Human Biology Overview Quiz

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Questions and Answers

What is the primary mode of transmission for HCV?

  • Oral contact with contaminated water
  • Sexual contact with an infected partner
  • Inhalation of infected respiratory droplets
  • Percutaneous exposures, particularly through injection drug use (correct)

Which cells in the pancreatic islets are primarily responsible for insulin production?

  • Delta cells
  • Alpha cells
  • Acinar cells
  • Beta cells (correct)

What is the role of acinar cells in the pancreas?

  • Store bile for digestion
  • Regulate blood glucose levels
  • Release hormones into the bloodstream
  • Synthesize digestive enzymes (correct)

What is the main anatomical feature that drains pancreatic enzymes into the duodenum?

<p>Main pancreatic duct of Wirsung (C)</p> Signup and view all the answers

What is the rank of colorectal cancer among commonly diagnosed cancers in the United States?

<p>Third (A)</p> Signup and view all the answers

What does a venous hum indicate regarding blood circulation?

<p>Increased collateral circulation (C)</p> Signup and view all the answers

Which condition is indicated by the presence of a hepatic bruit?

<p>Hepatic cirrhosis (B)</p> Signup and view all the answers

When auscultating for bowel sounds, how long should you listen before concluding they are absent?

<p>2 minutes (D)</p> Signup and view all the answers

What does tympany over the gastric air bubble typically indicate?

<p>Presence of air (B)</p> Signup and view all the answers

During light palpation of the abdomen, what should be identified?

<p>Superficial organs and areas of tenderness (A)</p> Signup and view all the answers

What is suggested by the presence of arterial bruits with both systolic and diastolic components?

<p>Partial occlusion of large arteries (D)</p> Signup and view all the answers

What is considered a rare finding that points to situs inversus?

<p>Organ reversal with liver on the right (B)</p> Signup and view all the answers

What technique is employed during light palpation of the abdomen?

<p>Gentle dipping motion with flat fingers (B)</p> Signup and view all the answers

What does borborygmi indicate in the gastrointestinal tract?

<p>Prolonged gurgles or rumbling due to hyperperistalsis (D)</p> Signup and view all the answers

What does the presence of tympany throughout a protuberant abdomen suggest?

<p>Intestinal obstruction or paralytic ileus (D)</p> Signup and view all the answers

What condition might be indicated by dull areas suggesting possible ascites?

<p>Fluid accumulation in the abdominal cavity (D)</p> Signup and view all the answers

What should be done when identifying abdominal bruits during examination?

<p>Listen for turbulent flow over the aorta (C)</p> Signup and view all the answers

Which of the following is a possible associated condition with the presence of friction rubs?

<p>Pancreatic carcinoma (B)</p> Signup and view all the answers

What might dullness in both flanks during abdominal percussion indicate?

<p>Presence of ascites (C)</p> Signup and view all the answers

What does scattered dullness in the abdomen typically suggest?

<p>Underlying mass or enlarged organ (B)</p> Signup and view all the answers

What should be noted when percussion reveals a change from tympany to dullness?

<p>Presence of solid posterior structures (D)</p> Signup and view all the answers

What characterizes the Immune-Active Phase of iron overload?

<p>High ALT and active inflammation (D)</p> Signup and view all the answers

Which iron accumulation amount is typically seen in cases of excessive body iron?

<p>50 gm (C)</p> Signup and view all the answers

In which phase is HBsAg positive and minimal inflammation noted?

<p>Inactive Carrier Phase (C)</p> Signup and view all the answers

What is often a consequence of fully developed hemochromatosis in patients?

<p>Cirrhosis (C)</p> Signup and view all the answers

Which condition is associated with autoimmune hepatitis?

<p>Increased iron storage in tissues (A)</p> Signup and view all the answers

Which viral infection is known for causing infectious mononucleosis?

<p>Epstein-Barr Virus (EBV) (B)</p> Signup and view all the answers

What is the primary treatment for autoimmune hepatitis?

<p>Corticosteroids and azathioprine (A)</p> Signup and view all the answers

What percentage of patients with hemochromatosis typically develops diabetes mellitus?

<p>75% to 80% (B)</p> Signup and view all the answers

What is the primary location of the sphincter of Oddi?

<p>In the second part of the duodenum (A)</p> Signup and view all the answers

Which of the following is NOT considered a strong risk factor for colorectal cancer?

<p>Increased tobacco use (B)</p> Signup and view all the answers

What is the most effective prevention strategy for colorectal cancer?

<p>Screening for and removing adenomatous polyps (C)</p> Signup and view all the answers

What do cuboidal cells lining the smaller ductules secrete?

<p>Bicarbonate-rich fluid (B)</p> Signup and view all the answers

What is the function of the CFTR protein expressed by columnar cells lining larger ducts?

<p>Affects the viscosity of pancreatic secretions (A)</p> Signup and view all the answers

Which screening method is used to detect colorectal cancer early?

<p>Fecal blood testing (C)</p> Signup and view all the answers

What catastrophic event can occur due to autodigestion of the pancreas?

<p>Pancreatitis (C)</p> Signup and view all the answers

In which part of the digestive system is the sphincter of Oddi located relative to the pylorus?

<p>Approximately 7-10 cm from the pylorus (A)</p> Signup and view all the answers

What is a critical reason for differentiating autoimmune pancreatitis from neoplasia?

<p>Autoimmune pancreatitis can respond to steroid therapy. (D)</p> Signup and view all the answers

Which mutation is commonly associated with invasive neoplasms arising from mucinous cystic neoplasms?

<p>TP53 mutation (C)</p> Signup and view all the answers

What characteristic differentiates a pancreatic pseudocyst from other pancreatic cysts?

<p>Formation due to fibrosis and granulation tissue (D)</p> Signup and view all the answers

In which population are intraductal papillary mucinous neoplasms (IPMNs) more frequently found?

<p>Men (C)</p> Signup and view all the answers

Which feature is used to differentiate intraductal papillary mucinous neoplasms from mucinous cystic neoplasms?

<p>The absence of dense 'ovarian' stroma (A)</p> Signup and view all the answers

What percentage of pancreatic cysts are pancreatic pseudocysts?

<p>75% (A)</p> Signup and view all the answers

What is a commonly observed mutation in mucinous cystic neoplasms?

<p>KRAS mutation (D)</p> Signup and view all the answers

How many years do patients with an invasive adenocarcinoma arising in a mucinous pancreatic carcinoma typically succumb to their disease?

<p>5 years (D)</p> Signup and view all the answers

Flashcards

Borborygmi

Prolonged gurgles or rumbling sounds in the abdomen, caused by increased bowel activity.

Bruits

Turbulent sounds heard over arteries, indicating abnormal blood flow.

Friction Rubs (abdomen)

Infrequent, grating sounds over abdominal organs, associated with inflammation or infection.

Abdominal Tympany

A hollow, drum-like sound upon percussion, mostly caused by air.

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Protuberant Abdomen with Tympany

A bulging abdomen with widespread hollow, drum-like percussion sounds, potentially indicating intestinal obstruction.

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Ascites

Abnormal fluid accumulation in the abdomen.

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Dullness on Percussion (Abdomen)

A muffled sound upon percussion, indicating the presence of solid structures or fluid.

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HCV Transmission

HCV is primarily spread through percutaneous exposures, such as injection drug use or needlestick injuries in healthcare workers, or mucosal exposure to HCV-positive blood.

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HCV Screening

Screening tests for HCV are highly sensitive.

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Colorectal Cancer

The third most common cancer in men and women worldwide.

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Pancreas Endocrine

The pancreas' endocrine portion comprises islets of Langerhans (cells), producing insulin, glucagon, and somatostatin.

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Pancreas Exocrine

The exocrine portion of the pancreas contains acinar cells that produce digestive enzymes.

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Pancreatic Enzymes

Pancreatic enzymes from the pancreatic duct mix with bile in the hepatopancreatic ampulla.

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Tympany over Gastric Air Bubble

A hollow, drum-like sound heard when percussing the area, typically over the stomach's gas.

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Situs Inversus

An anomaly where organs are reversed, like air bubble on the right and liver dullness on the left.

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Increased Bowel Sounds

Loud bowel sounds, often related to diarrhea or early intestinal blockage.

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Decreased/Absent Bowel Sounds

Quiet or no bowel sounds, suggesting poor movement or infection.

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Venous Hum

A soft, humming noise heard during both systole and diastole, linking portal and systemic veins.

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Hepatic Bruit

A whooshing sound over the liver; sign of liver cancer or cirrhosis.

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Arterial Bruit

A whooshing sound related to partially blocked arteries.

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Light Palpation

Gentle touch to feel for tenderness, organs and masses.

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Abdominal Tenderness

Pain or discomfort in the abdomen.

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Abdominal Muscular Resistance

The extent to which abdominal muscles resist palpation.

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Superficial Organs

Organs that lie relatively close to the surface of the body.

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Masses (abdomen)

Solid lumps or growths in the abdomen.

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Hernias

Protrusions of organs through weak points in the abdominal wall.

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Colorectal Cancer Risk Factors

Increasing age, personal history, adenomatous polyps, inflammatory bowel disease (IBD), and family history are key risk factors for colorectal cancer.

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Colorectal Cancer Prevention

Screening and removing precancerous polyps is the most effective prevention strategy.

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Pancreatic Duct Opening

The ampulla of Vater (Sphincter of Oddi) is the opening of the pancreatic duct into the duodenum.

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Pancreatic Secretion Cells

Cuboidal cells produce bicarbonate-rich fluid, while columnar cells produce mucus and contain CFTR.

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Pancreatic Autodigestion

Pancreatic autodigestion (e.g., in pancreatitis) can be harmful.

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Autoimmune pancreatitis

A disorder where the pancreas's immune system attacks its own tissues. It can mimic pancreatic cancer, requiring distinction.

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Mucinous cystic neoplasms

Tumors in the pancreas producing mucus and cysts. Often contain mutations and high risk of turning cancerous.

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Pancreatic pseudocysts

Fluid-filled sacs in the pancreas formed from walled-off damaged tissue, missing an epithelial lining.

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Intraductal papillary mucinous neoplasms (IPMNs)

Mucin-producing tumors that affect the larger pancreatic ducts. Often more frequent in men than mucinous cystic neoplasms.

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Pancreatic Carcinoma

Cancer of the pancreas, which can resemble other pancreatic conditions.

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KRAS mutations

Mutations of the KRAS oncogene, frequently found in mucinous cystic neoplasms.

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TP53 mutations

Mutations in the TP53 tumor suppressor gene, often found in invasive growths, arising from cysts.

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SMAD4 mutations

Mutations in the SMAD4 gene, often observed in invasive pancreatic neoplasms.

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RNF43 mutations

Mutations of RNF43, an E3 ubiquitin ligase potentially affecting Wnt signaling, found in some mucinous cystic neoplasms/colorectal cancers.

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Iron Overload

Excessive accumulation of iron in the body, often due to excessive intestinal absorption.

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Iron Overload Organs

Iron accumulates primarily in the liver, pancreas, and heart.

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Primary Iron Overload

Inherited autosomal recessive disorder (HFE gene mutation).

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Secondary Iron Overload

Iron accumulation due to factors like transfusions or ineffective erythropoiesis.

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Autoimmune Hepatitis

Chronic liver inflammation caused by the immune system attacking liver cells.

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Autoimmune Hepatitis Markers

Presence of certain autoantibodies in the blood (e.g., ANA, SMA, anti-LKM1).

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Autoimmune Hepatitis Treatment

Treated with corticosteroids and azathioprine.

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Viral Liver Infections

Infections from certain viruses can cause liver inflammation (hepatitis).

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HBV-Chronic Hepatitis Stages

Four stages ranging from minimal inflammation to reactivation, impacting HBV DNA and ALT levels.

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Study Notes

Gastrointestinal System 2

  • Jaundice (icterus) is a yellowish discoloration of skin and sclerae caused by elevated bilirubin levels.
  • Jaundice is usually noticeable when plasma bilirubin exceeds 3 mg/dL.
  • Jaundice can have a greenish tinge if bilirubin is oxidized to biliverdin.
  • Increased bilirubin production (e.g., hemolytic anemia), reduced uptake/conjugation by hepatocytes, and decreased excretion can lead to jaundice.
  • Intrahepatic jaundice involves liver cell damage or impaired bile duct function.
  • Extrahepatic jaundice stems from bile duct obstruction (e.g., gallstones, tumors).
  • Painless jaundice suggests malignant obstruction (e.g., bile duct or pancreatic cancer).

Physical Examination: General Approach

  • Position patient supine with pillow support.
  • Observe patient's general appearance (demeanor, distress).
  • Inspect for skin temperature, color, discolorations.
  • Listen to bowel sounds prior to palpation or percussion.
  • Percuss to assess tympany and dullness in quadrants.
  • Lightly palpate for tenderness and masses.
  • Deep palpate to check for masses, liver/spleen edge, or rebound tenderness.

Techniques of Examination

  • Inspect appearance, contour, and movements of the abdomen.
  • Palpate lightly for tenderness, masses, and rigidity, in all quadrants.
  • Deep palpate with two hands, noting liver edge, masses, tenderness, and pulsations.
  • Check for peritonitis with guarding, rigidity, and rebound tenderness.
  • Percuss to detect splenic enlargement in Traube space.
  • Check for costovertebral angle (CVA) tenderness, using fist percussion if needed.

Bowel Sounds

  • Normal sounds: Clicks and gurgles (5-34 per minute).
  • Hypoactive: (<5 per minute)
  • Hyperactive: (>34 per minute).
  • Auscultate abdominal region for suspected pain location.

Skin Inspection

  • Note skin temperature, color, and presence of scars or striations (stretch marks).
  • Evaluate any bruising, erythema, or jaundice.
  • Assess for dilated veins, indicating portal hypertension.
  • Note presence of rashes or ecchymoses, (bruising) in intra/retroperitoneal hemorrhage.

Localized Abdominal Wall Bulges

  • Note umbilical, incisional, epigastric hernias, and diastasis recti.
  • Examine for hernias by palpating affected areas with Valsalva maneuver.
  • Assess diastasis recti (separation of rectus muscles) in supine patients.

Abdominal Masses

  • Note symmetry or asymmetry of the abdomen.
  • Note possible cause of asymmetry, like hernias, enlarged organs, or masses.
  • Look for enlarged liver or spleen protruding below the rib cage.
  • Look for lower abdominal masses or hernias.
  • Be aware of the possibility of a lipoma (benign fatty tumor).

Peritoneal Signs

  • Evaluate for guarding, rigidity, and rebound tenderness.
  • Guarding = voluntary contraction diminishes with distraction.
  • Rigidity =reflex contraction (suggests peritonitis) persisting through examinations.
  • Rebound tenderness = pain when pressure is quickly released, suggestive of peritonitis.

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