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. FAP + osseous and soft tissue tumors - retinal hyperplasia
Warning
: Invalid argument supplied for foreach() in
/var/www/html/basicversity.com/show_quiz.php
on line
183
2. What are causes of extrahepatic biliary obstruction
Black - rotors syndrome
Obstruction of the common bile duct
Brunners
Gallstone - biliary stricture - chronic pancreatitis - carcinoma of the pancreatic head
3. Diaphragmatic hernias occur in infants because of defective development of which membrane
Hemolytic anemia
In the mucus that covers the gastric epithelium
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
Pleuroperitoneal
4. which pancreatic enzyme - secreted in its active form - is responsible for starch digestion
Hirschsprungs
Alpha amylase
Hypercoaguability - polycythemia vera - pregnancy - HCC
H2 receptor - inc cAMP
5. acute bowel obstruction - commonly from a recent surgery - can have well demarcated necrotic zones
Squamous - upper 1/3 - adeno - lower 1/3
Portal triad: hepatic artery - protal vein - common bile duct - greater and lesser sac - to control bleeding
Adhesion
Esophageal varices
6. What is diverticulosis
Many diverticula - associated with low fiber diets - caused by inc intraluminal pressure and focal weakness in colonic wall
Zollinger Ellison - phenylalanine and tryptophan
Falciform - ligamentum teres - fetal umbilical vein
Small intestine
7. AD - mutation of APC gene on chromosome 5q - two hit hypothesis - 100% progress to CRC - 1000s of polyps - pancolonic - rectal involvement
FAP
Hyperpigmented mouth - lips - hands - genitalia
External (superficial) ring only
Largest nimber of goblet cells in the small intestine - plicae circulares and crypts of lieberkuhn
8. What complication can arise from indirect inguinal hernias
Primary sclerosing cholangitis
Hydrocele
Causes of gall stones
AST>ALT
9. subQ peribumbilical metastasis
Sister mary joseph nodule
Conj/unconj - inc - nl to dec
Inc lower esphogeal tone leading to achalasia
Alfatoxin in peanuts
10. What receptor does histamine bind on the parietal cell and What does it activate
Conj/unconj - inc - nl to dec
H2 receptor - inc cAMP
Female - fat - fertile - forty
Upregulated intracellular signal transduction
11. In jaundice of hemolytic etiology - is the hyperbilirubinemia conj or unconj - what happens to urine bili - and urine urobilinogen
Failure of neural crest migration
Meconium ileus
SGLT1 (Na dependent) glucose - galactose - GLUT 5 fructose (facilitated diffusion)
Unconj - absent (acholuria) - inc
12. In what scenarios do pts with gilberts have inc bili
Inc pressure in the intrahepatic ducts leading to injury/fibrosis and bile stasis
AST >ALT - ration is usually 1.5
Hematogenous - alpha fetoprotein - budd chiari (hepatic vein blockage)
Fasting and stress
13. malnutrition - toxic megacolon - colorectal carcinoma
Juvenile polyposis syndrome - inc risk of adenocarcinoma
Adhesion
Bleeding - penetration into pancreas - perforation - obstruction
Complications of UC
14. HCC is associated with what other conditions
HBV - HCV - wilsons dz - hemochromatosis - alpha1- antitrypsin def - alcoholic cirrhosis
Penicillinamine - AR inheritance
Hyrdolyzes alpha 1-4 linkages to yield disaccharides
Failure of neural crest migration
15. Where does inflammation in diverticula likely cause pain - what other signs/symptoms are present and What are the complications
LLQ - fever - leukocytosis - can perforate leading to peritonitis - abscess formation - bowel stenosis - give antiobiotics
Conj - inc - dec
Alpha1 antitrypsin def - codominant trait
Chronic hemolysis - alcoholic cirrhosis - advanced age and biliary infxn
16. What are the layers of the gut wall from inside out
Muscularis mucosae
Meconium ileus
Mucosa - submucosa - muscularis externa - serosa/adventitia
5HT - wheezing - right sided heart murmurs - diarrhea - flushing -
17. bilateral mets to ovaries with abundant mucus - signet ring cells
Squamous - upper 1/3 - adeno - lower 1/3
Mallory bodies
Krukenbergs tumor
Acute pancreatitis
18. What is the most common indication of emergent abdominal surgery in children
VZV and influenza B treated with salicylates
Appendicitis
Turcot
Crigler - najjar type 1
19. What structure is Not contained in the femoral sheath
The femoral nerve - only the vein artyer and canal (with deep inguinal lymph nodes)
Aspirin metabolites dec beta oxidation by reversible inhibition of mitocondrial enzyme - ASPIRIN Not RECOMMENDED FOR CHILDREN
Air into the biliary tree - if gallstone obstructs ileocecal valve - air can be seen in biliary tree on imaging
Old men - arthralgias - cardiac and neuro sx
20. secretin - source - action - regulation
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
Colonic polyps
Alk phos
Stomach to proximal duodenum - liver - gall bladder - pancreas and spleen - celiac - vagus
21. What enzyme is necessary to create conjugated bilirubin
Sphincter of oddi
Juvenile polyposis syndrome - inc risk of adenocarcinoma
External - receive somatic innervation - internal receive visceral innervation - not painful but sign of portal HTN
Uridine glucuronyl transferase
22. blind pouch protruding from alimentary tract that communicates with lumen of the gut
Diverticulum
Juvenile polyposis syndrome - inc risk of adenocarcinoma
Epigastric abdominal pain radiating to back - anorexia - nausea
Esophageal carcinoma
23. How is bilirubin carried in the blood
VZV and influenza B treated with salicylates
With albumin
Failure of neural crest migration
Initial diffuse periumbilical pain localizing to mcburney's point with nausea - fever - possible perforation leading to peritonitis
24. Cholecytsokinin - source - action - regulation
GLUT 2
IgA secreting plasma cells - ultimately reside in the lamina proporia
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
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
25. What is the classic triad of hemochromatosis
Warning
: Invalid argument supplied for foreach() in
/var/www/html/basicversity.com/show_quiz.php
on line
183
26. What layer of fascia covers a direct inguinal hernia
Sister mary joseph nodule
Boerhaave's Syndrome - Been heaving syndrome
External spermatic fascia only
The proximal small bowel
27. What are motilin receptor agonists used for clinically
Stimulate intestinal persistalsis
Gardner's syndrome
Inc - weight loss
Splenic flexure
28. Where is bicarb trapped
Hemolytic anemia
In the mucus that covers the gastric epithelium
Corticosteroids - infliximab
Kids - lymphoid hyperplasia afer viral infxn - adults - obstruction - fecalith
29. When and How does Abetalipoproteinemia present
Hemolytic anemia
Chronic constipation early in life with dilated portion of the colon proximal to the aganglionic segment resulting in a transition zone - involves rectum - usually a failure to pass meconium
2 inches long - 2 feet from ileocecal valve - 2% of pop - first 2 years of life - 2 types of epithelia
Early childhood - neuro sx and malabsorption
30. What are the treatment options for uclerative colitis
NAV = nerve artery vein - venous near the penis (NAVEL)
ASA preparations (sulfasalazine) 6- mercaptopurine - infliximab - colectomy
Backup of blood into the liver - RHF - budd chiari
Inc size - villous histology - inc epithelial dysplasia - precursor to CRC
31. What is the sphincter of the pancreatic duct
Striated and smooth
Sphincter of oddi
Crigler - najjar type 1
Around the central vein (zone III)
32. involvement of left supraclavicular node by mets from stomach
Warning
: Invalid argument supplied for foreach() in
/var/www/html/basicversity.com/show_quiz.php
on line
183
33. If the abdominal aorta is blocked - How does blood get to the middle rectal artery
Superior rectal
So hypertrophied they look like brain gyri
Duodenum - 2nd - 3rd and 4th parts
Via the superior pancreaticduodenal
34. What does GET SMASHED stand for in acute pancreatitis
Gallstones - EtOH - trauma - steroids - mumps - autoimmune - scorpion sting - hypercalcemia/hyperlipidemia - ERCP - Drugs (sulfa)
Pleuroperitoneal
Internal thoracic to superior epigastric to inferior epigastric
Cholecystitis - also ascending cholangitis - acute pancreatitis and bililary infx
35. What does loss of APC cause
Old men - arthralgias - cardiac and neuro sx
Villi and microvilli inc absorptive surface - brunner's glands and crypts of lieberkuhn
Protrudes through the Hesselbach's triangle - bulges directly through abdominal wall medial to inferior epigastric vessels
Decreased intercellular adhesion and increased proliferation
36. In alchoholic hepatitis which liver enzyme is higher
AST>ALT
HBV - HCV - wilsons dz - hemochromatosis - alpha1- antitrypsin def - alcoholic cirrhosis
Liver - brain - cornea - kidneys - joints - Asterixis - Basal ganglia degeneration - dec Ceruloplasmin - Cirrhosis - Corneal deposits - Copper accumulation - Carcinoma (HCC) - Choreiform movements - Dementia
Inguninal ligament - sartorius muscle - adductor longus
37. Which IBD is autoimmune and which may be a disordered response to bacteria
Hemosiderosis - hemochromatosis
Glucouronate - water soluble (direct)
Inspiratory arrest on deep palpation due to pain
Autoimmune= ulcerative colitis - disordered response to bactere = crohns
38. What layer in the mucosa is repsonsible for motility
Coma - scleral icterus - fetor hepaticus - spider nevi - gynecomastia - jaundice - testicular atrophy - hand tremor - bleeding - anemia - ankle edema
Above
Averages 6 months - very aggressive - usually already metastasized at presentation
Muscularis mucosae
39. What is biliary colic
Pain associated with cholecystitis and galls stones - diabetics may not present with pain
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
ASA preparations (sulfasalazine) 6- mercaptopurine - infliximab - colectomy
The femoral nerve - only the vein artyer and canal (with deep inguinal lymph nodes)
40. Which IBD has skip lesions and can hit any portion of the GI tract but sprares the rectum - and Which is mainly has continuous lesions in the colon and always has rectal involvement
Parietal cells in the stomach - B12 binding protein
GERD - may also present with nocturnal cough and dyspnea
Neutralizes oral bacertial acids and maintains dental health
Skip lesions =crohns - colon = UC
41. trypsinogen is converted to trypsin via what enzyme
Enterokinase/enteropeptidase from the duodenal mucosa
PAS- positive globules in liver -
Closer to isotonic because of less time to reabsorb NaCl
T cell lymphoma
42. reduction in intestinal blood flow causes ischemia - pain after eating - weight loss - occurs at splenic flexure and distal colon - elderly
Pleuroperitoneal
Neural muscarinic pathways
Inc smooth muscle relaxation - including lower esophageal sphincter
Ischemic colitis
43. GIP - source - action regulation
Esophageal varices
Source - K cells (duod - jej) - action - exocrine - dec gastric H+ secretion - endocrine - inc insulin release - regulation - inc by fatty acids - amino acids - oral glucose
Greater curvature of stomach to transverse colon - gastroepiploic arteries - greater omentum
Copious diarrhea - non alpha - non beta cell pancreatic tumor
44. What transforms conjugated bilirubin to urobilinogen
Meconium ileus
Cushings ulcers - inc vagal stimulation leading to inc vagal stim - inc ACH and inc H+ secretion
Gut bacteria
CEA - CA-19-9
45. What does the splenorenal ligament connect - and What does it contain
Jaundice - tender hepatomegaly - ascites - polycythemia - hypoglycemia
Spleen to posterior abdominal wall - splenic artery and vein
Mucosal cells in the stomach - duod - salivary glands - pancreas - brunners glands in the duod - neutralizes acid - inc by pancreatic and biliary secretion with secretin
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
46. What retroperitoneal structure flanks both sides of the pancreas on CT
Hemolytic anemia
Duodenum - 2nd - 3rd and 4th parts
Muscularis mucosae
M3 - Gq - inc IP3/Ca
47. Bilirubin is the product of what?
Heme metabolism
Alk pho
Crohns = noncaseating granulomas - UC = crypt abscesses
Phenobarbital - inc liver enzyme synthesis
48. What causes primary biliary cirrhosis
Jaundice - fever - RUQ
Cigarettes and chronic pancreatitis - not EtOH
Primary sclerosing cholangitis
Autoimmune rxn leading to lymphcytic infiltrate + granulomas
49. What are the complications of duodenal PUD
Pertechnetate - study for uptake
Bleeding - penetration into pancreas - perforation - obstruction
Dec PGE2 leading to dec gastric mucosa protection
Epithelium
50. vasoactive intestinal polypeptide (VIP) - source - action - regulation
GERD - esophagitis - esophageal ulcers - inc risk of esophageal cancer
Inspiratory arrest on deep palpation due to pain
Hiatal hernia - sliding - hourglass shape - and paraesophageal hernia where stomach chomes up through the hiatus
Source - parasympathetic ganglion in sphincters - gallbladder - small intestine - action - inc intestinal water and electrolyte secretion - inc relaxation of intestinal smooth muscle and sphincters - regulation - inc by distention and vagal stimulati