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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 is the epi for CRC
3rd most common cancer - 3rd deadliest in US - pts > 50 - 1/4 have fam hx
External - receive somatic innervation - internal receive visceral innervation - not painful but sign of portal HTN
Inc lower esphogeal tone leading to achalasia
ALT>AST
2. Dysphagia in achalasia results from
Repeated phlebotomy - deferoxamine - HLA- A3
High LES opening pressure and uncoordinated peristalsis - both solids and liquids
Gastrin stimulating ECL cells to release histamine - histamine stimulation on parietal cells
VZV and influenza B treated with salicylates
3. What is the prognosis of adenocarcinoma
Hypotonic because of more time to reabsorb NaCl
Averages 6 months - very aggressive - usually already metastasized at presentation
Gastric glands
Peyers patches
4. How does gastrin increase acid secretion?
Primarly through ECL leading to histamine release
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
Antrum - H.pylori - inc risk of MALT lymphoma
Goes through deep inguinal ring - external inguinal ring and into the scrotum
5. What are the histological findings in the jejunum
Air into the biliary tree - if gallstone obstructs ileocecal valve - air can be seen in biliary tree on imaging
Largest nimber of goblet cells in the small intestine - plicae circulares and crypts of lieberkuhn
Zenkers - halitosis - dysphagia and obstruction
Curling's ulcer - dec plasma volume and sloughing of gastric mucosa
6. diffuse fibrosis of liver destroying nl architecture with nodular regeneration
Internal thoracic to superior epigastric to inferior epigastric
Failure of the processus vagainlis to close
Cirrhosis
Lactase is located at the tips of intestinal villi
7. HCC is associated with what other conditions
HBV - HCV - wilsons dz - hemochromatosis - alpha1- antitrypsin def - alcoholic cirrhosis
Uridine glucuronyl transferase
Adhesion
Inferior rectal artery - inferior rectal vein to pudendal vein to internal iliac vein to IVC
8. What are the results of hemochromatosis
GERD - may also present with nocturnal cough and dyspnea
Dense core bodies
CHF and inc risk of HCC
Cushings ulcers - inc vagal stimulation leading to inc vagal stim - inc ACH and inc H+ secretion
9. How do you DX and TX gallstones
US and cholecystectomy
Volvulus
90%
Hypotonic because of more time to reabsorb NaCl
10. What reaction does salivary amylase catalyze
<3mm nodules - metabolic - etoh - hemochromatosis - wilsons
Dysphagia (due to esophageal web) - glossitis - iron def anemia
Hyrdolyzes alpha 1-4 linkages to yield disaccharides
Alk phos
11. Autodigestion of pancreas by pancreatic enzymes
...
Neutralizes oral bacertial acids and maintains dental health
Pertechnetate - study for uptake
Acute pancreatitis
12. How are all 3 monosaccharides transported to the blood
GLUT 2
Northern european - Abs to gliadin and tissue transglutaminase - blunted villi - lymphcytes in the lamina proporia
Worldwide - SC - US - adeno
Bile salts (bile conjugated to glycine or taurine) phospholipids - cholesterol - bilirubin - water and ions
13. What do you use to diagnose meckels
Phototherapy
Pertechnetate - study for uptake
Source - SI - action - produces migrating motor complexes - regulation - inc in fasting state
Short gastrics - left greater and lesser
14. Cholecytsokinin - source - action - regulation
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
ALT>AST
Normal
Gallbladder
15. What is the other name for GIP (gastric inhibitory peptide)
HPNCC
Low pressure proximal to LES
Appendicitis
Glucose dependent insulinotropic peptide
16. Gq and inc cAMP both work to do what in parietal cells
Stimulate the H/K ATPase
Only mucosa or submucosa - occur where vasa recta perforate muscularis externa
Inc size - villous histology - inc epithelial dysplasia - precursor to CRC
Reye's syndrome
17. What carcinogens are associated with HCC
Smooth
Urobilin
Alfatoxin in peanuts
Redness and tenderness on palpation of extremities
18. Where does type B chronic gastritis occur and What causes it
Left and right gastroepiploics - left and right gastrics
Inc lower esphogeal tone leading to achalasia
Redundant mesentary
Antrum - H.pylori - inc risk of MALT lymphoma
19. alcoholic liver disease that requires sustained - long term consumption - with swollen and necrotic hepatocytes with neutrophilic infiltration
Lamina propora and submucosa
Alk phos
Alcoholic hepatitis
Right and left hepatic duct
20. What are the signs of peutz jehgers
Fundus/body - autoimmune - autoantibodies to parietal cells - perncious anemia - and achlorhydria
Hyperpigmented mouth - lips - hands - genitalia
Duodenum - 2nd - 3rd and 4th parts
Striated and smooth
21. What are the complications of acute pancreatitis
Conj - inc - dec
Liver metabolizes 5HT
DIC - ARDS - diffuse fat necrosis - hypcalcemia - pseudocyst formation - hemorrhage - infxn - multiorgan failure
Serous on the sides parotids - mucinous in the middle sublingual
22. what kind of fistula is associated with diverticulitis
Unconjugated - water insoluble
Colovesical leading to pneumaturia
Redness and tenderness on palpation of extremities
Inc size - villous histology - inc epithelial dysplasia - precursor to CRC
23. What causes nutmeg liver
Hernia
Myenteric nerve plexus - aurbach
Backup of blood into the liver - RHF - budd chiari
Below
24. milk intolerance
The gastroduodenal
Dissaccharidase def - most commonly lactase
Femoral hernia
Virchow's node
25. How does CRC present in the distal and proximal colon
Many diverticula - associated with low fiber diets - caused by inc intraluminal pressure and focal weakness in colonic wall
In the ileum with bile acids - requires IF
Distal colon - obstruction - colicky pain - hematochezia - proximal colon - dull pain - iron deficiency anemia - fatigue
Mitochondrial abnl - fatty liver - hypoglycemia - coma
26. What gives stool its characteristic color
Begins starch digestion - inactivated by low pH upon reaching the stomach
Stercobilin
Right and left hepatic duct
Gallbladder
27. mildly dec UDPGT or dec bilirubin uptake - asymptomatic - elevated uncong bili without over hemolysis
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28. What nerve innervates the external hemorrhoids
Centrilobular congestion and necrosis - cardiac cirrhosis
Osmotic
Gastrohepatic ligament
Inferior rectal nerve
29. What are the common causes of gastric ulcers - What causes gastric ulcer
H pylori (70%) - NSAIDS - dec mucosal protection against gastric acid
Upregulated intracellular signal transduction
Appendicitis
Alk pho
30. What ligament connects the liver to the abdominal wall - What is contained within it and From what structure is it derived
Female - fat - fertile - forty
Falciform - ligamentum teres - fetal umbilical vein
Superior rectal
Unconjugated - water insoluble
31. What is the clinical presentation of acute pancreatitis
Early childhood - neuro sx and malabsorption
Inc conj bilirubin - inc cholesterol - inc alk phos
Meckels
Epigastric abdominal pain radiating to back - anorexia - nausea
32. likely infectious form of malabsorption - responds to antibiotics
Short gastrics - left greater and lesser
Tropical sprue
CF - obstructing cancer - chronic pancreatitis - causes malabsorption of fat and fat soluble vitamins (ADEK)
Jaundice - fever - RUQ
33. How do NSAIDs cause acute gastritis
Below
Dec PGE2 leading to dec gastric mucosa protection
Cirrhosis - DM - skin pigmentation - 'bronze diabetes'
Terminal ileum and colon
34. What does loss of APC cause
Pancreatic and bile
Decreased intercellular adhesion and increased proliferation
Crohns = noncaseating granulomas - UC = crypt abscesses
Crypts but not villi
35. This disease commonly presents as heartburn and regurg when lying down - What is another common presentation
Colonic polyps
Esophageal varices
Krukenbergs tumor
GERD - may also present with nocturnal cough and dyspnea
36. What is the HLA association and treatment for hemochromatosis
Cholesterol
H2 receptor - inc cAMP
Repeated phlebotomy - deferoxamine - HLA- A3
Chief cells of the stomach - protein digestion - inc by vagal stimulation local acid
37. In what clinical scenarior do you see portosystemic anastomoses
Portal HTN
HSV-1 - CMV - Candida
Begins starch digestion - inactivated by low pH upon reaching the stomach
Only mucosa or submucosa - occur where vasa recta perforate muscularis externa
38. What do mucins do?
GLUT 2
Lubricate food (glycoprotiens)
The proximal small bowel
Enterokinase/enteropeptidase from the duodenal mucosa
39. What are the complications of duodenal PUD
Brush border of intestine - produce monosaccharides from oligo and di
Stimulate intestinal persistalsis
Bleeding - penetration into pancreas - perforation - obstruction
Brunners
40. What are the treatment options for uclerative colitis
L1
ASA preparations (sulfasalazine) 6- mercaptopurine - infliximab - colectomy
Upregulated intracellular signal transduction
Female - fat - fertile - forty
41. crigler - najjar type II responds to which therapy and How does it work
Elevated amylase - and lipase
Muscularis mucosae
Phenobarbital - inc liver enzyme synthesis
Inc size - villous histology - inc epithelial dysplasia - precursor to CRC
42. misfolded gene product protein accumulates in hepatocellular ER - dec in elastic tissu in lungs leading panacinar emphysema
Left gastric vein and esophogeal vein - esophagus
Ischemic colitis
Alpha1 antitrypsin def - codominant trait
GERD - may also present with nocturnal cough and dyspnea
43. What does alpha amylase do and what inactivates it
Begins starch digestion - inactivated by low pH upon reaching the stomach
Ceruplasmin
L1
Gallstone - biliary stricture - chronic pancreatitis - carcinoma of the pancreatic head
44. To what substance is bilirubin conjugated and why
Lye ingestion and acid reflux
Ampulla of vater
Brunners
Glucouronate - water soluble (direct)
45. Where are peyers patches found
Diarrhea - steatorrhea - weight loss - weakness
Barrett's esophagus
Protrudes through the Hesselbach's triangle - bulges directly through abdominal wall medial to inferior epigastric vessels
Lamina propora and submucosa
46. What are the borders of Hesselbach's triangle
Left and right gastroepiploics - left and right gastrics
Enterokinase/enteropeptidase from the duodenal mucosa
Terminal ileum and colon
Inferior epigastric artery - lateral border of rectus abdominis - inguinal ligament
47. What are the extraintestinal manifestations of ulcerative colitis
M3 - Gq - inc IP3/Ca
Pyoderma gangrenosum - primary sclerosing cholangitis
Barrett's esophagus
Hyperplastic
48. With esophageal varices - between What two vessels is the portosystemic anastomoses and Where is it
Oligosaccharide digestion
Left gastric vein and esophogeal vein - esophagus
Esophageal cancer
Hernia
49. What is contained within the muscularis externa
Barrett's esophagus
Hemosiderosis - hemochromatosis
Pancreatic and bile
Myenteric nerve plexus - aurbach
50. What serum enzyme is elevated inacute pancreatitis
Cholesterol
Averages 6 months - very aggressive - usually already metastasized at presentation
Lipase
Inferior rectal artery - inferior rectal vein to pudendal vein to internal iliac vein to IVC