuterus
...
EtOH
Normal
27. What type of insults result in micronodular cirrhosis
Peutz jeghers
Stomach to proximal duodenum - liver - gall bladder - pancreas and spleen - celiac - vagus
Erosive - disruption of mucosal barrier leading to inflammation
<3mm nodules - metabolic - etoh - hemochromatosis - wilsons
28. List the clinical findings of HCC
Mucosal cells in the stomach - duod - salivary glands - pancreas - brunners glands in the duod - neutralizes acid - inc by pancreatic and biliary secretion with secretin
Alk pho
Can lead to hematemesis - found in EtOHics and bulimics
Jaundice - tender hepatomegaly - ascites - polycythemia - hypoglycemia
29. What causes primary biliary cirrhosis
When diffusely infiltrative - thickened rigid appearance like a leather bottle
Autoimmune rxn leading to lymphcytic infiltrate + granulomas
Necrotizing enterocolitis
The submucosal nerve plexus - meissner's
30. How does gastrin increase acid secretion?
Primarly through ECL leading to histamine release
Alk pho
Increase tumorigenesis
Distal 1/3 of transverse colon to supper portion of rectum - IMA - and PANS
31. What serum enzyme is elevated in acute pancreatitis and mumps
DNA mistmatch repair gene mutations lead to sporadic and HNPCC syndrome - mutations accumulate but not define morphologic correlates
Amylase
Femoral hernia - through femoral canal - lateral to pubic tubercle and women
Appendicitis
32. What is the most common cause of gallstones
Pruritis - jaundice - dark urine - light stools - hepatosplenomegaly
<3mm nodules - metabolic - etoh - hemochromatosis - wilsons
Cholecystitis - also ascending cholangitis - acute pancreatitis and bililary infx
External (superficial) ring only
33. rare - often fatal childhood hepatoencephalopathy
Warning
: Invalid argument supplied for foreach() in
/var/www/html/basicversity.com/show_quiz.php
on line
183
34. How does abetalipoproteinemia lead to malabsorption
Menetriers disease
Serous on the sides parotids - mucinous in the middle sublingual
H+
Dec synthesis of apo B - inability to generate chylomicrons - dec secretion of cholesterol - VLDL into the bloodstream - fat accumulation in enterocytes
35. What do mucins do?
Hydrocele
Glucouronate - water soluble (direct)
Lubricate food (glycoprotiens)
Cirrhosis - DM - skin pigmentation - 'bronze diabetes'
36. What is the cause of Barrett's and the assocaited complications
Iron def anemia in older pts - screening of pts >50 with stool occult blood test and colonscopy - apple core lesion on barium enema xray - CEA tumor marker
Distal colon - obstruction - colicky pain - hematochezia - proximal colon - dull pain - iron deficiency anemia - fatigue
Primary sclerosing cholangitis
GERD - esophagitis - esophageal ulcers - inc risk of esophageal cancer
37. What is the presentation of pancreatic adenocarcinoma
Smooth
Gastrin stimulating ECL cells to release histamine - histamine stimulation on parietal cells
Hepatomegaly - ascitis - abdominal pain - varices - visible abdominal and back veins - absence of JVD
Abdominal pain radiating to back - weight loss due to malabsorption - migratory thrombophlebitis - obstructice jaundice with palpable gallbladder
38. What is the characteristic histo finding in alcoholic hepatitis
SGLT1 (Na dependent) glucose - galactose - GLUT 5 fructose (facilitated diffusion)
Mallory bodies
Sympathetic (T1- T3 superior cervical ganglion) and parasympathetic (facial and glossopharyngeal nerve)
Juvenille polyps - no risk if single
39. What serum marker increases with primary biliary cirrhosis and what other autoimmune conditions are it associated with
M3 - Gq - inc IP3/Ca
Serum mitochondrial antibodies including IgM - associated with CREST - RA and celiac dz
Chief cells of the stomach - protein digestion - inc by vagal stimulation local acid
Glucouronate - water soluble (direct)
40. What are the barium swallow findings of achalasia
Appendicitis
Pain associated with cholecystitis and galls stones - diabetics may not present with pain
Causes of gall stones
Dilated esophagus with an area of distal stenosis - birds beak
41. What is pancreatic adenocarcinoma associated with
Distal 1/3 of transverse colon to supper portion of rectum - IMA - and PANS
Cigarettes and chronic pancreatitis - not EtOH
HBV - HCV - wilsons dz - hemochromatosis - alpha1- antitrypsin def - alcoholic cirrhosis
HPNCC
42. Tumor of neuroendocrine cells constituting 50% of small bowel tumors - most common sites are the appendix - ileum and rectum
Esophageal varices
Carcinoid syndrome
Iron def anemia in older pts - screening of pts >50 with stool occult blood test and colonscopy - apple core lesion on barium enema xray - CEA tumor marker
Serous on the sides parotids - mucinous in the middle sublingual
43. What causes nutmeg liver
Pancreatic head causing obstructive jaundice
Backup of blood into the liver - RHF - budd chiari
The femoral nerve - only the vein artyer and canal (with deep inguinal lymph nodes)
Superior rectal
44. What are the ABCDEF of esophageal cancer
Alcohol/Achalasia - Barretts - Cigarettes - Diverticuli (Zenkers) Esophageal web/Esophagitis - Familial
Lesser curvature - gastric arteries - cut in surgery to access lesser sac
CCK8 receptor - Gq inc IP3/Ca
Corticosteroids - infliximab
45. Unencapsulated lymphoid tissue found in lamina proporia and submucosa of small intestine containing specialized M cells that take up antigen
Volvulus
Pancreatic head causing obstructive jaundice
Peyers patches
Juvenille polyps - no risk if single
46. What gives urine its characteristic color
Urobilin
Jaundice - tender hepatomegaly - ascites - polycythemia - hypoglycemia
Cholecystitis - also ascending cholangitis - acute pancreatitis and bililary infx
Inc - weight loss
47. What kind of insults results in macronodular cirrhosis
T cell lymphoma
>3mm nodules - significant liver injury leading to hepatic necrosis - postinfectious - drug induced hepatitis with inc risk of HCC
Neural muscarinic pathways
Hyrdolyzes alpha 1-4 linkages to yield disaccharides
48. What are the midgut structures and what supplies their blood and PANS innervation
Barrett's esophagus
Distal duodenum to proximal 2/3 of transverse colon - SMA - vagus
Hyrdolyzes alpha 1-4 linkages to yield disaccharides
IgA secreting plasma cells - ultimately reside in the lamina proporia
49. Where are peyers patches found
Falciform - ligamentum teres - fetal umbilical vein
Lamina propora and submucosa
DIC - ARDS - diffuse fat necrosis - hypcalcemia - pseudocyst formation - hemorrhage - infxn - multiorgan failure
Gastric glands
50. In what scenarios do pts with gilberts have inc bili
Around the central vein (zone III)
Fasting and stress
Zollinger ellison - brunners glands
Gamma glutamyl transferase GGT