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Mercy CLS 5: Chemistry > 19a) GI function > Flashcards

19a) GI function Flashcards

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1
Q

function of sphincters

A

Serve to compartmentalize the gut

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2
Q

3 major stomach regions

A

Cardiac (with fundus)
Body
Pylorus

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3
Q

cardiac/fundus region secretions

A

mucus
group II pepsinogens

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4
Q

body stomach region secretions

A

mucus (surface epis)
HCl (parietal)
IF (parietal)
groups I and II pepsinogens (chief)
serotonin (enterochromaffin)

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5
Q

areas of pylorus

A

Antrum
Pyloric canal
Sphincter

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6
Q

pyloric region secretions

A

Mucus
Group II pepsinogen
Serotonin
Gastrin
Other hormones

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7
Q

only stomach site of HCl

A

body

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8
Q

surface epi/goblet cells secrete…

A

mucus

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9
Q

parietal cells secrete…

A

HCl
IF

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10
Q

chief cells secrete…

A

groups I and II pepsinogen

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11
Q

enterochromaffin cells secrete…

A

serotonin

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12
Q

delivers bile and enzymes into the duodenum

A

Pancreaticobiliary duct

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13
Q

Nerves located in the gut wall assist in controlling…

A

propulsion and fluid regulation

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14
Q

Involuntary control of GI activities for each region are modulated via …

A

extrinsic neural inputs

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15
Q

2 principal GI functions

A

Assimilation of nutrients
Elimination of waste

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16
Q

sterilizes upper gut

A

gastric acid

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17
Q

Distal stomach has … to propel solid food against the pylorus

A

phasic contractions

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18
Q

contents of pancreatic juice

A

digestive enzymes
bicarbonate

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19
Q

——- absorbs vitamin B12 and bile acids

A

ileum

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20
Q

Small intestines help in waste elimination by removing bile from…

A

erythrocyte degradation
toxins metabolized
unaltered medications
cholesterol

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21
Q

terminal end of SI

A

ileocecal junction

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22
Q

Stool is dehydrated by…

A

colonic mucosa cells

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23
Q

Fermentation of …. in colon by bacterial colonization

A

undigested carbs and short-chain fatty acids

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24
Q

GI regulatory peptides influence…

A
  • Motility
  • Secretion
  • Digestion
  • Absorption
  • Bile flow and secretion of pancreatic hormones
  • Vascular wall tonicity, blood pressure, and cardiac output
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25
Q

main 5 gastric regulatory peptides

A
  • Cholecystokinin
  • Gastrin
  • Secretin
  • Vasoactive intestinal polypeptide
  • Glucose-dependent insulinotropic peptide (gastric inhibitory polypeptide)
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26
Q

Linear polypeptide with multiple molecular forms

A

CKK

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27
Q

CKK

A

cholecystokinin

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28
Q

from I cells of the upper small intestinal mucosa

A

CKK

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29
Q

CKK functions

A
  • Regulates gallbladder contractions
  • Increases motility
  • Stimulates gastric HCL and pepsinogen secretion
  • Pancreatic bicarbonate secretion
  • Pancreatic growth
  • Relaxation of the sphincter of Oddi
  • Secretion from duodenal glands
  • Regulating appetite
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30
Q

Formed after cleavage of a single precursor (———–) which contains 101 amino acids

Molecular forms include big, little, and mini

A

gastrin
preprogastrin

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31
Q

from endocrine cells (G cells) of the antral mucosa

A

gastrin

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32
Q

gastrin functions

A
  • Stimulates release of gastric acid in the stomach
  • Promotes the secretion of pepsinogen and intrinsic factor (IF)
  • Stimulates release of secretin by the small intestine
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33
Q

gastrin released in response to…

A
  • Antral distention (stomach stretching)
  • Amino acids, peptides, and polypeptides from partially digested proteins in the stomach

also…
Alcohol
Caffeine
Insulin-induced hypoglycemia
Infusion of calcium
Stimulation of the vagus nerve caused by smelling, tasting, chewing, and swallowing food

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34
Q

from granular S cells located primarily in the duodenum

A

secretin

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35
Q

secretin function

A
  • Stimulates the pancreas to secrete an increased volume of fluid with high bicarbonate content
  • Stimulates PTH
  • Inhibits gastrin secretion
  • Reduces motility
  • Reduces insulin
36
Q

VIP

A

Vasoactive Intestinal Polypeptide

37
Q

secretin released in response to…

A

gastric HCL coming into contact with S cells

38
Q

neurotransmitter from nervous system and gut

short duration of action

A

VIP

39
Q

VIP functions

A
  • Vasodilation and relaxation of smooth muscles of the circulatory and genitourinary systems and the gut
  • Increase water and electrolyte secretion from the pancreas and gut
  • Release of hormones from the pancreas, gut, and hypothalamus
  • Inhibition of gastrin and gastric acid secretion
  • Stimulation of lipolysis, glycolysis, and bile flow
40
Q

GIP

A

Glucose-Dependent Insulinotropic Peptide

Gastric Inhibitory Polypeptide

41
Q

from K cells located in the duodenal and jejuna mucosa

A

GIP

42
Q

GIP levels are increased by …

A

oral administration of glucose and triglycerides
intraduodenal infusion of solutions containing a mixture of amino acids

43
Q

GIP functions

A
  • Stimulates insulin secretion (insulinotropic)
  • Increases intestinal fluid and electrolyte secretion
  • Inhibits gastric acid, pepsin, and gastrin secretions
44
Q

characteristics of Zollinger-Ellison

A
  • fulminate peptic ulcers
  • large amounts of gastric hypersecretion
  • non-β-islet-cell tumors of the pancreas
45
Q

….. that secretes gastrin, which causes gastric acid hypersecretion, are related to Z-E syndrome

A

gastrinomas/neuroendocrine tumors

46
Q

Z-E syndrome usually results in…

A

PUD
diarrhea

47
Q

2 causes of PUD

A
  • H. pylori
  • NSAID use
48
Q

Increases HCl production, inflammatory cytokines, tissue necrosis factor-alpha, B-Cell response that consists of IgG and IgA antibodies

A

H.pylori

49
Q

Stool samples will have low pH and contain glucose

A

lactase deficiency

50
Q

Lactase deficiency differential diagnosis requires …. in conjunction with the lactose tolerance test

A

oral glucose tolerance test

51
Q

Disorder that leads to chronic diarrhea when there is…
- ileal disease (Crohn’s disease)
- after resection of the terminal ileum
- cholecystectomy
- IBS

A

bile salt malabsorption

52
Q

bile acids

A

Glycocholic acid and taurocholic acid

Exist as taurine or glycine conjugates (salts)

53
Q

bile acid function

A
  • Act as surface-active agents to form micelles
  • Facilitated digestion of triglycerides
  • Absorption of cholesterol and fat-soluble vitamins
54
Q

Condition in which large amounts of serum proteins pass into the bowel lumen and ultimately into the feces

A

PLE

55
Q

hypoalbuminemia
hypoalbuminuria

A

PLE

56
Q

PLE associated with…(3)

A
  • Inflammation or ulceration of bowel
  • Intestinal lymphatic system is obstructed
  • Altered immune status and some food allergies
57
Q

Characterized by transmural inflammation of the GI tract

A

Crohn’s disease

58
Q

likely to overgrow in SI

A

Escherichia coli and Bacteroides species

59
Q
  • conjugated bile salt deficiency; fat malabsorption
  • B12 deficiency
  • abdominal pain, diarrhea, and steatorrhea
A

bacterial overgrowth in SI

60
Q

Impaired esophageal body peristalsis and incomplete lower esophageal sphincter relaxation

A

achalasia

61
Q

Symptomatic delay in gastric emptying of solids or liquid meals secondary to impaired gastric motility

A

gastroparesis

62
Q

Diffusely impaired colonic propulsion or by outlet abnormalities

A

constipation

63
Q

Result of an inappropriate T-cell-mediated immune response to diet

A

Celiac’s disease (Gluten)

64
Q

toxic parts of gluten to Celiac pts

A

gliadins
hordeins
secalins

65
Q

Leads to intestinal epithelial damage and release of tissue transglutaminase

A

celiac

66
Q

———- cancer (3rd highest for new cases of cancer)
———- cancer (↑ alcohol and tobacco use)

A

colorectal
esophageal

67
Q

Rare, but most common GI neuroendocrine tumor
Age range 20-90 years old, peak 50-70 years

A

carcinoid tumor

68
Q
  • Arise from enterochromaffin cells of the GI tract
  • Appear as well-circumscribed, round, submucosal lesions, and the cut surface appears yellow due to lipid content
A

carcinoid tumor

69
Q

Cells can be stained with potassium chromate (chromaffin) due to the presence of serotonin in the cell

A

carcinoid tumor

70
Q

Classification based on origin: foregut, midgut, hindgut

A

carcinoid tumor

71
Q

lab tests for PUD

A
  • Helicobacter pylori biopsy
  • serum IgA, IgG
  • cytotoxic associated antigen A (CagA)
  • NSAID levels
72
Q

celiac lab tests

A
  • Gliadin antibodies (IgA & IgG)
  • IgA-antitissue transglutaminase antibody
  • IgA-endomysial antibody
73
Q

Z-E syndrome lab tests

A

Basal acid output
gastrin

74
Q

carcinoid tumor lab test

A

5-hydroxyindolacetic acid

75
Q

PLE lab test

A

Alpha-1-antitrypsin

76
Q

High Fasting gastrin levels >500 pg/mL (<100)
High Basal gastric acid output >25 mmol/h (2-5 mmol/h)

A

Z-E syndrome

77
Q

Urea breath tests use radio-labeled carbon or carbon dioxide

A

PUD (H. pylori)

78
Q

POC uses whole-blood to measure IgG antibodies, serum for IgA, IgG, and cytotoxin-associated gene A proteins

A

PUD (H. pylori)

79
Q

lactose tolerance test >30 mg/dL above baseline

A

excludes lactase def.

80
Q

principle of lactose breath hydrogen test

A

Hydrogen is not an end product of mammal metabolism, but breath hydrogen is derived from bacterial metabolism in the intestinal tract that is absorbed into the circulation and exhaled in the breath.

81
Q

lactose breath hydrogen results

A

Normal breath hydrogen: 10 ppm (uL/L)
Lactose malabsorption: >20 ppm (uL/L)

82
Q

Less frequent procedure uses 14C-xylose or 14C-glycocholic acid

A

bacterial overgrowth

83
Q

Whole-body scan after oral synthetic radioactive selenohomocholyltaurine (SeHCAT)

pos?

A

bile salt malabsorption
+ if retention of oral dose <10%

84
Q

Measurement of 7α-hydroxy-4-cholesten-3-one

tandem mass spec

A

bile salt malabsorption

85
Q

fecal clearance of α-1-antitrypsin test

pos?

A

PLE test

PLE patients: Fecal clearance of AAT ↑ and the amount of protein loss ↑

Mercy CLS 5: Chemistry (24 decks)

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