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Test your basic knowledge |
USMLE GI
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Subjects
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health-sciences
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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. What is contained with in the hepatoduodenal ligament - What two spaces does it connect - and when would you need to compress it
Portal triad: hepatic artery - protal vein - common bile duct - greater and lesser sac - to control bleeding
Reye's syndrome
Neutralizes gastric acid allowing pancreatic enzymes to fxn
AR
2. If trypsin activates more trypsinogen - what kind of feedback loop is established
Meconium ileus
Dilated esophagus with an area of distal stenosis - birds beak
Bleeding - penetration into pancreas - perforation - obstruction
Positive
3. What is the frequency of basal electric rhythm of the ilieum
Lubricate food (glycoprotiens)
Migratory polyarthritis - erythema nodusum - anklyosing spondylitis - uveitis - immunologic disorders
8-9 waves/min
Serum mitochondrial antibodies including IgM - associated with CREST - RA and celiac dz
4. What histological findings are present in the stomach
Gastric glands
H+
2ndary biliary cirrhosis
Increase tumorigenesis
5. How do villi appear in disaccharidease def
All 3 gut layers outpouch as in Meckels
Alpha amylase
L/R renal artery around L1
Normal
6. signet ring cells - acanthosis nigracans - dz - character/association - spread
Gallbladder
Dissaccharidase def - most commonly lactase
Myenteric nerve plexus - aurbach
Stomach cancer (usually adenocarcinoma) - early aggressive spread - node/liver mets - associated with nitrosamines (smoked foods) - achlorhydria - chronic gastritis - type A blood
7. To what substance is bilirubin conjugated and why
Hematogenous - alpha fetoprotein - budd chiari (hepatic vein blockage)
ASA preparations (sulfasalazine) 6- mercaptopurine - infliximab - colectomy
Glucouronate - water soluble (direct)
All 3
8. What is the frequency of basal electric rhythm of the stomach
3 waves/min
Meckels
Inc lower esphogeal tone leading to achalasia
Striated and smooth
9. Which monosaccharides are absorbed by the enterocytes and which transporters carry each
SGLT1 (Na dependent) glucose - galactose - GLUT 5 fructose (facilitated diffusion)
Via the middle colic
H pylori (almost 100%)
Femoral hernia
10. What do tumors that arise in the head of the pancreas cause
Sister mary joseph nodule
Urobilin
Goes through deep inguinal ring - external inguinal ring and into the scrotum
Obstruction of the common bile duct
11. Achalasia increases the risk For what complication
VZV and influenza B treated with salicylates
Pancreatic insuff - steatorrhea - fat soluble vitamin def - DM
Pyoderma gangrenosum - primary sclerosing cholangitis
Esophageal carcinoma
12. What are the effects of atropine on parietal cells and G cells
All 3 gut layers outpouch as in Meckels
Uremia
Penicillinamine - AR inheritance
Inhibits parietal cells because of ACH is NT - while GRP works at the G cells
13. Mucosal lacerations at the gastroesophageal junction due to severe vomiting - presentation - and risk groups
Can lead to hematemesis - found in EtOHics and bulimics
Esophageal cancer
IgA secreting plasma cells - ultimately reside in the lamina proporia
Lye ingestion and acid reflux
14. What gives stool its characteristic color
Obstruction of the common bile duct
Zollinger Ellison - phenylalanine and tryptophan
Lubricate food (glycoprotiens)
Stercobilin
15. glandular metaplasia - replacement of nonkeratinized (stratified) squamous epithelium with intestinal (columnar) epithelium in the distal esophagus
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16. How does abetalipoproteinemia lead to malabsorption
Dec synthesis of apo B - inability to generate chylomicrons - dec secretion of cholesterol - VLDL into the bloodstream - fat accumulation in enterocytes
Hydrocele
Urobilin
Juvenile polyposis syndrome - inc risk of adenocarcinoma
17. twisting of portion of bowel around its mesentery leading to obstruction and infarction - usually in elderly
Volvulus
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
L4
Lamina propora and submucosa
18. What is the TX of physiologic neonatal jaundice
Phototherapy
Mucosa - submucosa - muscularis externa - serosa/adventitia
Portal HTN
Via the middle colic
19. When and How does Abetalipoproteinemia present
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
Unconj - absent (acholuria) - inc
Early childhood - neuro sx and malabsorption
H pylori (almost 100%)
20. What receptor does histamine bind on the parietal cell and What does it activate
H2 receptor - inc cAMP
Decrease - weight gain
Osmotic
With albumin
21. Why would a self - limited lactase def occur following an injury (viral diarrhea)
AST
Low pressure proximal to LES
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
Lactase is located at the tips of intestinal villi
22. What are the borders of Hesselbach's triangle
Inferior epigastric artery - lateral border of rectus abdominis - inguinal ligament
No
Curling's ulcer - dec plasma volume and sloughing of gastric mucosa
Zenkers - halitosis - dysphagia and obstruction
23. Which IBD may or may not have blood diarrhea - and which will always have bloody diarrhea
IgA receives protective secretory component and is then transported across the epithelium to gut lumen
Inferior epigastric artery - lateral border of rectus abdominis - inguinal ligament
Spleen to posterior abdominal wall - splenic artery and vein
Crohns = maybe - UC= always
24. What is the cause of physiologic neonatal jaundice
Immature UDP- glucuronyl transferase to unconjugated hyperbilirubinemia - jaundice kernicuterus
Autoimmune= ulcerative colitis - disordered response to bactere = crohns
Jaundice - fever - RUQ
Aspirin metabolites dec beta oxidation by reversible inhibition of mitocondrial enzyme - ASPIRIN Not RECOMMENDED FOR CHILDREN
25. What structure is Not contained in the femoral sheath
Lubricate food (glycoprotiens)
H pylori (70%) - NSAIDS - dec mucosal protection against gastric acid
The femoral nerve - only the vein artyer and canal (with deep inguinal lymph nodes)
Penicillinamine - AR inheritance
26. In jaundice of hepatocellular etiology - is the hyperbilirubinemia conjugate or UN - what happens to urine bili - and urine urobilinogen
Conj/unconj - inc - nl to dec
Esophageal cancer
Begins starch digestion - inactivated by low pH upon reaching the stomach
Duodenum - 2nd - 3rd and 4th parts
27. What makes a true diverticula
Gilbert's
All 3 gut layers outpouch as in Meckels
Hypotonic because of more time to reabsorb NaCl
Neutralizes oral bacertial acids and maintains dental health
28. Malabsorption syndromes have what common clinical presentation
Goes through deep inguinal ring - external inguinal ring and into the scrotum
Diarrhea - steatorrhea - weight loss - weakness
Meconium ileus
Falciform - ligamentum teres - fetal umbilical vein
29. AD - mutation of APC gene on chromosome 5q - two hit hypothesis - 100% progress to CRC - 1000s of polyps - pancolonic - rectal involvement
FAP
L3
Villi and microvilli inc absorptive surface - brunner's glands and crypts of lieberkuhn
Abdominal pain radiating to back - weight loss due to malabsorption - migratory thrombophlebitis - obstructice jaundice with palpable gallbladder
30. What carcinogens are associated with HCC
Portal triad: hepatic artery - protal vein - common bile duct - greater and lesser sac - to control bleeding
Backup of blood into the liver - RHF - budd chiari
IBS at least 2 with recurrent abdominal pain
Alfatoxin in peanuts
31. Progressive dyshphage beginning with solids and moving to liquids and weight loss
Jaundice - fever - RUQ
Parietal cells in the stomach - decrease pH - inc by histamine - ACH - gastrin - dec by somatostatin - GIP - prostaglandin - secretin
Superior rectal
Esophageal cancer
32. What serum enzyme is elevated inacute pancreatitis
Mallory bodies
FAP
Cimetidine
Lipase
33. What complication can arise from indirect inguinal hernias
The proximal small bowel
Low pressure proximal to LES
Phototherapy
Hydrocele
34. most common non - neoplastic polyp in colon
Angiodysplasia
Hyperplastic
Omeprazole
Fe2+ in the duod
35. HyperIgM associated with ulcerative colitis can lead to what biliary tract disease
Sister mary joseph nodule
Causes of gall stones
2ndary biliary cirrhosis
Jaundice - fever - RUQ
36. What does bicarb do in the duodenum
Inc - weight loss
Neutralizes gastric acid allowing pancreatic enzymes to fxn
Lateral to the inferior epigastric artery
Distal colon - obstruction - colicky pain - hematochezia - proximal colon - dull pain - iron deficiency anemia - fatigue
37. In what syndrome is gastric very elevatad - and amino acids are potent gastrin stimulators
Neutralizes gastric acid allowing pancreatic enzymes to fxn
Virchow's node
Budd chiari syndrome
Zollinger Ellison - phenylalanine and tryptophan
38. Where are oligosaccharide hydrolases and What do they do
Lubricate food (glycoprotiens)
8-9 waves/min
Brush border of intestine - produce monosaccharides from oligo and di
ASA preparations (sulfasalazine) 6- mercaptopurine - infliximab - colectomy
39. What are the borders of the femoral triangle
IBS at least 2 with recurrent abdominal pain
Autoimmune rxn leading to lymphcytic infiltrate + granulomas
Inguninal ligament - sartorius muscle - adductor longus
Tropical sprue
40. What is Trousseau's sign
Redness and tenderness on palpation of extremities
Cystic duct and common hepatic duct
Hernia
Inc - weight loss
41. What is the most common indication of emergent abdominal surgery in children
Appendicitis
Glucouronate - water soluble (direct)
Crohns = noncaseating granulomas - UC = crypt abscesses
Hyrdolyzes alpha 1-4 linkages to yield disaccharides
42. What is the ddx associated with appendicitis
Early childhood - neuro sx and malabsorption
Diverticulitis in elderly - ectopic pregs use hCG to rule out
Complications of UC
When diffusely infiltrative - thickened rigid appearance like a leather bottle
43. Esophagitis can result From which 3 infectious agents - or chemical ingestion
Dermatitis herpetiformis
HSV-1 - CMV - Candida
Chronic transfusion therapy in beta thal major - inc ferritin - inc iron - dec TIBC - inc transferrin saturation
Pain associated with cholecystitis and galls stones - diabetics may not present with pain
44. Which is used more quickly - an oral glucose load - or that by IV
So hypertrophied they look like brain gyri
3rd most common cancer - 3rd deadliest in US - pts > 50 - 1/4 have fam hx
Oral glucose
Old men - arthralgias - cardiac and neuro sx
45. What is the prognosis of adenocarcinoma
Hepatic steatosis
CF - obstructing cancer - chronic pancreatitis - causes malabsorption of fat and fat soluble vitamins (ADEK)
Air into the biliary tree - if gallstone obstructs ileocecal valve - air can be seen in biliary tree on imaging
Averages 6 months - very aggressive - usually already metastasized at presentation
46. Who gets Whipple disease and How do they present
Old men - arthralgias - cardiac and neuro sx
Ceruplasmin
H+
Juvenille polyps - no risk if single
47. What causes carcinoid syndrome amd What are the symptoms
Brunners
IgA secreting plasma cells - ultimately reside in the lamina proporia
5HT - wheezing - right sided heart murmurs - diarrhea - flushing -
AST >ALT - ration is usually 1.5
48. What intervention will intervention will relieve portal HTN
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
Transjugular intrahepatic portosystemic shunt between portal and hepatic vein percutaneously by shunting blood to the systemic circulation
Source - SI - action - produces migrating motor complexes - regulation - inc in fasting state
Kids - lymphoid hyperplasia afer viral infxn - adults - obstruction - fecalith
49. What is one potential precipitating factor for intussusception
Falciform - ligamentum teres - fetal umbilical vein
Viral - adenovirus in kids - rare in adults but associated with intraluminal mass or tumor
Peptic ulcer disease
Gallstones - EtOH - trauma - steroids - mumps - autoimmune - scorpion sting - hypercalcemia/hyperlipidemia - ERCP - Drugs (sulfa)
50. what kind of muscle is in the upper 1/3 of esophagus
Striated
Goes through deep inguinal ring - external inguinal ring and into the scrotum
Sphincter of oddi
Kids - lymphoid hyperplasia afer viral infxn - adults - obstruction - fecalith
Sorry!:) No result found.
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