GI

Question 1

rostral fold closure defect

Answer 1

sternal defect (ectopic cordis)

Question 2

gastroschisis

Answer 2

abdominal contents through folds, not covered by anything

Question 3

omphalocele

Answer 3

protrusion of abdominal contents, covered by peritoneum

Question 4

jejunal and ileal atresia

Answer 4

from disruption of mesenteric vessels - ischemic necrosis - segmental resorption

Question 5

exposure risk in hypertrophic pyloric stenosis

Answer 5

macrolides

Question 6

ventral pancreatic buds form

Answer 6

uncinate process and main pancreatic duct

Question 7

dorsal pancreatic bud forms…

Answer 7

body, tail, isthmus, and accessory duct

Question 8

spleen embryonic origin…

Answer 8

mesentery of stomach, has foregut supply

Question 9

retroperitoneal structures

Answer 9

Suprarenal glands
Aorta
Duodenum
Pancreas
Ureters
Colon (descending/ascending)
Kidneys
Esophagus
Rectum

Question 10

falciform ligament

Answer 10

connects liver to anterior abdominal wall

- contains ligamentum teres hepatis (remnants of umbilical vein)

Question 11

hepatoduodenal ligament

Answer 11

connects liver to duodenum

- contains portal triad

Question 12

gastrohepatic ligament

Answer 12

connects liver to lesser curvature of stomach

- contains gastric arteries

Question 13

layers of gut wall

Answer 13

mucosa - epithelium, lamina propria, muscularis mucosa
submucosa - contains Meissner
muscularis externa - myenteric (Auerbach plexus)
serosa or adventitia

Question 14

erosions

Answer 14

mucosa only

Question 15

brunner glands

Answer 15

secrete bicarb in duodenum

Question 16

paneth cells

Answer 16

in duodenum, secrete defensins and lysozymes and TNF

Question 17

plicae circulares

Answer 17

mostly in jejunum

Question 18

histology of colon

Answer 18

abundant goblet cells

Question 19

what causes SMA syndrome

Answer 19

decrease in mesenteric fat (low body weight and poor nutrition) - blockage of third part of duodenum

Question 20

parasympathetic innervation of gut

Answer 20

first 2/3 = vagus

last 1/3 = pelvic

Question 21

branches of celiac artery

Answer 21

left gastric, common hepatic, splenic

Question 22

posterior duodenal ulcers penetrate…

Answer 22

gastroduodenal artery

Question 23

three veins involved in portal HTN

Answer 23

• left gastric to azygous
• paraumbilical to epigastric
• superior rectal to middle/inferior rectal

Question 24

TIPS

Answer 24

shunt blood from portal vein to hepatic vein

Question 25

venous drainage from above anal pectinate line

Answer 25

superior rectal vein to inferior mesenteric to splenic to portal (can cause internal hemorroids

Question 26

arterial supply from anus above pectinate line

Answer 26

superior rectal artery

Question 27

location of anal fissures

Answer 27

posterior - poorly perfused

Question 28

hepatic stellate cells

Answer 28

store vitamin A and product ECM

Question 29

things affecting liver zone 1

Answer 29

- viral hepatitis | - ingested toxins

Question 30

things affecting liver zone II

Answer 30

yellow fever

Question 31

things affecting liver zone III

Answer 31

ischemia p450 metabolic toxins alcoholic hepatitis

Question 32

mnemonic for remembering spermaticord

Answer 32

ICE tie - internal spermatic fascia - transversalis fascia - cremasteric muscle and fascia - internal oblique - external fascia - external oblique

Question 33

indirect inguinal hernia

Answer 33

lateral to inferior epigastric arteries, failure of processus vaginalis to close

Question 34

direct inguinal hernia

Answer 34

through hasselbachs triangle - medial to inferior epigastric arteries, lateral to rectus abdominis

Question 35

hesselbach triangle

Answer 35

inferior epigastric arteries, rectus abdominis, inguinal ligament

Question 36

gastrin

Answer 36

- secreted by G cells - increased H+ and stomach motility - release from GRP, stomach distension, contents, decrease with high acid - large increase in Zollinger-Ellison syndrome

Question 37

somatostatin

Answer 37

- secreted by D cells in pancreas - decreases secretion of everything - secreted with high acid and low vagal stimulation - octreotide = analog

Question 38

octreotide

Answer 38

analog of somatostatin

Question 39

CCK

Answer 39

- secreted by I cells in small bowel - increase in pancreatic secretion, gallbladder contraction, oddi relaxation - secreted b/c fatty acid and amino acids - acts on muscarinic pathways

Question 40

secretin

Answer 40

- secreted by S cells in duodenum - increases pancreatic bicarb, decrease stomach acid, increased bile secretion - caused by acid in lumen of duodenum - allows enzymes to function

Question 41

GIP (glucose dependent insulinotropic peptide)

Answer 41

- K cells in duodenum - decreases H secretion and increases insulin release - increased by acids and glucose - oral glucose leads to higher insulin because of this

Question 42

VIP

Answer 42

- leads to relaxation of smooth muscles and sphincters | - increase in intestinal water and electrolyte secretion

Question 43

NO

Answer 43

relaxation of LES, implicated in achalasia

Question 44

ghrelin

Answer 44

hunger hormone, increased in Prader-Willi, decreased in gastric bypass

Question 45

intrinsic factor

Answer 45

secreted by parietal cells, leads to B12 absorption in terminal ileum

Question 46

pepsin

Answer 46

secreted by chief cells in stomach, starts protein digestion

Question 47

low vs high flow of pancreas

Answer 47

``` low = high Cl- high = high bicarb ```

Question 48

glucose and fructose absorption

Answer 48

glucose - SGLT1 (Na dependent) | fructose - facilitated diffusion by GLUT2

Question 49

iron is absorbed in...

Answer 49

duodenum

Question 50

folate is absorbed in...

Answer 50

small bowel

Question 51

b12 is absorbed in...

Answer 51

terminal ileum, along with bile salts

Question 52

menetrier disease

Answer 52

hyperplasia of gastric mucosa, hypertrophied rugae, too much mucus, parietal cell atrophy with less acid production - precancerous