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GEM > 2.06 GI Secretions & Asorption > Flashcards

2.06 GI Secretions & Asorption Flashcards

1
Q

How is the stomach antrum different from the corpus/body in terms of what cells it has?

A

No parietal cells
Endocrine Cells

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2
Q

What does gastric fluid look like in a low secretion or low gastric acid state?

A

Resembles plasma electrolyte composition (pH 6-7)
High Na+ and Low H+ b/c non parietal cells

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3
Q

What does gastric fluid look like in a high gastric acid or high secretion state?

A

Low pH (1-2), H+ secreted by parietal cells (HCL) rather than NaCl , b/c increase in gastrin and Histamine signaling

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4
Q

What does the parietal cells have that allows it to increase its surface are when cell is stimulated?

A

Tubulovesicular structures (canaliculus when active)

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5
Q

Where do the H+ ions pumped out by the parietal cells come from?

A

Passive uptake of CO2 and H20 (OH) that gets converted by carbonic anhydride to HCO3- (bicarb/Cl- exchanger) and H+

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6
Q

What helps regulate parietal cell pH levels at the basal state?

A

Na-H exchanger

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7
Q

What are three things that acts synergistically to release H+ from parietal cells?

A

Ach
Histamine
Gastrin

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8
Q

Where does Ach come from and bind to directly act on parietal cells?

A

Ach from vagus binds to M3 receptor

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9
Q

Where does gastrin come from and what does it bind to in order to directly stimulate parietal cells?

A

Gastrin from G cells to CCK2 receptor

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10
Q

Where does Histamine come from and what does it bind to in order to active parietal cells?

A

His from ECL cell binds to H2 receptor

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11
Q

What are H2 blockers that act as competitive antagonists to block Histamine?

A

Cimetidine & Ranitidine

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12
Q

What are indirect ways to activate the parietal cell?

A

All through the ECL cells
Ach to M3 to release His
Gastrin to CCK2 to release His

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13
Q

Condition that results in gastric hypersecretion that can lead to peptic ulcers and gastrinomas?

A

Zollinger Ellison Syndrome

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14
Q

How does high gastrin both directly and indirectly acts on pathways?

A

Direct = CCK2 on parietal
Indirect = ECL stimulation

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15
Q

What is the endocrine cels responsible for relabeling gastrin?

A

G cells

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16
Q

What is the endocrine cell responsible for the inhibition of gastrin release?

A

D cell

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17
Q

What are the stimuli for gastrin release?

A

Food (luminal peptides and amino acids) and Neuronal (direct vagal or D cells)

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18
Q

What is the stimuli for the inhibition of gastrin?

A

Gastrin activates CCK2 on C cells and stimulated tor release Somatostatin that inhibits G cells & partial cells

19
Q

What cells works to inhibit the release of gastrin?

A

D cells

20
Q

What inhibits the release of somatostatin from D cells?

A

Ach on M3 receptor (D cells)

21
Q

What is GRP>

A

Gastrin releasing peptide activated by vagus and directly stimulates G cell

22
Q

The D cell in the antrum has what pathway source?

A

Endocrine

23
Q

The D cell in the corpus has what pathway source?

A

Paracrine

24
Q

What is the stimuli that inhibits gastric acid secretion?

A

Fat, acid, and hyperosmolar solution in the duodenum!

25
Q

What is the most potent stimuli to inhibit gastric acid release?

A

Fat

26
Q

Where does secretin come from?

A

S cells from duodenum and jejunum

27
Q

Where does CCK come from?

A

I cells from duodenum and jejunum

28
Q

Where does gastric inhibitory peptide (GIP) come from?

A

K cells from duodenum and jejunum response to nutrients

29
Q

Where does peptide YY come from?

A

L cells in distal intestine

30
Q

What are the direct effects of secretion?

A

Down regulate H/K atpase pump from parietal cells and inhibit gastrin release form G cells

31
Q

What are teh indirect affects of secretin?

A

Stimulate D cells to release somatostatin that further inhibits acid secretion

32
Q

What stimulates the release of prostaglandin E2?

A

Increased luminal acid exposure

33
Q

What does prostaglandin E2 INdirectly do?

A

Bind to EP3 on BL membrane to inhibit AC and prevent AMP increase and blocked H2 receptor pathway (not receptor)

Indirect inhib His and gastrin release

34
Q

What drug activates the EP3 receptor to indirectly inhibit H/K ATPase?

A

Misoprostol

35
Q

What does ingesting food do to the gastric acid?

A

Decreases cause it buffers it, it increases as food leaves the stomach to the standard 1-2.5 pH

36
Q

What do chief cells do?

A

Release pepsinogen (inactive)

37
Q

What converts pepsinogen to pepsin?

A

HCL

38
Q

When does pepsin become inactive?

A

When it reaches duodenum cause of higher pH

39
Q

What does pepsin do?

A

Breakdown proteins into AA at stomach

40
Q

What stimulates chief cells to release pepsinogen?

A

Ach from vagal, gastrin from G cells, local cholinergic reflex triggered by low pH, secretin from S cells

41
Q

Where is B12 absorbed?

A

Ilium

42
Q

Where is IF secreted?

A

Parietal cells

43
Q

Damage to what can contribute to loss of acid secretion and loss of IF?

A

Parietal cells

44
Q

Unvaccinated child under <5 years with watery diarrhea and viral origin should hint at?

A

Rotavirus

GEM (28 decks)

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