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. At what spinal level does the celiac trunk exit
Dec PGE2 leading to dec gastric mucosa protection
T12
5HT - wheezing - right sided heart murmurs - diarrhea - flushing -
<3mm nodules - metabolic - etoh - hemochromatosis - wilsons
2. How does gastrin increase acid secretion?
Meconium ileus
Primarly through ECL leading to histamine release
Femoral hernia
Gilbert's
3. Autoantibodies to gluten (gliadin) in wheat and other grains
Internal thoracic to superior epigastric to inferior epigastric
Peptic ulcer disease
All 3
Celiac sprue
4. What are the results of hemochromatosis
CHF and inc risk of HCC
H pylori (70%) - NSAIDS - dec mucosal protection against gastric acid
VZV and influenza B treated with salicylates
Hydrocele
5. Which IBD has noncaseating granulomas and lymphoid aggregates - and which has crypt abscesses and ulcers with bleeding
Cirrhosis - DM - skin pigmentation - 'bronze diabetes'
Curling's ulcer - dec plasma volume and sloughing of gastric mucosa
Crohns = noncaseating granulomas - UC = crypt abscesses
Upregulated intracellular signal transduction
6. What do mucins do?
Tropical sprue
Unconj - absent (acholuria) - inc
Lubricate food (glycoprotiens)
Ischemic colitis
7. What commonly leads to appendicity in kids vs adults
Kids - lymphoid hyperplasia afer viral infxn - adults - obstruction - fecalith
Source - D cells (pancreatic islets - GI mucosa) - action - dec gastric acid and pepsinogen secretion - dec pancreatic and small intestine fluid secretion - dec gallbladder contraction - dec insulin and glucagon release
Terminal ileum and colon
Common hepatic - splenic - left gastric - main blood supply for stomach
8. What retroperitoneal structure flanks both sides of the pancreas on CT
Necrotizing enterocolitis
Chronic gastritis and pernicious anemia
Zollinger Ellison - phenylalanine and tryptophan
Duodenum - 2nd - 3rd and 4th parts
9. List the clinical findings of HCC
AR
Lubricate food (glycoprotiens)
Pruritis - jaundice - dark urine - light stools - hepatosplenomegaly
Jaundice - tender hepatomegaly - ascites - polycythemia - hypoglycemia
10. What receptor does histamine bind on the parietal cell and What does it activate
The entire
Left and right gastroepiploics - left and right gastrics
Aspirin metabolites dec beta oxidation by reversible inhibition of mitocondrial enzyme - ASPIRIN Not RECOMMENDED FOR CHILDREN
H2 receptor - inc cAMP
11. In PUD - with gastric ulcers - does pain inc or dec with meals?
Inc - weight loss
Villi and microvilli inc absorptive surface - brunner's glands and crypts of lieberkuhn
So hypertrophied they look like brain gyri
Complications of crohns
12. What is the TX of physiologic neonatal jaundice
Juvenile polyposis syndrome - inc risk of adenocarcinoma
Inspiratory arrest on deep palpation due to pain
Glucouronate - water soluble (direct)
Phototherapy
13. What test and result confirms H pylori infxn
Begins starch digestion - inactivated by low pH upon reaching the stomach
3rd most common cancer - 3rd deadliest in US - pts > 50 - 1/4 have fam hx
Positive urease test
Pancreatic head causing obstructive jaundice
14. Why are most diverticula considered false
Lack or have an attenuated muscularis externa - often in the sigmoid colon
Fasting and stress
Brush border of intestine - produce monosaccharides from oligo and di
Lye ingestion and acid reflux
15. Bilirubin is the product of what?
Epigastric abdominal pain radiating to back - anorexia - nausea
Reye's syndrome
Oral glucose
Heme metabolism
16. This disease commonly presents as heartburn and regurg when lying down - What is another common presentation
GERD - may also present with nocturnal cough and dyspnea
Juvenille polyps - no risk if single
Ceruplasmin
Hyrdolyzes alpha 1-4 linkages to yield disaccharides
17. What is pancreatic adenocarcinoma associated with
AST >ALT - ration is usually 1.5
Ceruplasmin
Cigarettes and chronic pancreatitis - not EtOH
Peyers patches
18. 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
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
Distal 1/3 of transverse colon to supper portion of rectum - IMA - and PANS
Hepatic steatosis
19. What are the histological findings of the colon
Diarrhea - steatorrhea - weight loss - weakness
Crypts but not villi
Sphincter of oddi
Penicillinamine - AR inheritance
20. What kind of hernia protrudes below the inguinal ligament - Where does travel relative to pubic tubercle and who gets them
Femoral hernia - through femoral canal - lateral to pubic tubercle and women
Neutralizes gastric acid allowing pancreatic enzymes to fxn
Failure of neural crest migration
Striated
21. Painless bleedgin of submucosal veins in lower 1/3 of esophagus
Decrease - weight gain
Esophageal varices
Pain associated with cholecystitis and galls stones - diabetics may not present with pain
FAP
22. What do you treat Wilsons disease with and What is the inheritance
DIC - ARDS - diffuse fat necrosis - hypcalcemia - pseudocyst formation - hemorrhage - infxn - multiorgan failure
Penicillinamine - AR inheritance
Copious diarrhea - non alpha - non beta cell pancreatic tumor
Sympathetic (T1- T3 superior cervical ganglion) and parasympathetic (facial and glossopharyngeal nerve)
23. What parts of the small bowel can tropical sprue effect
The entire
Pancreatic head causing obstructive jaundice
GERD - esophagitis - esophageal ulcers - inc risk of esophageal cancer
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
24. What are the barium swallow findings of achalasia
Brunners
Hemosiderosis - hemochromatosis
Dilated esophagus with an area of distal stenosis - birds beak
Elevated amylase - and lipase
25. Where is IgA shuttled
IgA receives protective secretory component and is then transported across the epithelium to gut lumen
Achalasia due to loss of myenteric plexus (auberach)
HPNCC
Lactase is located at the tips of intestinal villi
26. bilateral mets to ovaries with abundant mucus - signet ring cells
Worldwide - SC - US - adeno
Centrilobular leading to congestive liver disease
Fundus/body - autoimmune - autoantibodies to parietal cells - perncious anemia - and achlorhydria
Krukenbergs tumor
27. In what scenarios do pts with gilberts have inc bili
Alk pho
Poor anastamoses
Diverticulitis in elderly - ectopic pregs use hCG to rule out
Fasting and stress
28. FAP + malignant CNS tumor
Turcot
Inhibits parietal cells because of ACH is NT - while GRP works at the G cells
2ndary biliary cirrhosis
Femoral hernia - through femoral canal - lateral to pubic tubercle and women
29. Is there any structural abnl with IBS - What is the course of disease and presentation
Spleen to posterior abdominal wall - splenic artery and vein
No - chronic - can present with diarrhea or constipation or alternation - treat sx
Dense core bodies
Decrease - weight gain
30. concentric onion skin bile duct fibrosis
Primary sclerosing cholangitis
Cholecystitis - usually from gallstones rarely ischemia or infxn (CMV)
Liver - brain - cornea - kidneys - joints - Asterixis - Basal ganglia degeneration - dec Ceruloplasmin - Cirrhosis - Corneal deposits - Copper accumulation - Carcinoma (HCC) - Choreiform movements - Dementia
Copious diarrhea - non alpha - non beta cell pancreatic tumor
31. Where is there sclerosis in alcoholic cirrohosis
Around the central vein (zone III)
Cholecystitis - usually from gallstones rarely ischemia or infxn (CMV)
Elevated amylase - and lipase
Transjugular intrahepatic portosystemic shunt between portal and hepatic vein percutaneously by shunting blood to the systemic circulation
32. What are the histological findings in the jejunum
IgA receives protective secretory component and is then transported across the epithelium to gut lumen
Failure of neural crest migration
Repeated phlebotomy - deferoxamine - HLA- A3
Largest nimber of goblet cells in the small intestine - plicae circulares and crypts of lieberkuhn
33. Progressive dyshphage beginning with solids and moving to liquids and weight loss
Esophageal cancer
L1
Dec PGE2 leading to dec gastric mucosa protection
Phenobarbital - inc liver enzyme synthesis
34. What serum enzyme is elevated inacute pancreatitis
Lipase
Repeated phlebotomy - deferoxamine - HLA- A3
Chagas disease
Crohns = transmural (cobblestone mucosa - creeping fat - string sign - linear ulcers fissures - fistulas) UC = mucosal and submucosal (friable mucosal pseudopolyps with freely hanging mesentary - loss of haustra - lead pipe appearance on imaging
35. in CF - meconium plug obstructs intestine - preventing stool passage at birth
CHF and inc risk of HCC
Inc pressure in the intrahepatic ducts leading to injury/fibrosis and bile stasis
Urobilin
Meconium ileus
36. What is the most important mechanism in gastric acid secretion
Oral glucose
Gastrin stimulating ECL cells to release histamine - histamine stimulation on parietal cells
Distal duodenum to proximal 2/3 of transverse colon - SMA - vagus
AST >ALT - ration is usually 1.5
37. What cells make gastric acid - What does it do to stomach pH and what substances regulate it
Gastrohepatic ligament
Alcoholic hepatitis
Parietal cells in the stomach - decrease pH - inc by histamine - ACH - gastrin - dec by somatostatin - GIP - prostaglandin - secretin
Carcinoid syndrome
38. In an MI - which liver enzyme is elevated
AST
Bleeding - penetration into pancreas - perforation - obstruction
Stimulate intestinal persistalsis
Antrum - H.pylori - inc risk of MALT lymphoma
39. What portion of the bowel does sprue effect
Tropheryma whippelii - gram positive and PAS- positive MACS in intestinal lamina proporia and mesenteric nodes
The proximal small bowel
...
Curling's ulcer - dec plasma volume and sloughing of gastric mucosa
40. What structures feed into the cystic duct
Neutralizes gastric acid allowing pancreatic enzymes to fxn
Low pressure proximal to LES
Below
Gallbladder
41. What is the cause of physiologic neonatal jaundice
Northern european - Abs to gliadin and tissue transglutaminase - blunted villi - lymphcytes in the lamina proporia
Left and right gastroepiploics - left and right gastrics
Immature UDP- glucuronyl transferase to unconjugated hyperbilirubinemia - jaundice kernicuterus
Mucosa - submucosa - muscularis externa - serosa/adventitia
42. In jaundice of hemolytic etiology - is the hyperbilirubinemia conj or unconj - what happens to urine bili - and urine urobilinogen
Immature UDP- glucuronyl transferase to unconjugated hyperbilirubinemia - jaundice kernicuterus
Distal 1/3 of transverse colon to supper portion of rectum - IMA - and PANS
Unconj - absent (acholuria) - inc
Alternating strictures and dilation with beading of intra and extrahepatic bile ducts on ERCP
43. What is a positive murphy's sign
Serous on the sides parotids - mucinous in the middle sublingual
Chronic gastritis and pernicious anemia
Inspiratory arrest on deep palpation due to pain
SGLT1 (Na dependent) glucose - galactose - GLUT 5 fructose (facilitated diffusion)
44. When and How does Abetalipoproteinemia present
Redness and tenderness on palpation of extremities
Glucouronate - water soluble (direct)
Barrett's esophagus
Early childhood - neuro sx and malabsorption
45. What is biliary colic
Pain associated with cholecystitis and galls stones - diabetics may not present with pain
Chronic transfusion therapy in beta thal major - inc ferritin - inc iron - dec TIBC - inc transferrin saturation
Angiodysplasia
Erosive - disruption of mucosal barrier leading to inflammation
46. How is the diagonsis of CRC made
Pertechnetate - study for uptake
Distal duodenum to proximal 2/3 of transverse colon - SMA - vagus
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
GLUT 2
47. How is salivary secretion stimulated
Zenkers - halitosis - dysphagia and obstruction
Sympathetic (T1- T3 superior cervical ganglion) and parasympathetic (facial and glossopharyngeal nerve)
2 inches long - 2 feet from ileocecal valve - 2% of pop - first 2 years of life - 2 types of epithelia
Liver metabolizes 5HT
48. What reaction does salivary amylase catalyze
So hypertrophied they look like brain gyri
Hyrdolyzes alpha 1-4 linkages to yield disaccharides
Zollinger Ellison - phenylalanine and tryptophan
Falciform - ligamentum teres - fetal umbilical vein
49. What kind of insults results in macronodular cirrhosis
Distal duodenum to proximal 2/3 of transverse colon - SMA - vagus
Sister mary joseph nodule
Old men - arthralgias - cardiac and neuro sx
>3mm nodules - significant liver injury leading to hepatic necrosis - postinfectious - drug induced hepatitis with inc risk of HCC
50. What transforms conjugated bilirubin to urobilinogen
Gut bacteria
Only mucosa or submucosa - occur where vasa recta perforate muscularis externa
Inferior epigastric artery - lateral border of rectus abdominis - inguinal ligament
Worldwide - SC - US - adeno