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NBME High Yield

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What are sentinel lymph nodes? - First group of lymph nodes draining a specific organ Describe the lymph node drainage of the GI tract - *Trachea and esophagus = Mediastinal *Liver, spleen, pancreas, stomach, upper duodenum = Celiac *Lower duodenum, jejunum, ilecum, colon to splenic flexure = SMA *Colon from splenic flexure to upper rectum = IMA *Lower rectum to anal canal (above pectinate line) =Internal Iliac Anal rectum (below pectinate line) =Superficial inguinal What is the mechanism by which Lactulose is used to treat Hepatic Encephalopathy? - *Lactulose is resistant to intestinal disaccharides *Metabolized by gut flora into lactic and formic acid. *These acids have an osmotic/laxative effect and cause an acidifying effect *Acids also cause NH3 to be trapped as NH4+ and cannot cross intestinal wall; excreted into feces What antimuscarinics are used to prevent postprandial abdominal pain of IBS patient - Hyoscyamine,dicyclomine Which drugs are contraindicated in patients with glaucoma? - Drugs that cause mydriasis: A1 agonists or M3 antagonists (antimuscarinics) A1 agonists: Epinephrine M3 antagonists:Atropine and other antimuscarinics Mydriasis pulls the iris to it's base, making the angle narrow


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