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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. What kind of muscle is in the middle 1/3 of esophagus
True and most common congenital anomoly of GI tract
AST>ALT
Penicillinamine - AR inheritance
Striated and smooth
2. How do burns cause acute gastritis and What is it called
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3. conjugated hyperbilirubinemia due to defective liver excretion
Dubin johnson
Serum mitochondrial antibodies including IgM - associated with CREST - RA and celiac dz
IgA receives protective secretory component and is then transported across the epithelium to gut lumen
H pylori (almost 100%)
4. What histological findings are present in the stomach
Goes through deep inguinal ring - external inguinal ring and into the scrotum
Heme metabolism
Hyrdolyzes alpha 1-4 linkages to yield disaccharides
Gastric glands
5. What are the complications of chronic pancreatitis
Transjugular intrahepatic portosystemic shunt between portal and hepatic vein percutaneously by shunting blood to the systemic circulation
Around the central vein (zone III)
Hyperplastic
Pancreatic insuff - steatorrhea - fat soluble vitamin def - DM
6. Where does inflammation in diverticula likely cause pain - what other signs/symptoms are present and What are the complications
Upregulated intracellular signal transduction
Crigler - najjar type 1
Pancreatic and bile
LLQ - fever - leukocytosis - can perforate leading to peritonitis - abscess formation - bowel stenosis - give antiobiotics
7. People of what decent are associated with celiac sprue and what findings/antibodies are present
Northern european - Abs to gliadin and tissue transglutaminase - blunted villi - lymphcytes in the lamina proporia
Hypercoaguability - polycythemia vera - pregnancy - HCC
Low pressure proximal to LES
Esophageal varices
8. In alchoholic hepatitis which liver enzyme is higher
Crohns - CF - advanced age - clofibrate - estrogens - multiparity - rapid weight loss - Native American origin
Esophageal cancer
Necrotizing enterocolitis
AST>ALT
9. What conditions are associated with budd chiari
Duodenal lumen - hydrolyzes starch to oligosaccharides and disaccharides
Hypercoaguability - polycythemia vera - pregnancy - HCC
Chagas disease
Dissaccharidase def - most commonly lactase
10. What does high flow rate mean
Closer to isotonic because of less time to reabsorb NaCl
Oral glucose
Lye ingestion and acid reflux
Superior rectal from IMA - superior rectal vein to inf mesenteric to portal system
11. What gives stool its characteristic color
Decrease - weight gain
Gilbert's
Hemolytic anemia
Stercobilin
12. What are the main components of bile
Bile salts (bile conjugated to glycine or taurine) phospholipids - cholesterol - bilirubin - water and ions
Viral - adenovirus in kids - rare in adults but associated with intraluminal mass or tumor
Parietal cells in the stomach - decrease pH - inc by histamine - ACH - gastrin - dec by somatostatin - GIP - prostaglandin - secretin
Hiatal hernia - sliding - hourglass shape - and paraesophageal hernia where stomach chomes up through the hiatus
13. What tumor cause PUD with duodenal ulcer and what glands become hypertrophied
Repeated phlebotomy - deferoxamine - HLA- A3
Parietal cells in the stomach - B12 binding protein
Crohns = noncaseating granulomas - UC = crypt abscesses
Zollinger ellison - brunners glands
14. What artery passes around the duodenum
Causes of gall stones
The jejunum
Adhesion
The gastroduodenal
15. In an MI - which liver enzyme is elevated
Goes through deep inguinal ring - external inguinal ring and into the scrotum
Hypotonic because of more time to reabsorb NaCl
Crypts but not villi
AST
16. Where is folate absorbed
Mallory bodies
Trypsin - chymotrypsin - elastase - carboxypeptidases
The jejunum
GLUT 2
17. What does extrahepatic biliary obstruction cause
Bleeding - penetration into pancreas - perforation - obstruction
Inc pressure in the intrahepatic ducts leading to injury/fibrosis and bile stasis
Cholecystitis - also ascending cholangitis - acute pancreatitis and bililary infx
Obstruction of the common bile duct
18. What transforms conjugated bilirubin to urobilinogen
Gut bacteria
Common hepatic - splenic - left gastric - main blood supply for stomach
Obstruction of the common bile duct
Short gastrics - left greater and lesser
19. What kind of digestion is bile needed for
Alpha amylase
L1
Triglycerides and micelle formation - required for absorption of of non polar nutrients in small intestine
NAV = nerve artery vein - venous near the penis (NAVEL)
20. How many layers outpouch in a false diverticula and they occur At what point of weakness and what?
Cigarettes and chronic pancreatitis - not EtOH
Oligosaccharide digestion
Splenic flexure
Only mucosa or submucosa - occur where vasa recta perforate muscularis externa
21. What are the histological findings in the duodenum
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22. What serum marker increases with primary biliary cirrhosis and what other autoimmune conditions are it associated with
MSI (15%) and APC/beta catenin chromosomal instability (85%)
Fe2+ in the duod
Serum mitochondrial antibodies including IgM - associated with CREST - RA and celiac dz
Inc pressure in the intrahepatic ducts leading to injury/fibrosis and bile stasis
23. What causes hirschsprungs
Positive urease test
Failure of neural crest migration
All 3
Alcoholic hepatitis
24. necrosis of intestinal mucosa and possible perforation - usual colon involvement - more common in preemies
Necrotizing enterocolitis
External (superficial) ring only
Dense core bodies
The jejunum
25. reduction in intestinal blood flow causes ischemia - pain after eating - weight loss - occurs at splenic flexure and distal colon - elderly
Achalasia due to loss of myenteric plexus (auberach)
Greater curvature of stomach to transverse colon - gastroepiploic arteries - greater omentum
Oligosaccharide digestion
Ischemic colitis
26. What is the cause of Barrett's and the assocaited complications
Neutralizes oral bacertial acids and maintains dental health
GERD - esophagitis - esophageal ulcers - inc risk of esophageal cancer
H pylori (70%) - NSAIDS - dec mucosal protection against gastric acid
M3 - Gq - inc IP3/Ca
27. What does a gastrinoma cause
Alpha1 antitrypsin def - codominant trait
Superior rectal from IMA - superior rectal vein to inf mesenteric to portal system
Causes of gall stones
Gastrin secreting tumor that causes continuous high levels of acid secretion and ulcers
28. likely infectious form of malabsorption - responds to antibiotics
When diffusely infiltrative - thickened rigid appearance like a leather bottle
Backup of blood into the liver - RHF - budd chiari
Repeated phlebotomy - deferoxamine - HLA- A3
Tropical sprue
29. bilateral mets to ovaries with abundant mucus - signet ring cells
VZV and influenza B treated with salicylates
Krukenbergs tumor
CHF and inc risk of HCC
True and most common congenital anomoly of GI tract
30. Failure of relaxation of lower esophageal sphincter - Name and etiology
Achalasia due to loss of myenteric plexus (auberach)
Redundant mesentary
Uremia
Juvenile polyposis syndrome - inc risk of adenocarcinoma
31. subQ peribumbilical metastasis
Sister mary joseph nodule
FAP
Initial diffuse periumbilical pain localizing to mcburney's point with nausea - fever - possible perforation leading to peritonitis
H pylori (almost 100%)
32. Dysphagia in achalasia results from
Menetriers disease
High LES opening pressure and uncoordinated peristalsis - both solids and liquids
AST >ALT - ration is usually 1.5
Diverticulitis in elderly - ectopic pregs use hCG to rule out
33. what kind of muscle is in the upper 1/3 of esophagus
Dilated esophagus with an area of distal stenosis - birds beak
Striated
Myenteric nerve plexus - aurbach
L2
34. AD mutation in DNA mismatch repair genes - 80% progress to CRC - proximal colon always involved
Inspiratory arrest on deep palpation due to pain
HPNCC
Normal
EtOH
35. What is the path of a direct inguinal hernia and Where does it travel relative to the inferior epigastric artery
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36. What are the labs in acute pancreatitis
Elevated amylase - and lipase
H pylori (almost 100%)
Omeprazole
Lactase is located at the tips of intestinal villi
37. external hemorrhoids and squamous cell carcinoma occur above or below the pectinate line
Serous on the sides parotids - mucinous in the middle sublingual
Chronic transfusion therapy in beta thal major - inc ferritin - inc iron - dec TIBC - inc transferrin saturation
Below
In the mucus that covers the gastric epithelium
38. involvement of left supraclavicular node by mets from stomach
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39. most common malignant salivary gland tumor
Mucoepidermoid carcinoma
Closer to isotonic because of less time to reabsorb NaCl
Hypercoaguability - polycythemia vera - pregnancy - HCC
Amylase
40. alcoholic liver disease that requires sustained - long term consumption - with swollen and necrotic hepatocytes with neutrophilic infiltration
Barrett's esophagus
Goes through deep inguinal ring - external inguinal ring and into the scrotum
Heme metabolism
Alcoholic hepatitis
41. What congenital birth defect is associated with Hirschsprung
Downs
Crohns = noncaseating granulomas - UC = crypt abscesses
The gastroduodenal
3rd most common cancer - 3rd deadliest in US - pts > 50 - 1/4 have fam hx
42. gastric hypertrophy with protein loss - parietal cell atrophy and inc mucous cells
Chronic gastritis and pernicious anemia
Chagas disease
Menetriers disease
CCK8 receptor - Gq inc IP3/Ca
43. Which IBD has noncaseating granulomas and lymphoid aggregates - and which has crypt abscesses and ulcers with bleeding
Volvulus
GERD - esophagitis - esophageal ulcers - inc risk of esophageal cancer
Crohns = noncaseating granulomas - UC = crypt abscesses
Femoral hernia
44. What is the leading cause of bowel incarceration
Curling's ulcer - dec plasma volume and sloughing of gastric mucosa
Alk pho
Only mucosa or submucosa - occur where vasa recta perforate muscularis externa
Femoral hernia
45. What does histo show for alpha1 antitrypsin def
AST>ALT
Ampulla of vater
L3
PAS- positive globules in liver -
46. What kind of salivary gland tumor is painless - moveable mass - bening with high rate of recurrence - most common salivary gland tumor
AST >ALT - ration is usually 1.5
Pleomorphic adenoma
Antrum - H.pylori - inc risk of MALT lymphoma
Source - SI - action - produces migrating motor complexes - regulation - inc in fasting state
47. How does gastrin increase acid secretion?
CCK8 receptor - Gq inc IP3/Ca
Primarly through ECL leading to histamine release
Villi and microvilli inc absorptive surface - brunner's glands and crypts of lieberkuhn
Zollinger ellison - brunners glands
48. secretin - source - action - regulation
Peptic ulcer disease
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
PAS- positive globules in liver -
No
49. What is the most common indication of emergent abdominal surgery in children
Appendicitis
Portal triad: hepatic artery - protal vein - common bile duct - greater and lesser sac - to control bleeding
Terminal ileum and colon
Unconjugated - water insoluble
50. Achalasia can be secondary to what infectious disease common in South America
Chagas disease
Migratory polyarthritis - erythema nodusum - anklyosing spondylitis - uveitis - immunologic disorders
Diverticulitis in elderly - ectopic pregs use hCG to rule out
Brush border of intestine - produce monosaccharides from oligo and di