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. Where are oligosaccharide hydrolases and What do they do
Inhibits parietal cells because of ACH is NT - while GRP works at the G cells
Cirrhosis - DM - skin pigmentation - 'bronze diabetes'
FAP
Brush border of intestine - produce monosaccharides from oligo and di
2. likely infectious form of malabsorption - responds to antibiotics
Pruritis - jaundice - dark urine - light stools - hepatosplenomegaly
Stomach to proximal duodenum - liver - gall bladder - pancreas and spleen - celiac - vagus
Zollinger Ellison - phenylalanine and tryptophan
Tropical sprue
3. With caput medusaw - between what vessels is the anastomoses and Where is it
Lack or have an attenuated muscularis externa - often in the sigmoid colon
Fundus/body - autoimmune - autoantibodies to parietal cells - perncious anemia - and achlorhydria
Alpha1 antitrypsin def - codominant trait
Paraumbilical and superficial and inferior epigastric - umbilicus
4. a false diverticulum - herniation of mucosal tissue at junction of pharynx and esophagus - How does this present
Zenkers - halitosis - dysphagia and obstruction
Transjugular intrahepatic portosystemic shunt between portal and hepatic vein percutaneously by shunting blood to the systemic circulation
Hiatal hernia - sliding - hourglass shape - and paraesophageal hernia where stomach chomes up through the hiatus
Black - rotors syndrome
5. What kind of muscle is in the middle 1/3 of esophagus
Below
Backup of blood into the liver - RHF - budd chiari
Striated and smooth
Fundus/body - autoimmune - autoantibodies to parietal cells - perncious anemia - and achlorhydria
6. At what spinal level does the celiac trunk exit
NAV = nerve artery vein - venous near the penis (NAVEL)
Sphincter of oddi
Meckels
T12
7. in budd chiari syndrome - Where is the congestion and necrosis
Centrilobular leading to congestive liver disease
H pylori (almost 100%)
Internal thoracic to superior epigastric to inferior epigastric
Protrudes through the Hesselbach's triangle - bulges directly through abdominal wall medial to inferior epigastric vessels
8. How do you DX and TX gallstones
Cholesterol - 10-20% opaque due to calcifications
Peyers patches
US and cholecystectomy
Neutralizes oral bacertial acids and maintains dental health
9. What transforms conjugated bilirubin to urobilinogen
Fasting and stress
Dec synthesis of apo B - inability to generate chylomicrons - dec secretion of cholesterol - VLDL into the bloodstream - fat accumulation in enterocytes
Gut bacteria
Chronic gastritis and pernicious anemia
10. What makes a true diverticula
HPNCC
Kids - lymphoid hyperplasia afer viral infxn - adults - obstruction - fecalith
All 3 gut layers outpouch as in Meckels
Stimulate the H/K ATPase
11. Where and How is iron absorbed
Centrilobular congestion and necrosis - cardiac cirrhosis
CF - obstructing cancer - chronic pancreatitis - causes malabsorption of fat and fat soluble vitamins (ADEK)
Fe2+ in the duod
Celiac sprue
12. What serum enzyme is elevated in obstructive liver disease - bone disease and bile duct disease
Gastrin stimulating ECL cells to release histamine - histamine stimulation on parietal cells
Repeated phlebotomy - deferoxamine - HLA- A3
Inhibits parietal cells because of ACH is NT - while GRP works at the G cells
Alk pho
13. What causes pancreatic insuff and What does it cause
Terminal ileum and colon
CF - obstructing cancer - chronic pancreatitis - causes malabsorption of fat and fat soluble vitamins (ADEK)
Zollinger ellison - brunners glands
Source - K cells (duod - jej) - action - exocrine - dec gastric H+ secretion - endocrine - inc insulin release - regulation - inc by fatty acids - amino acids - oral glucose
14. How does CRC present in the distal and proximal colon
Source - SI - action - produces migrating motor complexes - regulation - inc in fasting state
Distal colon - obstruction - colicky pain - hematochezia - proximal colon - dull pain - iron deficiency anemia - fatigue
Diverticulitis in elderly - ectopic pregs use hCG to rule out
H+
15. What other condition can lead to acute gastritis - think renal
Uremia
External spermatic fascia only
Volvulus
Boerhaave's Syndrome - Been heaving syndrome
16. glandular metaplasia - replacement of nonkeratinized (stratified) squamous epithelium with intestinal (columnar) epithelium in the distal esophagus
Warning
: Invalid argument supplied for foreach() in
/var/www/html/basicversity.com/show_quiz.php
on line
183
17. What is the leading cause of bowel incarceration
Source - SI - action - produces migrating motor complexes - regulation - inc in fasting state
When diffusely infiltrative - thickened rigid appearance like a leather bottle
Femoral hernia
Gallbladder
18. Which serum enzyme increases with heavy EtOH consumption
Alternating strictures and dilation with beading of intra and extrahepatic bile ducts on ERCP
Gamma glutamyl transferase GGT
Chronic hemolysis - alcoholic cirrhosis - advanced age and biliary infxn
Source - I cells (duod - jej - action - inc pancreative secretion - inc gallbladder contraction - dec gastric emptying - sphincter of Oddi relaxation - regulation - inc by fatty acids and amino acids
19. Which IBD has noncaseating granulomas and lymphoid aggregates - and which has crypt abscesses and ulcers with bleeding
Lipase - phospholipase A - colipase
Superior rectal from IMA - superior rectal vein to inf mesenteric to portal system
Crohns = noncaseating granulomas - UC = crypt abscesses
EtOH
20. AD - mutation of APC gene on chromosome 5q - two hit hypothesis - 100% progress to CRC - 1000s of polyps - pancolonic - rectal involvement
Inc conj bilirubin - inc cholesterol - inc alk phos
Villi and microvilli inc absorptive surface - brunner's glands and crypts of lieberkuhn
Dilated esophagus with an area of distal stenosis - birds beak
FAP
21. What do the rugae of stomach look like in menetriers disease
Worldwide - SC - US - adeno
So hypertrophied they look like brain gyri
Carcinoid syndrome
CEA - CA-19-9
22. How many layers of spermatic fascia are covers an indirect inguinal hernia
Pruritis - jaundice - dark urine - light stools - hepatosplenomegaly
Centrilobular leading to congestive liver disease
PAS- positive globules in liver -
All 3
23. What serum enzyme is elevated in acute pancreatitis and mumps
Peutz jeghers
No
Amylase
...
24. inadequate hepatic liver copper excretion and failure of copper to enter circulation as ceruloplasmin
2 inches long - 2 feet from ileocecal valve - 2% of pop - first 2 years of life - 2 types of epithelia
Copious diarrhea - non alpha - non beta cell pancreatic tumor
Crohns - CF - advanced age - clofibrate - estrogens - multiparity - rapid weight loss - Native American origin
...
25. What is the characteristic histo finding in alcoholic hepatitis
Failure of the processus vagainlis to close
Mallory bodies
Gastrin stimulating ECL cells to release histamine - histamine stimulation on parietal cells
Increase tumorigenesis
26. What are the results of hemochromatosis
Oral glucose
Primarly through ECL leading to histamine release
Colonic polyps
CHF and inc risk of HCC
27. What does histo show for alpha1 antitrypsin def
FAP
Complications of UC
In the ileum with bile acids - requires IF
PAS- positive globules in liver -
28. HCC is associated with what other conditions
Neural muscarinic pathways
LLQ - fever - leukocytosis - can perforate leading to peritonitis - abscess formation - bowel stenosis - give antiobiotics
HBV - HCV - wilsons dz - hemochromatosis - alpha1- antitrypsin def - alcoholic cirrhosis
Gallbladder
29. In an MI - which liver enzyme is elevated
Distal colon - obstruction - colicky pain - hematochezia - proximal colon - dull pain - iron deficiency anemia - fatigue
AST
Unconjugated - water insoluble
Skip lesions =crohns - colon = UC
30. What drug inhibits the H/K ATPase
Mucoepidermoid carcinoma
Omeprazole
Duodenum - 2nd - 3rd and 4th parts
Femoral hernia
31. is meckels a true diverticulum and how common is it
True and most common congenital anomoly of GI tract
Trypsin - chymotrypsin - elastase - carboxypeptidases
Heme metabolism
Autoimmune rxn leading to lymphcytic infiltrate + granulomas
32. Where does crohns usually affect the GI tract
Via the middle colic
Terminal ileum and colon
Upregulated intracellular signal transduction
Stomach cancer (usually adenocarcinoma) - early aggressive spread - node/liver mets - associated with nitrosamines (smoked foods) - achlorhydria - chronic gastritis - type A blood
33. Cholecytsokinin - source - action - regulation
Cushings ulcers - inc vagal stimulation leading to inc vagal stim - inc ACH and inc H+ secretion
Source - I cells (duod - jej - action - inc pancreative secretion - inc gallbladder contraction - dec gastric emptying - sphincter of Oddi relaxation - regulation - inc by fatty acids and amino acids
Transjugular intrahepatic portosystemic shunt between portal and hepatic vein percutaneously by shunting blood to the systemic circulation
Duodenal atresia - Downs
34. Why does volvulus occur more at cecum and sigmoid colon
Bile salts (bile conjugated to glycine or taurine) phospholipids - cholesterol - bilirubin - water and ions
Redundant mesentary
Distal colon - obstruction - colicky pain - hematochezia - proximal colon - dull pain - iron deficiency anemia - fatigue
Squamous - upper 1/3 - adeno - lower 1/3
35. What artery passes around the duodenum
The gastroduodenal
Angiodysplasia
Coma - scleral icterus - fetor hepaticus - spider nevi - gynecomastia - jaundice - testicular atrophy - hand tremor - bleeding - anemia - ankle edema
Chronic hemolysis - alcoholic cirrhosis - advanced age and biliary infxn
36. This disease commonly presents as heartburn and regurg when lying down - What is another common presentation
Trypsin - chymotrypsin - elastase - carboxypeptidases
Glucouronate - water soluble (direct)
GERD - may also present with nocturnal cough and dyspnea
Lamina propora and submucosa
37. What kind of gall stones are mostly radiolucent and what percentage is opaque and due to what?
Hyperplastic
Cholesterol - 10-20% opaque due to calcifications
Inc - weight loss
Normal
38. What does alpha amylase do and what inactivates it
Dubin johnson
AST >ALT - ration is usually 1.5
Lesser curvature - gastric arteries - cut in surgery to access lesser sac
Begins starch digestion - inactivated by low pH upon reaching the stomach
39. What can fistula between the gallbladder and small intestine create and how can you tell
Sympathetic (T1- T3 superior cervical ganglion) and parasympathetic (facial and glossopharyngeal nerve)
Air into the biliary tree - if gallstone obstructs ileocecal valve - air can be seen in biliary tree on imaging
Abdominal pain radiating to back - weight loss due to malabsorption - migratory thrombophlebitis - obstructice jaundice with palpable gallbladder
>3mm nodules - significant liver injury leading to hepatic necrosis - postinfectious - drug induced hepatitis with inc risk of HCC
40. What are the complications of duodenal PUD
Lipase
Omeprazole
Bleeding - penetration into pancreas - perforation - obstruction
Female - fat - fertile - forty
41. in CF - meconium plug obstructs intestine - preventing stool passage at birth
Alcoholic cirrhosis
Decrease - weight gain
Menetriers disease
Meconium ileus
42. necrosis of intestinal mucosa and possible perforation - usual colon involvement - more common in preemies
Epithelium
Above
The gastroduodenal
Necrotizing enterocolitis
43. What do you use to diagnose meckels
With albumin
Pancreatic insuff - steatorrhea - fat soluble vitamin def - DM
Causes of gall stones
Pertechnetate - study for uptake
44. Which IBD may or may not have blood diarrhea - and which will always have bloody diarrhea
Source - parasympathetic ganglion in sphincters - gallbladder - small intestine - action - inc intestinal water and electrolyte secretion - inc relaxation of intestinal smooth muscle and sphincters - regulation - inc by distention and vagal stimulati
Cirrhosis - DM - skin pigmentation - 'bronze diabetes'
Crohns = maybe - UC= always
Old men - arthralgias - cardiac and neuro sx
45. What are the barium swallow findings of achalasia
Esophageal varices
Serum mitochondrial antibodies including IgM - associated with CREST - RA and celiac dz
GERD - esophagitis - esophageal ulcers - inc risk of esophageal cancer
Dilated esophagus with an area of distal stenosis - birds beak
46. What is the sphincter of the pancreatic duct
Sphincter of oddi
Nonkeritinized stratified sqamous epithelium
Cholecystitis - usually from gallstones rarely ischemia or infxn (CMV)
Meckels
47. In alchoholic hepatitis which liver enzyme is higher
Upregulated intracellular signal transduction
AST>ALT
Left gastric vein and esophogeal vein - esophagus
Dubin johnson
48. If the abdominal aorta is blocked - How does blood get to the left colic artery
Upregulated intracellular signal transduction
Corticosteroids - infliximab
Via the middle colic
Crigler - najjar type 1
49. Which kind of hemorrhoids are painful and why
External - receive somatic innervation - internal receive visceral innervation - not painful but sign of portal HTN
Phenobarbital - inc liver enzyme synthesis
Source - K cells (duod - jej) - action - exocrine - dec gastric H+ secretion - endocrine - inc insulin release - regulation - inc by fatty acids - amino acids - oral glucose
L4
50. Failure of relaxation of lower esophageal sphincter - Name and etiology
Redundant mesentary
True and most common congenital anomoly of GI tract
Achalasia due to loss of myenteric plexus (auberach)
Budd chiari syndrome