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. Bile is critical for exrection of what substance
Cholesterol
Inspiratory arrest on deep palpation due to pain
Myenteric nerve plexus - aurbach
Primarly through ECL leading to histamine release
2. what kind of muscle is in the upper 1/3 of esophagus
Striated
Centrilobular leading to congestive liver disease
Barrett's esophagus
Can lead to hematemesis - found in EtOHics and bulimics
3. Which IBD may or may not have blood diarrhea - and which will always have bloody diarrhea
Normal
Stimulate intestinal persistalsis
Crohns = maybe - UC= always
Around the central vein (zone III)
4. What pancreatic enzymes are responsible for fat digestion
Lesser curvature - gastric arteries - cut in surgery to access lesser sac
Lipase - phospholipase A - colipase
H2 receptor - inc cAMP
LLQ - fever - leukocytosis - can perforate leading to peritonitis - abscess formation - bowel stenosis - give antiobiotics
5. Why does volvulus occur more at cecum and sigmoid colon
Redundant mesentary
Protrudes through the Hesselbach's triangle - bulges directly through abdominal wall medial to inferior epigastric vessels
Peutz jeghers
Hypercoaguability - polycythemia vera - pregnancy - HCC
6. What arteries exit just below the SMA
L/R renal artery around L1
HBV - HCV - wilsons dz - hemochromatosis - alpha1- antitrypsin def - alcoholic cirrhosis
Brunners
Distal duodenum to proximal 2/3 of transverse colon - SMA - vagus
7. inc cholesterol and/or bilirubin - dec bile salts and gallbladder stasis
Inguninal ligament - sartorius muscle - adductor longus
Neural muscarinic pathways
Mucoepidermoid carcinoma
Causes of gall stones
8. Painless bleedgin of submucosal veins in lower 1/3 of esophagus
Esophageal varices
Below
Complications of UC
IgA receives protective secretory component and is then transported across the epithelium to gut lumen
9. What are the hindgut structures and what supplies their blood and PANS innvervation
CEA - CA-19-9
Krukenbergs tumor
Inferior epigastric artery - lateral border of rectus abdominis - inguinal ligament
Distal 1/3 of transverse colon to supper portion of rectum - IMA - and PANS
10. twisting of portion of bowel around its mesentery leading to obstruction and infarction - usually in elderly
Volvulus
Trypsin - chymotrypsin - elastase - carboxypeptidases
Fe2+ in the duod
Obstruction of the common bile duct
11. Which IBD is autoimmune and which may be a disordered response to bacteria
Hydrocele
Autoimmune= ulcerative colitis - disordered response to bactere = crohns
SGLT1 (Na dependent) glucose - galactose - GLUT 5 fructose (facilitated diffusion)
All 3
12. What parts of the small bowel can tropical sprue effect
Primarly through ECL leading to histamine release
Early childhood - neuro sx and malabsorption
Parietal cells in the stomach - B12 binding protein
The entire
13. Why does carcinoid syndrome not occur if tumor is confined to GI system
Jaundice - tender hepatomegaly - ascites - polycythemia - hypoglycemia
8-9 waves/min
Liver metabolizes 5HT
Small intestine
14. GIP - source - action regulation
Source - K cells (duod - jej) - action - exocrine - dec gastric H+ secretion - endocrine - inc insulin release - regulation - inc by fatty acids - amino acids - oral glucose
Boerhaave's Syndrome - Been heaving syndrome
Coma - scleral icterus - fetor hepaticus - spider nevi - gynecomastia - jaundice - testicular atrophy - hand tremor - bleeding - anemia - ankle edema
Duodenal atresia - Downs
15. Who gets gastric ulcers
LLQ - fever - leukocytosis - can perforate leading to peritonitis - abscess formation - bowel stenosis - give antiobiotics
Older patients
Phototherapy
Hirschsprungs
16. Who is at risk for pancreatic adenocarcinoma
Hepatic steatosis
Pain associated with cholecystitis and galls stones - diabetics may not present with pain
Jewish and African American men
Pleuroperitoneal
17. What are the histological findings in the ileum
Warning
: Invalid argument supplied for foreach() in
/var/www/html/basicversity.com/show_quiz.php
on line
183
18. B cells stimuated in the germinal centers of peyers patches differentiate into what?
IgA secreting plasma cells - ultimately reside in the lamina proporia
Hemolytic anemia
Cirrhosis
FAP
19. What type of insults result in micronodular cirrhosis
Complications of UC
In the ileum with bile acids - requires IF
<3mm nodules - metabolic - etoh - hemochromatosis - wilsons
AST
20. What are the extraintestinal manifestations of crohns
Migratory polyarthritis - erythema nodusum - anklyosing spondylitis - uveitis - immunologic disorders
Stimulate intestinal persistalsis
Inc - weight loss
Terminal ileum and colon
21. How is the diagonsis of CRC made
Lipase
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
Pancreatic insuff - steatorrhea - fat soluble vitamin def - DM
Tropheryma whippelii - gram positive and PAS- positive MACS in intestinal lamina proporia and mesenteric nodes
22. What are the histological findings of the colon
H pylori (70%) - NSAIDS - dec mucosal protection against gastric acid
External spermatic fascia only
Positive
Crypts but not villi
23. likely infectious form of malabsorption - responds to antibiotics
Tropical sprue
Aspirin metabolites dec beta oxidation by reversible inhibition of mitocondrial enzyme - ASPIRIN Not RECOMMENDED FOR CHILDREN
Corticosteroids - infliximab
Femoral hernia - through femoral canal - lateral to pubic tubercle and women
24. in carcinoid tumors - What is seen on EM
Dense core bodies
Femoral hernia - through femoral canal - lateral to pubic tubercle and women
Jewish and African American men
Alcoholic hepatitis
25. In jaundice of hepatocellular etiology - is the hyperbilirubinemia conjugate or UN - what happens to urine bili - and urine urobilinogen
Carcinoid syndrome
External (superficial) ring only
AST>ALT
Conj/unconj - inc - nl to dec
26. masses protruding into gut lumen leading to a sawtooth appearance - often rectosigmoid
SGLT1 (Na dependent) glucose - galactose - GLUT 5 fructose (facilitated diffusion)
Alternating strictures and dilation with beading of intra and extrahepatic bile ducts on ERCP
Dissaccharidase def - most commonly lactase
Colonic polyps
27. What serum markers increase in cholecystitis with bile duct involvement
HPNCC
Alk phos
Alk pho
Black - rotors syndrome
28. most common malignant salivary gland tumor
Mucoepidermoid carcinoma
VZV and influenza B treated with salicylates
HPNCC
Crigler - najjar type 1
29. What does K- ras mutation cause
Begins starch digestion - inactivated by low pH upon reaching the stomach
Upregulated intracellular signal transduction
Brunners
Zollinger ellison - brunners glands
30. What is indirect bilirubin
Crigler - najjar type 1
Parietal cells in the stomach - decrease pH - inc by histamine - ACH - gastrin - dec by somatostatin - GIP - prostaglandin - secretin
Complications of crohns
Unconjugated - water insoluble
31. How is salivary secretion stimulated
Sympathetic (T1- T3 superior cervical ganglion) and parasympathetic (facial and glossopharyngeal nerve)
PAS- positive globules in liver -
Pancreatic insuff - steatorrhea - fat soluble vitamin def - DM
Lateral
32. What are additional risk factors for CRC
IBD - Strep bovis bacteremia - tobacco - large villous adenomas - juvenille polyposis syndrome - peutz jehgers syndrome
Failure of neural crest migration
Stomach cancer (usually adenocarcinoma) - early aggressive spread - node/liver mets - associated with nitrosamines (smoked foods) - achlorhydria - chronic gastritis - type A blood
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
33. Which serum enzyme increases with heavy EtOH consumption
Distal duodenum to proximal 2/3 of transverse colon - SMA - vagus
Gamma glutamyl transferase GGT
<3mm nodules - metabolic - etoh - hemochromatosis - wilsons
Pyoderma gangrenosum - primary sclerosing cholangitis
34. What retroperitoneal structure flanks both sides of the pancreas on CT
Northern european - Abs to gliadin and tissue transglutaminase - blunted villi - lymphcytes in the lamina proporia
Cholecystitis - also ascending cholangitis - acute pancreatitis and bililary infx
Cystic dilation of the viteline duct
Duodenum - 2nd - 3rd and 4th parts
35. What are the longterm sequelae of nutmeg liver
No
Splenic flexure
AST>ALT
Centrilobular congestion and necrosis - cardiac cirrhosis
36. How does HCC spread - What is a common tumor marker and what syndrome can it lead to...
Hematogenous - alpha fetoprotein - budd chiari (hepatic vein blockage)
Brush border of intestine - produce monosaccharides from oligo and di
Left and right gastroepiploics - left and right gastrics
Repeated phlebotomy - deferoxamine - HLA- A3
37. When do you see hypertrophy of brunners glands
Decrease - weight gain
Elevated amylase - and lipase
Peptic ulcer disease
Chronic transfusion therapy in beta thal major - inc ferritin - inc iron - dec TIBC - inc transferrin saturation
38. AD - mutation of APC gene on chromosome 5q - two hit hypothesis - 100% progress to CRC - 1000s of polyps - pancolonic - rectal involvement
FAP
Superior rectal and middle and inferior rectal - rectum
CHF and inc risk of HCC
Sister mary joseph nodule
39. What are the results of hemochromatosis
CHF and inc risk of HCC
Epigastric abdominal pain radiating to back - anorexia - nausea
Centrilobular leading to congestive liver disease
Enterokinase/enteropeptidase from the duodenal mucosa
40. alcoholic liver disease that requires sustained - long term consumption - with swollen and necrotic hepatocytes with neutrophilic infiltration
Backup of blood into the liver - RHF - budd chiari
Alcoholic hepatitis
Budd chiari syndrome
Failure of neural crest migration
41. What is the frequency of basal electric rhythm of the stomach
T cell lymphoma
3 waves/min
Upregulated intracellular signal transduction
Smooth
42. What congenital birth defect is associated with Hirschsprung
Hyperplastic
Can lead to hematemesis - found in EtOHics and bulimics
Jewish and African American men
Downs
43. What are the barium swallow findings of achalasia
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
The femoral nerve - only the vein artyer and canal (with deep inguinal lymph nodes)
Left gastric vein and esophogeal vein - esophagus
Dilated esophagus with an area of distal stenosis - birds beak
44. Achalasia increases the risk For what complication
Esophageal carcinoma
Inc conj bilirubin - inc cholesterol - inc alk phos
Below
IgA secreting plasma cells - ultimately reside in the lamina proporia
45. What does high flow rate mean
Penicillinamine - AR inheritance
Closer to isotonic because of less time to reabsorb NaCl
Lipase
Phototherapy
46. Is there any structural abnl with IBS - What is the course of disease and presentation
No - chronic - can present with diarrhea or constipation or alternation - treat sx
Smooth
Liver - brain - cornea - kidneys - joints - Asterixis - Basal ganglia degeneration - dec Ceruloplasmin - Cirrhosis - Corneal deposits - Copper accumulation - Carcinoma (HCC) - Choreiform movements - Dementia
Bleeding - intussusception - volvulus - obstruction near terminal ileum
47. alcoholic liver disease with short term change and moderate EtOH intake - macrovesicular fatty change that may be reversible
Short gastrics - left greater and lesser
Lamina propora and submucosa
Hepatic steatosis
Inc - weight loss
48. What is the main symptom if a VIPoma
Copious diarrhea - non alpha - non beta cell pancreatic tumor
CHF and inc risk of HCC
Jaundice - tender hepatomegaly - ascites - polycythemia - hypoglycemia
Superior rectal
49. Which patients have pigment stones
Portal triad: hepatic artery - protal vein - common bile duct - greater and lesser sac - to control bleeding
Glucouronate - water soluble (direct)
Chronic hemolysis - alcoholic cirrhosis - advanced age and biliary infxn
Jewish and African American men
50. motilin - source - action - regulation
M3 - Gq - inc IP3/Ca
Squamous - upper 1/3 - adeno - lower 1/3
Source - SI - action - produces migrating motor complexes - regulation - inc in fasting state
US and cholecystectomy