STEP 1 Content Outline

Gastrointestinal System


Normal processes

  • embryonic development, fetal maturation, and perinatal changes
  • organ structure and function, including alimentary canal, liver and biliary system, salivary glands and exocrine pancreas, motility, and digestion and absorption
  • cell/tissue structure and function
    • endocrine and neural regulatory functions, including GI hormones
    • salivary, gastrointestinal, pancreatic, hepatic secretory products, including enzymes, proteins, bile salts, and processes
    • synthetic and metabolic functions of hepatocytes
  • repair, regeneration, and changes associated with stage of life
  • gastrointestinal defense mechanisms and normal flora

Abnormal processes

  • infectious, inflammatory, and immunologic disorders
    • infectious disorders (eg, peritonitis, hepatitis, gingivostomatitis, peptic ulcer, gastritis, esophagitis, traveler’s diarrhea, food poisoning)
    • inflammatory disorders (eg, cholecystitis, pancreatitis)
    • immunologic disorders (eg, Crohn disease, ulcerative colitis)
  • traumatic and mechanical disorders
    • malocclusion
    • hiatus hernia
    • obstruction (eg, volvulus, intussusception, esophageal atresia, annular pancreas, postsurgical obstruction)
    • perforation of hollow viscus and blunt trauma
    • inguinal, femoral, and abdominal wall hernias
    • esophageal and intestinal diverticula (eg, Meckel diverticulum)
  • neoplastic disorders, including benign and malignant
  • metabolic and regulatory disorders (eg, motility disorders, malabsorption, hepatic failure, cholelithiasis)
  • vascular disorders (eg, portal hypertension, hemorrhoids, ischemia, angiodysplasia)
  • systemic disorders affecting the gastrointestinal system

Principles of therapeutics

  • mechanisms of action, use, and adverse effects of drugs for treatment of disorders of the gastrointestinal system
    • treatment and prophylaxis of peptic ulcer disease and gastroesophageal reflux (eg, antacids, antisecretory drugs, motility drugs, mucosal protective agents, antibiotics)
    • drugs to alter gastrointestinal motility (eg, cathartics, antidiarrheal drugs, antiemetic drugs, prokinetic drugs)
    • fluid replacement (eg, oral rehydration)
    • pancreatic replacement therapy and treatment of pancreatitis
    • drugs for treatment of hepatic failure (eg, lactulose) and biliary disease (eg, drugs to dissolve gallstones)
    • anti-inflammatory, immunosuppressive, antineoplastic, and antimicrobial drugs
  • other therapeutic modalities (eg, surgical procedures, stents, feeding tubes)

Gender, ethnic, and behavioral considerations affecting disease treatment and prevention, including psychosocial, cultural, occupational, and environmental

  • emotional and behavioral factors (eg, peptic ulcer, encopresis, Monday morning stomach)
  • influence on person, family, and society (eg, inflammatory bowel disease, irritable bowel disease, pancreatitis and alcohol, chronic laxative abuse)
  • occupational and other environmental risk factors
  • gender and ethnic factors (eg, diets)