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. Where is there sclerosis in alcoholic cirrohosis
Conj - inc - dec
Around the central vein (zone III)
Migratory polyarthritis - erythema nodusum - anklyosing spondylitis - uveitis - immunologic disorders
Crohns - CF - advanced age - clofibrate - estrogens - multiparity - rapid weight loss - Native American origin
2. Cholecytsokinin - source - action - regulation
Pyoderma gangrenosum - primary sclerosing cholangitis
Lipase
Distal colon - obstruction - colicky pain - hematochezia - proximal colon - dull pain - iron deficiency anemia - fatigue
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
3. What are the signs of peutz jehgers
Duodenum - 2nd - 3rd and 4th parts
Hyperpigmented mouth - lips - hands - genitalia
Superior rectal
Chief cells of the stomach - protein digestion - inc by vagal stimulation local acid
4. Why does indirect inguinal hernia happen in infacnts
Failure of the processus vagainlis to close
Stomach cancer (usually adenocarcinoma) - early aggressive spread - node/liver mets - associated with nitrosamines (smoked foods) - achlorhydria - chronic gastritis - type A blood
Superior rectal from IMA - superior rectal vein to inf mesenteric to portal system
Esophageal varices
5. In what scenarios do pts with gilberts have inc bili
Boerhaave's Syndrome - Been heaving syndrome
Upregulated intracellular signal transduction
Tropical sprue
Fasting and stress
6. inadequate hepatic liver copper excretion and failure of copper to enter circulation as ceruloplasmin
Meconium ileus
...
Goes through deep inguinal ring - external inguinal ring and into the scrotum
H2 receptor - inc cAMP
7. What converts inactive pepsinogen to pepsin
Greater curvature of stomach to transverse colon - gastroepiploic arteries - greater omentum
H+
Volvulus
Hirschsprungs
8. What is charcot triad of cholangitis
Alternating strictures and dilation with beading of intra and extrahepatic bile ducts on ERCP
Jaundice - fever - RUQ
Menetriers disease
Ischemic colitis
9. In PUD - with gastric ulcers - does pain inc or dec with meals?
Inferior rectal artery - inferior rectal vein to pudendal vein to internal iliac vein to IVC
High LES opening pressure and uncoordinated peristalsis - both solids and liquids
<3mm nodules - metabolic - etoh - hemochromatosis - wilsons
Inc - weight loss
10. What is the TX of physiologic neonatal jaundice
Internal thoracic to superior epigastric to inferior epigastric
Pleomorphic adenoma
Alk phos
Phototherapy
11. mildly dec UDPGT or dec bilirubin uptake - asymptomatic - elevated uncong bili without over hemolysis
Warning
: Invalid argument supplied for foreach() in
/var/www/html/basicversity.com/show_quiz.php
on line
183
12. What pancreatic proteases are secreted as zymogens
Turcot
5HT - wheezing - right sided heart murmurs - diarrhea - flushing -
Duodenum - 2nd - 3rd and 4th parts
Trypsin - chymotrypsin - elastase - carboxypeptidases
13. With caput medusaw - between what vessels is the anastomoses and Where is it
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
Glucouronate - water soluble (direct)
Paraumbilical and superficial and inferior epigastric - umbilicus
Complications of crohns
14. HCC is associated with what other conditions
HBV - HCV - wilsons dz - hemochromatosis - alpha1- antitrypsin def - alcoholic cirrhosis
Fasting and stress
Achalasia due to loss of myenteric plexus (auberach)
MSI (15%) and APC/beta catenin chromosomal instability (85%)
15. What is the cause of Barrett's and the assocaited complications
Source - K cells (duod - jej) - action - exocrine - dec gastric H+ secretion - endocrine - inc insulin release - regulation - inc by fatty acids - amino acids - oral glucose
Primary sclerosing cholangitis
GERD - esophagitis - esophageal ulcers - inc risk of esophageal cancer
Goes through deep inguinal ring - external inguinal ring and into the scrotum
16. Where are oligosaccharide hydrolases and What do they do
Colonic polyps
Virchow's node
Cigarettes and chronic pancreatitis - not EtOH
Brush border of intestine - produce monosaccharides from oligo and di
17. In jaundice of hemolytic etiology - is the hyperbilirubinemia conj or unconj - what happens to urine bili - and urine urobilinogen
Unconj - absent (acholuria) - inc
CF - obstructing cancer - chronic pancreatitis - causes malabsorption of fat and fat soluble vitamins (ADEK)
Unconjugated - water insoluble
Mitochondrial abnl - fatty liver - hypoglycemia - coma
18. Which patients have pigment stones
Gilbert's
EtOH
Abdominal pain radiating to back - weight loss due to malabsorption - migratory thrombophlebitis - obstructice jaundice with palpable gallbladder
Chronic hemolysis - alcoholic cirrhosis - advanced age and biliary infxn
19. Where are peyers patches found
Striated and smooth
Lamina propora and submucosa
Epigastric abdominal pain radiating to back - anorexia - nausea
Left gastric vein and esophogeal vein - esophagus
20. 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
Urobilin
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
Skip lesions =crohns - colon = UC
Meckels
21. What cells make pepsin - What does it do - and what regulates it
Chief cells of the stomach - protein digestion - inc by vagal stimulation local acid
Barrett's esophagus
Redness and tenderness on palpation of extremities
2 inches long - 2 feet from ileocecal valve - 2% of pop - first 2 years of life - 2 types of epithelia
22. 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
Dysphagia (due to esophageal web) - glossitis - iron def anemia
Gallbladder
ASA preparations (sulfasalazine) 6- mercaptopurine - infliximab - colectomy
23. Why does volvulus occur more at cecum and sigmoid colon
Redundant mesentary
Chronic transfusion therapy in beta thal major - inc ferritin - inc iron - dec TIBC - inc transferrin saturation
Pancreatic and bile
The femoral nerve - only the vein artyer and canal (with deep inguinal lymph nodes)
24. What causes nutmeg liver
Cystic dilation of the viteline duct
Gastrin stimulating ECL cells to release histamine - histamine stimulation on parietal cells
Backup of blood into the liver - RHF - budd chiari
External spermatic fascia only
25. In what syndrome is gastric very elevatad - and amino acids are potent gastrin stimulators
Peptic ulcer disease
Zollinger Ellison - phenylalanine and tryptophan
Erosive - disruption of mucosal barrier leading to inflammation
Air into the biliary tree - if gallstone obstructs ileocecal valve - air can be seen in biliary tree on imaging
26. in jaundice of obstructive etiolgy is the hyperbilirubinemia conj or unconj - what happens to urine bili - and what happens to urine urobilinogen
Conj - inc - dec
Short gastrics - left greater and lesser
Alternating strictures and dilation with beading of intra and extrahepatic bile ducts on ERCP
Angiodysplasia
27. Who is at risk for pancreatic adenocarcinoma
Phenobarbital - inc liver enzyme synthesis
Jewish and African American men
Zollinger ellison - brunners glands
High LES opening pressure and uncoordinated peristalsis - both solids and liquids
28. What are the extraintestinal manifestations of ulcerative colitis
Distal colon - obstruction - colicky pain - hematochezia - proximal colon - dull pain - iron deficiency anemia - fatigue
Appendicitis
Pyoderma gangrenosum - primary sclerosing cholangitis
GERD - esophagitis - esophageal ulcers - inc risk of esophageal cancer
29. Where are tumors commonly in pancreatic adenocarcinoma
Gallstone - biliary stricture - chronic pancreatitis - carcinoma of the pancreatic head
CF - obstructing cancer - chronic pancreatitis - causes malabsorption of fat and fat soluble vitamins (ADEK)
Worldwide - SC - US - adeno
Pancreatic head causing obstructive jaundice
30. secretin - source - action - regulation
Inc pressure in the intrahepatic ducts leading to injury/fibrosis and bile stasis
Terminal ileum and colon
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
Osmotic
31. Esophagitis can result From which 3 infectious agents - or chemical ingestion
Oligosaccharide digestion
Chronic transfusion therapy in beta thal major - inc ferritin - inc iron - dec TIBC - inc transferrin saturation
HSV-1 - CMV - Candida
Redundant mesentary
32. Painless bleedgin of submucosal veins in lower 1/3 of esophagus
Lipase
Esophageal varices
Lactase is located at the tips of intestinal villi
Lack or have an attenuated muscularis externa - often in the sigmoid colon
33. What receptors does gastrin bind on the parietal cell and What does it activate
Lactase is located at the tips of intestinal villi
CCK8 receptor - Gq inc IP3/Ca
T12
Warthins' tumor
34. What does a gastrinoma cause
Gastrin secreting tumor that causes continuous high levels of acid secretion and ulcers
SGLT1 (Na dependent) glucose - galactose - GLUT 5 fructose (facilitated diffusion)
Lipase - phospholipase A - colipase
Lamina propora and submucosa
35. What is the prognosis of adenocarcinoma
Zollinger ellison - brunners glands
Hirschsprungs
The proximal small bowel
Averages 6 months - very aggressive - usually already metastasized at presentation
36. What are the histological findings in the duodenum
Warning
: Invalid argument supplied for foreach() in
/var/www/html/basicversity.com/show_quiz.php
on line
183
37. What structure is Not contained in the femoral sheath
Gastrin stimulating ECL cells to release histamine - histamine stimulation on parietal cells
Alfatoxin in peanuts
The femoral nerve - only the vein artyer and canal (with deep inguinal lymph nodes)
IgA receives protective secretory component and is then transported across the epithelium to gut lumen
38. What ligament connects the liver to the abdominal wall - What is contained within it and From what structure is it derived
Hirschsprungs
Falciform - ligamentum teres - fetal umbilical vein
Parietal cells in the stomach - decrease pH - inc by histamine - ACH - gastrin - dec by somatostatin - GIP - prostaglandin - secretin
Superior rectal and middle and inferior rectal - rectum
39. what kind of fistula is associated with diverticulitis
Hyperpigmented mouth - lips - hands - genitalia
Colovesical leading to pneumaturia
MSI (15%) and APC/beta catenin chromosomal instability (85%)
Alcohol/Achalasia - Barretts - Cigarettes - Diverticuli (Zenkers) Esophageal web/Esophagitis - Familial
40. Acute gastritis is caused By what process
Erosive - disruption of mucosal barrier leading to inflammation
Crypts but not villi
L3
With albumin
41. What are the longterm sequelae of nutmeg liver
Ischemic colitis
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
Serous on the sides parotids - mucinous in the middle sublingual
Centrilobular congestion and necrosis - cardiac cirrhosis
42. This disease commonly presents as heartburn and regurg when lying down - What is another common presentation
Low pressure proximal to LES
Closer to isotonic because of less time to reabsorb NaCl
Spleen to posterior abdominal wall - splenic artery and vein
GERD - may also present with nocturnal cough and dyspnea
43. How do burns cause acute gastritis and What is it called
Warning
: Invalid argument supplied for foreach() in
/var/www/html/basicversity.com/show_quiz.php
on line
183
44. What makes a true diverticula
EtOH
Inc size - villous histology - inc epithelial dysplasia - precursor to CRC
All 3 gut layers outpouch as in Meckels
Cigarettes and chronic pancreatitis - not EtOH
45. What transforms conjugated bilirubin to urobilinogen
Penicillinamine - AR inheritance
Largest nimber of goblet cells in the small intestine - plicae circulares and crypts of lieberkuhn
Dysphagia (due to esophageal web) - glossitis - iron def anemia
Gut bacteria
46. How does CRC present in the distal and proximal colon
Air into the biliary tree - if gallstone obstructs ileocecal valve - air can be seen in biliary tree on imaging
Distal colon - obstruction - colicky pain - hematochezia - proximal colon - dull pain - iron deficiency anemia - fatigue
Muscularis mucosae
Decreased intercellular adhesion and increased proliferation
47. reduction in intestinal blood flow causes ischemia - pain after eating - weight loss - occurs at splenic flexure and distal colon - elderly
Bleeding - intussusception - volvulus - obstruction near terminal ileum
Epithelium
GERD - esophagitis - esophageal ulcers - inc risk of esophageal cancer
Ischemic colitis
48. With esophageal varices - between What two vessels is the portosystemic anastomoses and Where is it
Inc risk of CRC and other visceral malignancies
Left gastric vein and esophogeal vein - esophagus
IBS at least 2 with recurrent abdominal pain
Hyperplastic
49. What is the rate limiting step of carbohydrate digestion
Fundus/body - autoimmune - autoantibodies to parietal cells - perncious anemia - and achlorhydria
Crigler - najjar type 1
Oligosaccharide digestion
IgA receives protective secretory component and is then transported across the epithelium to gut lumen
50. What are the tumor markers for pancreatic adenocarcinoma
Volvulus
CEA - CA-19-9
Alk phos
3 waves/min