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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 are the four Fs of gallstones
Female - fat - fertile - forty
Chronic transfusion therapy in beta thal major - inc ferritin - inc iron - dec TIBC - inc transferrin saturation
Hyrdolyzes alpha 1-4 linkages to yield disaccharides
Inc - weight loss
2. What cell produces IF and What does it do
Air into the biliary tree - if gallstone obstructs ileocecal valve - air can be seen in biliary tree on imaging
Early childhood - neuro sx and malabsorption
Parietal cells in the stomach - B12 binding protein
Terminal ileum and colon
3. What is the HLA association and treatment for hemochromatosis
Repeated phlebotomy - deferoxamine - HLA- A3
Jaundice - fever - RUQ
Failure of the processus vagainlis to close
Lateral to the inferior epigastric artery
4. Why would a self - limited lactase def occur following an injury (viral diarrhea)
Cholecystitis - also ascending cholangitis - acute pancreatitis and bililary infx
Abdominal pain radiating to back - weight loss due to malabsorption - migratory thrombophlebitis - obstructice jaundice with palpable gallbladder
Lactase is located at the tips of intestinal villi
Cimetidine
5. What separates the right greater and lesser sacs
The jejunum
Gastrohepatic ligament
Krukenbergs tumor
HBV - HCV - wilsons dz - hemochromatosis - alpha1- antitrypsin def - alcoholic cirrhosis
6. What structure is Not contained in the femoral sheath
CEA - CA-19-9
The femoral nerve - only the vein artyer and canal (with deep inguinal lymph nodes)
Neutralizes oral bacertial acids and maintains dental health
Pertechnetate - study for uptake
7. How is salivary secretion stimulated
Diverticulum
Sympathetic (T1- T3 superior cervical ganglion) and parasympathetic (facial and glossopharyngeal nerve)
Dubin johnson
Old men - arthralgias - cardiac and neuro sx
8. What makes a true diverticula
Backup of blood into the liver - RHF - budd chiari
Striated and smooth
Glucouronate - water soluble (direct)
All 3 gut layers outpouch as in Meckels
9. What kind of digestion is bile needed for
Portal triad: hepatic artery - protal vein - common bile duct - greater and lesser sac - to control bleeding
Inc smooth muscle relaxation - including lower esophageal sphincter
3rd most common cancer - 3rd deadliest in US - pts > 50 - 1/4 have fam hx
Triglycerides and micelle formation - required for absorption of of non polar nutrients in small intestine
10. What test and result confirms H pylori infxn
Cholecystitis - usually from gallstones rarely ischemia or infxn (CMV)
Triglycerides and micelle formation - required for absorption of of non polar nutrients in small intestine
Positive urease test
Crypts but not villi
11. What kind of anemia is in Wilsons
Hemolytic anemia
Necrotizing enterocolitis
Cholecystitis - also ascending cholangitis - acute pancreatitis and bililary infx
Hernia
12. What does loss of p53 cause
Increase tumorigenesis
Urobilin
Angiodysplasia
Intussusception
13. What are the foregut structures and what supplies their blood and PANS innvervation
Appendicitis
Chronic calcifying pancreatitis - inc risk of panreatic cancer
Stomach to proximal duodenum - liver - gall bladder - pancreas and spleen - celiac - vagus
Decreased intercellular adhesion and increased proliferation
14. What does a gastrinoma cause
Gastrin secreting tumor that causes continuous high levels of acid secretion and ulcers
Centrilobular congestion and necrosis - cardiac cirrhosis
Positive
Esophageal varices
15. How are all 3 monosaccharides transported to the blood
Unconj - absent (acholuria) - inc
Myenteric nerve plexus - aurbach
...
GLUT 2
16. What kind of pathways do CCK act on to cause pancreatic secretion
Neural muscarinic pathways
L3
Only mucosa or submucosa - occur where vasa recta perforate muscularis externa
Enterokinase/enteropeptidase from the duodenal mucosa
17. Tortuous dilation of vessels and bleeding - most often in cecum - terminal ileum and ascending colon - common in older patients - confirmed by angiography
Above
Angiodysplasia
Failure of neural crest migration
Jewish and African American men
18. How does loss of NO secretion affect the esophagus and what results
2ndary biliary cirrhosis
Inc lower esphogeal tone leading to achalasia
Viral - adenovirus in kids - rare in adults but associated with intraluminal mass or tumor
H+
19. What does K- ras mutation cause
Upregulated intracellular signal transduction
Jaundice - tender hepatomegaly - ascites - polycythemia - hypoglycemia
Immature UDP- glucuronyl transferase to unconjugated hyperbilirubinemia - jaundice kernicuterus
Unconj - absent (acholuria) - inc
20. Where does type B chronic gastritis occur and What causes it
Hypercoaguability - polycythemia vera - pregnancy - HCC
Mallory bodies
Antrum - H.pylori - inc risk of MALT lymphoma
Hematogenous - alpha fetoprotein - budd chiari (hepatic vein blockage)
21. At what spinal level does the is the bifurcation of aorta
Stimulate the H/K ATPase
Chronic transfusion therapy in beta thal major - inc ferritin - inc iron - dec TIBC - inc transferrin saturation
L4
Serum mitochondrial antibodies including IgM - associated with CREST - RA and celiac dz
22. What pancreatic proteases are secreted as zymogens
Trypsin - chymotrypsin - elastase - carboxypeptidases
Aspirin metabolites dec beta oxidation by reversible inhibition of mitocondrial enzyme - ASPIRIN Not RECOMMENDED FOR CHILDREN
Esophageal cancer
Mallory bodies
23. multiple juvenil polyps in GI tract - risk
Brush border of intestine - produce monosaccharides from oligo and di
Pancreatic insuff - steatorrhea - fat soluble vitamin def - DM
Juvenile polyposis syndrome - inc risk of adenocarcinoma
Chronic hemolysis - alcoholic cirrhosis - advanced age and biliary infxn
24. Are single polyps malignant in peutz jehgers
Stomach to proximal duodenum - liver - gall bladder - pancreas and spleen - celiac - vagus
The submucosal nerve plexus - meissner's
Chronic gastritis and pernicious anemia
No
25. If the abdominal aorta is blocked - How does blood get to the middle rectal artery
Superior rectal
Liver - brain - cornea - kidneys - joints - Asterixis - Basal ganglia degeneration - dec Ceruloplasmin - Cirrhosis - Corneal deposits - Copper accumulation - Carcinoma (HCC) - Choreiform movements - Dementia
Source - K cells (duod - jej) - action - exocrine - dec gastric H+ secretion - endocrine - inc insulin release - regulation - inc by fatty acids - amino acids - oral glucose
Pain associated with cholecystitis and galls stones - diabetics may not present with pain
26. With esophageal varices - between What two vessels is the portosystemic anastomoses and Where is it
Duodenal lumen - hydrolyzes starch to oligosaccharides and disaccharides
Left gastric vein and esophogeal vein - esophagus
Hypercoaguability - polycythemia vera - pregnancy - HCC
Via the superior pancreaticduodenal
27. What is the characteristic histo finding in alcoholic hepatitis
Mallory bodies
Cystic duct and common hepatic duct
Via the middle colic
Decreased intercellular adhesion and increased proliferation
28. What skin condition is associated with celiac sprue
Budd chiari syndrome
Autoimmune rxn leading to lymphcytic infiltrate + granulomas
Fundus/body - autoimmune - autoantibodies to parietal cells - perncious anemia - and achlorhydria
Dermatitis herpetiformis
29. Which IBD is autoimmune and which may be a disordered response to bacteria
Autoimmune= ulcerative colitis - disordered response to bactere = crohns
Volvulus
Zollinger ellison - brunners glands
Myenteric nerve plexus - aurbach
30. persistence of viteline duct or yolk stalk possibly containing ectopic acid secreting gastric mucosa and/or pancreatic tissue
Villi and microvilli inc absorptive surface - brunner's glands and crypts of lieberkuhn
Meckels
Worldwide - SC - US - adeno
Lipase - phospholipase A - colipase
31. Is there any structural abnl with IBS - What is the course of disease and presentation
Northern european - Abs to gliadin and tissue transglutaminase - blunted villi - lymphcytes in the lamina proporia
Squamous - upper 1/3 - adeno - lower 1/3
The submucosal nerve plexus - meissner's
No - chronic - can present with diarrhea or constipation or alternation - treat sx
32. What is the triad of Plummer - Vinson syndrome
DNA mistmatch repair gene mutations lead to sporadic and HNPCC syndrome - mutations accumulate but not define morphologic correlates
Cimetidine
Hematogenous - alpha fetoprotein - budd chiari (hepatic vein blockage)
Dysphagia (due to esophageal web) - glossitis - iron def anemia
33. What artery passes around the duodenum
The gastroduodenal
Liver - brain - cornea - kidneys - joints - Asterixis - Basal ganglia degeneration - dec Ceruloplasmin - Cirrhosis - Corneal deposits - Copper accumulation - Carcinoma (HCC) - Choreiform movements - Dementia
Viral - adenovirus in kids - rare in adults but associated with intraluminal mass or tumor
...
34. What kind of muscle is in the middle 1/3 of esophagus
Averages 6 months - very aggressive - usually already metastasized at presentation
Meckels
3 waves/min
Striated and smooth
35. What are the complications of acute pancreatitis
The entire
DIC - ARDS - diffuse fat necrosis - hypcalcemia - pseudocyst formation - hemorrhage - infxn - multiorgan failure
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
Phenobarbital - inc liver enzyme synthesis
36. This disease commonly presents as heartburn and regurg when lying down - What is another common presentation
Virchow's node
Abdominal pain radiating to back - weight loss due to malabsorption - migratory thrombophlebitis - obstructice jaundice with palpable gallbladder
IBD - Strep bovis bacteremia - tobacco - large villous adenomas - juvenille polyposis syndrome - peutz jehgers syndrome
GERD - may also present with nocturnal cough and dyspnea
37. What layer in the mucosa is repsonsible for motility
Gastrohepatic ligament
Muscularis mucosae
Chronic transfusion therapy in beta thal major - inc ferritin - inc iron - dec TIBC - inc transferrin saturation
Early childhood - neuro sx and malabsorption
38. Autodigestion of pancreas by pancreatic enzymes
The entire
Acute pancreatitis
Diarrhea - steatorrhea - weight loss - weakness
Unconjugated - water insoluble
39. If the abdominal aorta is blocked - How does blood get to the left colic artery
Decreased intercellular adhesion and increased proliferation
Zollinger Ellison - phenylalanine and tryptophan
Via the middle colic
Ischemic colitis
40. What does loss of APC cause
Decreased intercellular adhesion and increased proliferation
Dilated esophagus with an area of distal stenosis - birds beak
Source - SI - action - produces migrating motor complexes - regulation - inc in fasting state
Around the central vein (zone III)
41. Where is there sclerosis in alcoholic cirrohosis
Glucouronate - water soluble (direct)
Around the central vein (zone III)
CF - obstructing cancer - chronic pancreatitis - causes malabsorption of fat and fat soluble vitamins (ADEK)
Bile salts (bile conjugated to glycine or taurine) phospholipids - cholesterol - bilirubin - water and ions
42. At what level of the spine does the IM exit the aorta
So hypertrophied they look like brain gyri
Hydrocele
Distal colon - obstruction - colicky pain - hematochezia - proximal colon - dull pain - iron deficiency anemia - fatigue
L3
43. Gallstones that reach the common channel at ampulla can block which two ducts
Crypts but not villi
Distal duodenum to proximal 2/3 of transverse colon - SMA - vagus
Hydrocele
Pancreatic and bile
44. What reaction does salivary amylase catalyze
Alfatoxin in peanuts
Hyrdolyzes alpha 1-4 linkages to yield disaccharides
GERD - may also present with nocturnal cough and dyspnea
DNA mistmatch repair gene mutations lead to sporadic and HNPCC syndrome - mutations accumulate but not define morphologic correlates
45. What is the classic triad of hemochromatosis
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46. What is the presentation of pancreatic adenocarcinoma
Abdominal pain radiating to back - weight loss due to malabsorption - migratory thrombophlebitis - obstructice jaundice with palpable gallbladder
Pain associated with cholecystitis and galls stones - diabetics may not present with pain
Sphincter of oddi
Chronic hemolysis - alcoholic cirrhosis - advanced age and biliary infxn
47. What portion of the bowel does sprue effect
Chronic transfusion therapy in beta thal major - inc ferritin - inc iron - dec TIBC - inc transferrin saturation
No
The proximal small bowel
Lye ingestion and acid reflux
48. At what spinal level does the SMA exit
Urobilin
Mucosa - submucosa - muscularis externa - serosa/adventitia
Villi and microvilli inc absorptive surface - brunner's glands and crypts of lieberkuhn
L1
49. Which IBD has noncaseating granulomas and lymphoid aggregates - and which has crypt abscesses and ulcers with bleeding
Chief cells of the stomach - protein digestion - inc by vagal stimulation local acid
Protrudes through the Hesselbach's triangle - bulges directly through abdominal wall medial to inferior epigastric vessels
Crohns = noncaseating granulomas - UC = crypt abscesses
Diarrhea - steatorrhea - weight loss - weakness
50. What is the frequency of basal electric rhythm of the stomach
Achalasia due to loss of myenteric plexus (auberach)
Complications of crohns
Cirrhosis
3 waves/min