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GIGU Exam 1 > 11: GI Secretions And Exocrine Pancreas > Flashcards

11: GI Secretions And Exocrine Pancreas Flashcards

1
Q

Parotid gland secretion contents

A

Water, ions, enzymes (amylase rich)

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2
Q

Submaxillary and sublingual gland secretion

A

Aqueous fluid + mucin glycoproteins

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3
Q

How does saliva compare to plasma?

A

Hypotonic; higher in K and bicarb but lower in Na and Cl

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4
Q

Salivary ductal cell mechanism for absorbing NaCl and secreting K and bicarb

A
  1. Na/K ATPase utilization to form gradient
  2. Cotransport of bicarb + Na into ductal cell
  3. Bicarb enters lumen as chlorine enters ductal cell
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5
Q

Salivary gland innervation

A

Both symp and parasymp stimulate it, but parasymp dominates

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6
Q

What does Omeprazole block? What’s the point?

A

Blocks H/K ATPase in parietal cells -> H cant enter lumen from cell

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7
Q

What does atropine block?

A

Direct pathway where vagus nerve stimulates parietal cells

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8
Q

What two things can cause lack of intrinsic factor?

A

Absence of parietal cells, achlorydia

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9
Q

Pernicious anemia

A

Stomach doesn’t produce enough IF, so decreases B12 absorption

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10
Q

Four common causes of pernicious anemia

A
  1. Atrophic gastritis
  2. Autoimmune metaplastic atrophic gastritis
  3. Gastrectomy
  4. Gastric bypass
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11
Q

Atrophic gastritis

A

Chronic inflammation of stomach mucosa -> loss of parietal cells

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12
Q

Why can gastric bypass cause pernicious anemia?

A

Loss of stomach, duodenum, and jejunum from B12 absorption

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13
Q

Two main parts of the stomach’s mucosal barrier

A

Mucus, bicarb

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14
Q

Four things that protect the mucosal barrier

A
  1. Prostaglandins
  2. Blood flow
  3. Gastrin
  4. GFs
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15
Q

8 things that damage the mucosal barrier

A
  1. Stress
  2. Acid
  3. Pepsin
  4. NSAIDs
  5. H pylori
  6. Alcohol
  7. Smoking
  8. Bile
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16
Q

Two component model for gastric secretion

A
  1. Parietal secretions: H and K and Cl - slightly hyperosmotic
  2. Non-parietal secretions: basal alkaline secretion at constant low volume made of Na, Cl, and bicarb
17
Q

Potentiation

A

combined response of 2 stimulants exceeds sum of individual responses

18
Q

Gastrinoma

A

duodenal or pancreatic NE tumors that secrete gastrin

19
Q

What causes Zollinger-Ellison Syndrome

A

Gastrinomas

20
Q

How do gastrinomas work?

A

Cause increased H secretion by parietal cells -> enzymes in SI are overwhelmed

21
Q

Four effects of excess H in duodenum in Zollinger-Ellison Syndrome

A
  1. Inactivates pancreatic digestive enzymes -> les digestion
  2. Inhibits absorption of Na and water -> diarrhea
  3. Interferes with fat emulsification -> steatorrhea
  4. Damages intestinal villi -> ulcers
22
Q

How to test for Zollinger-Ellison Syndrome

A

Secretin stimulation test: inject secretin -> paradoxical increase in gastrin

23
Q

Two mechanisms of peptic ulcer disease

A
  1. Loss of mucosal barrier

2. Excess H and pepsin

24
Q

Main causes of gastric vs duodenal ulcers

A

Gastric: defective mucosal barrier
Duodenal: high H secretion rates

25
Q

Which type of peptic ulcer is more common?

A

Duodenal

26
Q

H pylori mechanism

A

Release cytotoxins like urease that breakdown mucosal barrier and underlying cells

27
Q

How does urease from H pylori work?

A

Converts urea to ammonia -> alkalizes the environment -> damage

28
Q

Diagnostic test for peptic ulcer disease

A

Based on urease activity

29
Q

Three things that stimulate I cells to produce CCK

A
  1. Phenylalanine
  2. Peptides and AAs
  3. FAs
30
Q

Sympathetic innervation to exocrine pancreas

A

Post-ganglionic s from celiac and superior mesenteric plexuses

31
Q

Parasymp innervation to exocrine pancreas

A

Vagus nerve, with a ganglionic synapse in the ENS

32
Q

What causes cystic fibrosis

A

Mutation in CFTR, a Cl channel

33
Q

One of the first organs to fail in cystic fibrosis

A

Pancreas

34
Q

What can CFTR cause in the pancreas

A

Loss of bicarb secretions + inability to flush active enzymes out of pancreatic ducts -> can cause acute or chronic pancreatitis

GIGU Exam 1 (22 decks)

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