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Test your basic knowledge |
USMLE GI
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Subjects
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health-sciences
,
usmle
Instructions:
Answer 50 questions in 15 minutes.
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study here
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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. trypsinogen is converted to trypsin via what enzyme
Below
Protrudes through the Hesselbach's triangle - bulges directly through abdominal wall medial to inferior epigastric vessels
Enterokinase/enteropeptidase from the duodenal mucosa
Decrease - weight gain
2. What conditions are associated with budd chiari
Hypercoaguability - polycythemia vera - pregnancy - HCC
Glucose dependent insulinotropic peptide
Immature UDP- glucuronyl transferase to unconjugated hyperbilirubinemia - jaundice kernicuterus
Crohns - CF - advanced age - clofibrate - estrogens - multiparity - rapid weight loss - Native American origin
3. glandular metaplasia - replacement of nonkeratinized (stratified) squamous epithelium with intestinal (columnar) epithelium in the distal esophagus
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4. How does loss of NO secretion affect the esophagus and what results
Cystic dilation of the viteline duct
Around the central vein (zone III)
Dec synthesis of apo B - inability to generate chylomicrons - dec secretion of cholesterol - VLDL into the bloodstream - fat accumulation in enterocytes
Inc lower esphogeal tone leading to achalasia
5. Where are carcinoid tumors most commonly malignant
Uridine glucuronyl transferase
Small intestine
Urobilin
Fundus/body - autoimmune - autoantibodies to parietal cells - perncious anemia - and achlorhydria
6. What does extrahepatic biliary obstruction cause
Inc pressure in the intrahepatic ducts leading to injury/fibrosis and bile stasis
Penicillinamine - AR inheritance
Dense core bodies
Pancreatic head causing obstructive jaundice
7. Mucosal lacerations at the gastroesophageal junction due to severe vomiting - presentation - and risk groups
Can lead to hematemesis - found in EtOHics and bulimics
Pleuroperitoneal
Triglycerides and micelle formation - required for absorption of of non polar nutrients in small intestine
HSV-1 - CMV - Candida
8. How do you DX and TX gallstones
Oligosaccharide digestion
US and cholecystectomy
Fasting and stress
Decreased intercellular adhesion and increased proliferation
9. What are the treatment options for uclerative colitis
Zenkers - halitosis - dysphagia and obstruction
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
ASA preparations (sulfasalazine) 6- mercaptopurine - infliximab - colectomy
Primarly through ECL leading to histamine release
10. necrosis of intestinal mucosa and possible perforation - usual colon involvement - more common in preemies
GERD - esophagitis - esophageal ulcers - inc risk of esophageal cancer
Cholesterol - 10-20% opaque due to calcifications
Necrotizing enterocolitis
No
11. external hemorrhoids and squamous cell carcinoma occur above or below the pectinate line
Corticosteroids - infliximab
Older patients
Below
Amylase
12. How are all 3 monosaccharides transported to the blood
Pertechnetate - study for uptake
GLUT 2
Largest nimber of goblet cells in the small intestine - plicae circulares and crypts of lieberkuhn
Alcohol/Achalasia - Barretts - Cigarettes - Diverticuli (Zenkers) Esophageal web/Esophagitis - Familial
13. What does high flow rate mean
Lipase
The submucosal nerve plexus - meissner's
Parietal cells in the stomach - B12 binding protein
Closer to isotonic because of less time to reabsorb NaCl
14. What kind of gall stones are mostly radiolucent and what percentage is opaque and due to what?
Cholesterol - 10-20% opaque due to calcifications
Inferior rectal artery - inferior rectal vein to pudendal vein to internal iliac vein to IVC
So hypertrophied they look like brain gyri
GLUT 2
15. Who is at risk for pancreatic adenocarcinoma
Bile salts (bile conjugated to glycine or taurine) phospholipids - cholesterol - bilirubin - water and ions
Repeated phlebotomy - deferoxamine - HLA- A3
Jewish and African American men
Cimetidine
16. Achalasia can be secondary to what infectious disease common in South America
Appendicitis
Chagas disease
H pylori (almost 100%)
Largest nimber of goblet cells in the small intestine - plicae circulares and crypts of lieberkuhn
17. Which IBD has noncaseating granulomas and lymphoid aggregates - and which has crypt abscesses and ulcers with bleeding
Crohns = noncaseating granulomas - UC = crypt abscesses
Skip lesions =crohns - colon = UC
Serous on the sides parotids - mucinous in the middle sublingual
Curling's ulcer - dec plasma volume and sloughing of gastric mucosa
18. What does GET SMASHED stand for in acute pancreatitis
Oligosaccharide digestion
Jaundice - tender hepatomegaly - ascites - polycythemia - hypoglycemia
Cholecystitis - also ascending cholangitis - acute pancreatitis and bililary infx
Gallstones - EtOH - trauma - steroids - mumps - autoimmune - scorpion sting - hypercalcemia/hyperlipidemia - ERCP - Drugs (sulfa)
19. What is the leading cause of bowel incarceration
H pylori (almost 100%)
Femoral hernia
Villi and microvilli inc absorptive surface - brunner's glands and crypts of lieberkuhn
Autoimmune= ulcerative colitis - disordered response to bactere = crohns
20. What does the splenorenal ligament connect - and What does it contain
Terminal ileum and colon
Superior rectal and middle and inferior rectal - rectum
Superior rectal from IMA - superior rectal vein to inf mesenteric to portal system
Spleen to posterior abdominal wall - splenic artery and vein
21. bilateral mets to ovaries with abundant mucus - signet ring cells
Neutralizes gastric acid allowing pancreatic enzymes to fxn
Gastrin secreting tumor that causes continuous high levels of acid secretion and ulcers
Jewish and African American men
Krukenbergs tumor
22. Liver cell failure can lead to multisystem signs including
No - chronic - can present with diarrhea or constipation or alternation - treat sx
Increase tumorigenesis
Above
Coma - scleral icterus - fetor hepaticus - spider nevi - gynecomastia - jaundice - testicular atrophy - hand tremor - bleeding - anemia - ankle edema
23. What is the most common indication of emergent abdominal surgery in children
Abdominal pain radiating to back - weight loss due to malabsorption - migratory thrombophlebitis - obstructice jaundice with palpable gallbladder
Downs
Gastrin stimulating ECL cells to release histamine - histamine stimulation on parietal cells
Appendicitis
24. What do mucins do?
Neutralizes gastric acid allowing pancreatic enzymes to fxn
Erosive - disruption of mucosal barrier leading to inflammation
Above
Lubricate food (glycoprotiens)
25. What can hemochromatosis be secondary to...
Glucose dependent insulinotropic peptide
Centrilobular leading to congestive liver disease
Chronic transfusion therapy in beta thal major - inc ferritin - inc iron - dec TIBC - inc transferrin saturation
When diffusely infiltrative - thickened rigid appearance like a leather bottle
26. concentric onion skin bile duct fibrosis
The jejunum
Primary sclerosing cholangitis
L4
Gut bacteria
27. What gives stool its characteristic color
Bleeding - intussusception - volvulus - obstruction near terminal ileum
Stercobilin
HSV-1 - CMV - Candida
ASA preparations (sulfasalazine) 6- mercaptopurine - infliximab - colectomy
28. why infxn is implicated in duodenal PUD
Boerhaave's Syndrome - Been heaving syndrome
True and most common congenital anomoly of GI tract
Alk phos
H pylori (almost 100%)
29. alcoholic liver disease that requires sustained - long term consumption - with swollen and necrotic hepatocytes with neutrophilic infiltration
Source - SI - action - produces migrating motor complexes - regulation - inc in fasting state
Alcoholic hepatitis
Crigler - najjar type 1
Inc conj bilirubin - inc cholesterol - inc alk phos
30. In which portion of the esophagus is it sqamous cell cancer and in which portion is adenocarcinoma
Alk phos
Squamous - upper 1/3 - adeno - lower 1/3
Muscularis mucosae
Hepatic steatosis
31. Where is the pectinate line
L3
SGLT1 (Na dependent) glucose - galactose - GLUT 5 fructose (facilitated diffusion)
Where hindgut meets ectoderm
Trypsin - chymotrypsin - elastase - carboxypeptidases
32. What is the frequency of basal electric rhythm in the duodenum
Fundus/body - autoimmune - autoantibodies to parietal cells - perncious anemia - and achlorhydria
True and most common congenital anomoly of GI tract
12 waves/min
Esophageal varices
33. Gastrin - source - action - regulation
Oligosaccharide digestion
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
Distal duodenum to proximal 2/3 of transverse colon - SMA - vagus
External (superficial) ring only
34. What other condition can lead to acute gastritis - think renal
Uremia
No - chronic - can present with diarrhea or constipation or alternation - treat sx
Urobilin
Oral glucose
35. congenital megacolon characterized by lack of ganglion/enteric nervous plexuses in segment on intestinal biopsy
Hirschsprungs
Enterokinase/enteropeptidase from the duodenal mucosa
Backup of blood into the liver - RHF - budd chiari
Fundus/body - autoimmune - autoantibodies to parietal cells - perncious anemia - and achlorhydria
36. diffuse fibrosis of liver destroying nl architecture with nodular regeneration
AR
Closer to isotonic because of less time to reabsorb NaCl
Source - K cells (duod - jej) - action - exocrine - dec gastric H+ secretion - endocrine - inc insulin release - regulation - inc by fatty acids - amino acids - oral glucose
Cirrhosis
37. When do you see hypertrophy of brunners glands
Striated
Villi and microvilli inc absorptive surface - brunner's glands and crypts of lieberkuhn
Peptic ulcer disease
AR
38. What separates the right greater and lesser sacs
Gastrohepatic ligament
Virchow's node
US and cholecystectomy
Early childhood - neuro sx and malabsorption
39. How do burns cause acute gastritis and What is it called
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40. Autodigestion of pancreas by pancreatic enzymes
Acute pancreatitis
Increase tumorigenesis
Stimulate the H/K ATPase
Alcoholic hepatitis
41. What is the frequency of basal electric rhythm of the stomach
Gastric glands
Cirrhosis
ASA preparations (sulfasalazine) 6- mercaptopurine - infliximab - colectomy
3 waves/min
42. What structures feed into the common bile duct
Small intestine
Left gastric vein and esophogeal vein - esophagus
Epithelium
Cystic duct and common hepatic duct
43. What is the frequency of basal electric rhythm of the ilieum
Warthins' tumor
8-9 waves/min
Peyers patches
The entire
44. What color is the liver in dubin johnson - and what similar syndrome doesn't have gross color changes in the liver
Black - rotors syndrome
All 3
CHF and inc risk of HCC
Esophageal varices
45. Achalasia increases the risk For what complication
Mucosa - submucosa - muscularis externa - serosa/adventitia
Alcohol/Achalasia - Barretts - Cigarettes - Diverticuli (Zenkers) Esophageal web/Esophagitis - Familial
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
Esophageal carcinoma
46. Where are oligosaccharide hydrolases and What do they do
Protrudes through the Hesselbach's triangle - bulges directly through abdominal wall medial to inferior epigastric vessels
Dense core bodies
Brush border of intestine - produce monosaccharides from oligo and di
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
47. A protrusion of peritoneum through an opening - usually a site of weakness
Zollinger ellison - brunners glands
Gastrin stimulating ECL cells to release histamine - histamine stimulation on parietal cells
Positive urease test
Hernia
48. What kind of lesions are characteristic of duodenal PUD vs cancer
Brush border of intestine - produce monosaccharides from oligo and di
Punched out - clean margins - carcinoma =raised irregular margins
Duodenum - 2nd - 3rd and 4th parts
Fe2+ in the duod
49. What are the complications of Meckels
Peutz jeghers
Mucoepidermoid carcinoma
Transjugular intrahepatic portosystemic shunt between portal and hepatic vein percutaneously by shunting blood to the systemic circulation
Bleeding - intussusception - volvulus - obstruction near terminal ileum
50. This disease commonly presents as heartburn and regurg when lying down - What is another common presentation
Ceruplasmin
GERD - may also present with nocturnal cough and dyspnea
Erosive - disruption of mucosal barrier leading to inflammation
Bleeding - intussusception - volvulus - obstruction near terminal ileum
Sorry!:) No result found.
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