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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 structures feed into the cystic duct
Peutz jeghers
L1
Gallbladder
Complications of crohns
2. What are the layers of the gut wall from inside out
US and cholecystectomy
Trypsin - chymotrypsin - elastase - carboxypeptidases
Falciform - ligamentum teres - fetal umbilical vein
Mucosa - submucosa - muscularis externa - serosa/adventitia
3. At what level do the testicular/ovarian arteries exit the aorta
<3mm nodules - metabolic - etoh - hemochromatosis - wilsons
Jewish and African American men
Protrudes through the Hesselbach's triangle - bulges directly through abdominal wall medial to inferior epigastric vessels
L2
4. How many layers outpouch in a false diverticula and they occur At what point of weakness and what?
Only mucosa or submucosa - occur where vasa recta perforate muscularis externa
Lactase is located at the tips of intestinal villi
Hematogenous - alpha fetoprotein - budd chiari (hepatic vein blockage)
90%
5. What are the hindgut structures and what supplies their blood and PANS innvervation
Distal 1/3 of transverse colon to supper portion of rectum - IMA - and PANS
12 waves/min
Tropical sprue
GERD - esophagitis - esophageal ulcers - inc risk of esophageal cancer
6. What are the branches of the celiac trunk and What do they supply
Alpha1 antitrypsin def - codominant trait
Positive urease test
90%
Common hepatic - splenic - left gastric - main blood supply for stomach
7. How does HCC spread - What is a common tumor marker and what syndrome can it lead to...
High LES opening pressure and uncoordinated peristalsis - both solids and liquids
Virchow's node
2ndary biliary cirrhosis
Hematogenous - alpha fetoprotein - budd chiari (hepatic vein blockage)
8. Where is bicarb trapped
Upregulated intracellular signal transduction
Chronic gastritis and pernicious anemia
In the mucus that covers the gastric epithelium
Budd chiari syndrome
9. What is the classic triad of hemochromatosis
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10. Which is used more quickly - an oral glucose load - or that by IV
Striated and smooth
Redundant mesentary
Neutralizes oral bacertial acids and maintains dental health
Oral glucose
11. How are all 3 monosaccharides transported to the blood
FAP
Serum mitochondrial antibodies including IgM - associated with CREST - RA and celiac dz
>3mm nodules - significant liver injury leading to hepatic necrosis - postinfectious - drug induced hepatitis with inc risk of HCC
GLUT 2
12. Which IBD is autoimmune and which may be a disordered response to bacteria
Autoimmune= ulcerative colitis - disordered response to bactere = crohns
PAS- positive globules in liver -
Protrudes through the Hesselbach's triangle - bulges directly through abdominal wall medial to inferior epigastric vessels
Distal 1/3 of transverse colon to supper portion of rectum - IMA - and PANS
13. What does a low flow rate mean for saliva
All 3
Dilated esophagus with an area of distal stenosis - birds beak
Hypotonic because of more time to reabsorb NaCl
Oligosaccharide digestion
14. If the abdomincal aorta is obstructed - What is the path of blood to the inferior epigastric
Menetriers disease
Cholecystitis - usually from gallstones rarely ischemia or infxn (CMV)
GERD - may also present with nocturnal cough and dyspnea
Internal thoracic to superior epigastric to inferior epigastric
15. milk intolerance
Virchow's node
Diarrhea - steatorrhea - weight loss - weakness
Dissaccharidase def - most commonly lactase
Mallory bodies
16. secretin - source - action - regulation
LLQ - fever - leukocytosis - can perforate leading to peritonitis - abscess formation - bowel stenosis - give antiobiotics
MSI (15%) and APC/beta catenin chromosomal instability (85%)
Duodenum - 2nd - 3rd and 4th parts
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
17. What layer in the mucosa is repsonsible for motility
Muscularis mucosae
Worldwide - SC - US - adeno
Esophageal cancer
Peptic ulcer disease
18. rare - often fatal childhood hepatoencephalopathy
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19. What is contained in the gastrosplenic and What areas does it separate
Mitochondrial abnl - fatty liver - hypoglycemia - coma
Short gastrics - left greater and lesser
So hypertrophied they look like brain gyri
Serous on the sides parotids - mucinous in the middle sublingual
20. What are esophageal strictures associated with
Acute pancreatitis
H pylori (almost 100%)
Lye ingestion and acid reflux
External spermatic fascia only
21. What are the signs of peutz jehgers
EtOH
Hydrocele
Gallbladder
Hyperpigmented mouth - lips - hands - genitalia
22. What is the cause of Barrett's and the assocaited complications
Lack or have an attenuated muscularis externa - often in the sigmoid colon
Cirrhosis
GERD - esophagitis - esophageal ulcers - inc risk of esophageal cancer
HPNCC
23. What does autoimmune destruction of parietal cells lead to...
Inferior epigastric artery - lateral border of rectus abdominis - inguinal ligament
Chronic gastritis and pernicious anemia
Uremia
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
24. What other condition can lead to acute gastritis - think renal
Boerhaave's Syndrome - Been heaving syndrome
Parietal cells in the stomach - B12 binding protein
Autoimmune= ulcerative colitis - disordered response to bactere = crohns
Uremia
25. What parts of the small bowel can tropical sprue effect
Paraumbilical and superficial and inferior epigastric - umbilicus
Cystic dilation of the viteline duct
Inc size - villous histology - inc epithelial dysplasia - precursor to CRC
The entire
26. Progressive dyshphage beginning with solids and moving to liquids and weight loss
Lubricate food (glycoprotiens)
Esophageal cancer
Only mucosa or submucosa - occur where vasa recta perforate muscularis externa
HPNCC
27. At what spinal level does the is the bifurcation of aorta
Small intestine
L4
Gamma glutamyl transferase GGT
Goes through deep inguinal ring - external inguinal ring and into the scrotum
28. What skin condition is associated with celiac sprue
Inhibits parietal cells because of ACH is NT - while GRP works at the G cells
Dermatitis herpetiformis
Acute pancreatitis
Diarrhea - steatorrhea - weight loss - weakness
29. What congenital birth defect is associated with Hirschsprung
Spleen to posterior abdominal wall - splenic artery and vein
Downs
True and most common congenital anomoly of GI tract
Right and left hepatic duct
30. What cell produces IF and What does it do
Parietal cells in the stomach - B12 binding protein
Gastrohepatic ligament
Warthins' tumor
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
31. When do you see hypertrophy of brunners glands
Initial diffuse periumbilical pain localizing to mcburney's point with nausea - fever - possible perforation leading to peritonitis
Chronic hemolysis - alcoholic cirrhosis - advanced age and biliary infxn
Dermatitis herpetiformis
Peptic ulcer disease
32. glandular metaplasia - replacement of nonkeratinized (stratified) squamous epithelium with intestinal (columnar) epithelium in the distal esophagus
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33. What does loss of p53 cause
Stimulate intestinal persistalsis
Lamina propora and submucosa
Angiodysplasia
Increase tumorigenesis
34. How does loss of NO secretion affect the esophagus and what results
Inc lower esphogeal tone leading to achalasia
Internal thoracic to superior epigastric to inferior epigastric
Hepatomegaly - ascitis - abdominal pain - varices - visible abdominal and back veins - absence of JVD
Hypotonic because of more time to reabsorb NaCl
35. What drug inhibits the H/K ATPase
Omeprazole
Diverticulitis in elderly - ectopic pregs use hCG to rule out
Serum mitochondrial antibodies including IgM - associated with CREST - RA and celiac dz
DIC - ARDS - diffuse fat necrosis - hypcalcemia - pseudocyst formation - hemorrhage - infxn - multiorgan failure
36. What histological findings are present in the esophagus
Unconjugated - water insoluble
Nonkeritinized stratified sqamous epithelium
Alk phos
Esophageal carcinoma
37. What cells make gastric acid - What does it do to stomach pH and what substances regulate it
Urobilin
Diarrhea - steatorrhea - weight loss - weakness
All 3
Parietal cells in the stomach - decrease pH - inc by histamine - ACH - gastrin - dec by somatostatin - GIP - prostaglandin - secretin
38. Acute gastritis is caused By what process
Erosive - disruption of mucosal barrier leading to inflammation
The jejunum
Warthins' tumor
AST>ALT
39. What is the frequency of basal electric rhythm of the ilieum
So hypertrophied they look like brain gyri
8-9 waves/min
H pylori (70%) - NSAIDS - dec mucosal protection against gastric acid
H+
40. Malabsorption syndromes have what common clinical presentation
Antrum - H.pylori - inc risk of MALT lymphoma
Below
Diarrhea - steatorrhea - weight loss - weakness
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
41. What are the structures of the femoral triangle and how are they organized
NAV = nerve artery vein - venous near the penis (NAVEL)
Striated and smooth
Smooth
Immature UDP- glucuronyl transferase to unconjugated hyperbilirubinemia - jaundice kernicuterus
42. reduction in intestinal blood flow causes ischemia - pain after eating - weight loss - occurs at splenic flexure and distal colon - elderly
Ischemic colitis
In the ileum with bile acids - requires IF
Duodenal atresia - Downs
Autoimmune rxn leading to lymphcytic infiltrate + granulomas
43. What commonly leads to appendicity in kids vs adults
Kids - lymphoid hyperplasia afer viral infxn - adults - obstruction - fecalith
Source - G cells in the antrum - action - inc gastric H+ secretion - inc growth of gastric mucosa - and inc gastric motility - regulation - inc by stomach distention/alkalinaztion - amino acids - peptides - vagal stimulation - dec by stomach pH < 1.5
Unconj - absent (acholuria) - inc
Appendicitis
44. Tortuous dilation of vessels and bleeding - most often in cecum - terminal ileum and ascending colon - common in older patients - confirmed by angiography
The entire
Angiodysplasia
Lateral to the inferior epigastric artery
So hypertrophied they look like brain gyri
45. What kind of lesions are characteristic of duodenal PUD vs cancer
Punched out - clean margins - carcinoma =raised irregular margins
Alk pho
Stomach to proximal duodenum - liver - gall bladder - pancreas and spleen - celiac - vagus
Elevated amylase - and lipase
46. If the hemochromatosis is primary - What is the pattern of inheritance
Unconj - absent (acholuria) - inc
Brush border of intestine - produce monosaccharides from oligo and di
Ischemic colitis
AR
47. Gallstones that reach the common channel at ampulla can block which two ducts
Jaundice - fever - RUQ
Pleuroperitoneal
Decreased intercellular adhesion and increased proliferation
Pancreatic and bile
48. What complication can arise from indirect inguinal hernias
Serous on the sides parotids - mucinous in the middle sublingual
Lateral
Hydrocele
Trypsin - chymotrypsin - elastase - carboxypeptidases
49. What are causes of extrahepatic biliary obstruction
Gallstone - biliary stricture - chronic pancreatitis - carcinoma of the pancreatic head
Splenic flexure
Conj - inc - dec
Neutralizes gastric acid allowing pancreatic enzymes to fxn
50. What kind of muscle is in the middle 1/3 of esophagus
Striated and smooth
Crigler - najjar type 1
Pancreatic and bile
Enterokinase/enteropeptidase from the duodenal mucosa
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