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Question corrections > 29/04 > Flashcards

29/04 Flashcards

1
Q

liver cirrhosis glucose

A

hypoglycaemia- encalopathy

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2
Q

Nodules in the palm of the hands.

A

alcoholic liver disease symptoms

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3
Q

anti 1 antitrypsin deficiency

type of emphysema

A

panacinar

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4
Q

liver cirrhosis histology

A

excess collagen and extracellular matrix deposition in periportal and pericentral zones making regenerative nodules

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5
Q

varicose veins investiagtions

A

duplex US

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6
Q

mesenteric ischaemia, what part affects mostly

A

splenic flexure

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7
Q

Interstitial Cells of Cajal (ICCs)–

A

pacemaker cells located between circular and longitudinal smooth muscle. Determines Max frequency, direction + velocity of rhythmic contractions.

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8
Q

Enteric Nervous system

A

parasympathetic and sympathetic

autonomic

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9
Q

Sympathetic

A

increase sphincter tone. Decreases motility, secretion and blood flow

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10
Q

affarent

A

signals to CNS/pons+medulla

CN 9,10

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11
Q

efferent

A

signals away from CNS

CN12, 9, 10, 11

to pharynx and laynx

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12
Q

parotid

A

innervated by the glossopharyngeal nerve

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13
Q

Formation of saliva

A

Primary secretion by acinar cells then secondary modification by duct cells

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14
Q

cephalic stage of gastric secretion

A

before food reaches stomach

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15
Q

Muscuranic receptor antagonists (e.g. pirenzipine)

A

block competitively M3

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16
Q

H2 histamine receptor antagonists (e.g. ranitidine

A

block competitively (reversible).

17
Q

Proton-pump inhibitors (e.g. omeprazole

A

inhibit active H+/K+ dependent ATPase (proton pump). Must be present in plasma at an effective concentration whilst proton pumps are active

18
Q

NSAIDs (e.g. aspirin

A

block irreversibly cyclo-oxygenase

reduce prostaglandin formation so may trigger gastric ulceration and bleeding

19
Q

BMI

A

Weight (kg) / Square of height (m)

20
Q

adiposity signals (hormones)

A

Leptin (from fat cells), reduced levels mimics starvation causing unrestrained appetite.
-Insulin (pancreatic cells), high levels inhibit food intake and decrease body weight. (Deletion of insulin receptors = obesity)

21
Q

Drug Treatment of Obesity

A

-Orlistat – inhibits pancreatic lipase so decreases triglyceride absorption. (Causes cramping and diarrhoea).
-Contrave (Mysimba) – combination of dopamine re-uptake inhibitor + opioid antagonist
Liraglutide (Saxenda) – Glucagon like peptide 1 receptor agonist (GLP-1 a satiety peptide) injected.
Bariatric Surgery – gastric bypass surgery – weight loss + reduces mortality. Induces resolution of type II diabetes.

22
Q

Carbs

A

starch, cellulose, glycogen, dissacharides

23
Q

lipids

A

triacylglycerols, phospholipids, cholesterol, free fatty acids, lipid vitamins

24
Q

luminal digestion

A

by pancreatic enzymes secreted into the duodenum

25
Q

Absorption

A

where absorbable products are transferred across both apical (brush border) and basolateral membranes of enterocytes

26
Q

CARB DIGESTION

A

polysaccharides (45-60%) starch and glycogen, - oligossacharides (30-40%) sucrose and lactose, - monosaccharides (5-10%) Glucose and fructose

all converted to monosaccharides for absorption

27
Q

PROTEIN DIGESTION

A

digested to oligopeptides and amino acids

Peptides are hydrolysed (by peptidases) to amino acids which cross basolateral membrane by Na+ independent transporters.

In Duodenum – pancreatic lipase + bile salts (HCO3- in pancreatic juice neutralises stomach acid).
[Bile salts – emulsify large lipid droplets to small so greater surface area for lipase to act. Colipase allows access of lipase to hydrophobic core of small droplets. Failure to secret bile salts causes Steatorrhea, and secondary vitamin deficiency.]

28
Q

Plasma protein secretion

A
  • Albumin
  • Alpha Globulins – transport lipoproteins, lipids, hormones and bilirubin (eg ceruloplasmin transports copper). Retinol binding protein transports vitamin A.
  • Beta Globulins – transferrin (transports Fe3+, stored bound to ferritin), Fibrinogen (inactive form of fibrin, clotting of blood
29
Q

GGT

A

gamma-glutamyl transferase (GGT) blood test measures the activity of GGT in your blood. GGT may leak into your bloodstream if your liver or bile duct is damaged, so having high levels of GGT in your blood may indicate liver disease or damage to your liver’s bile ducts

30
Q

Achalasia

symptoms

signs

treatment

A

unknown aetiology which causes failure of the lower oesophageal sphincter to relax.

associated with underlying oesophageal cancer

Dysphagia – gradual onset (months to years)
Regurgitation of undigested food
Aspiration
Retrosternal chest pain / heartburn – often does not respond to PPI
Weight loss – often mild

dilated oesophagus, containing residual materia
‘bird’s beak appearance’ in barium swallow

Botulinum toxin injections (botox)
Medical therapy can be tried (calcium channel blockers / nitrites) in patients who fail botox therapy or are not suitable surgical candidates
Surgery: Options include oesophageal dilatation and surgical cleavage of the muscle, called ‘Heller’s Myotomy’.

31
Q

Bacillus cereus

A

Gram-positive rods that produce 2 toxins, an emetic pre-formed enterotoxin that is absorbed into the blood-stream from the stomach, and a diarrhoea-causing enterotoxin that acts on receptors in the small intestine and large bowel.
Symptoms start 30 minutes to 6 hours after eating contaminated food (due to the pre-formed toxin), and profuse vomiting is a common feature. Fever is usually absent.
Rice is a common source, as it provides the carbohydrate for the bacteria to produce the toxins.
These are heat stable, so when the rice is reheated they remain active

32
Q

types of ascities

A

exudate- malignancy/infection

transudate- increased pressure from portal hypertension

33
Q

causes of oesophageal varicies

A

portal hypertension
from liver cirrhosis, hep, liver disease, budd chiari

leads to enlarged spleen but GB isn’t affected!! because the hepatic vein doesn’t supply the gall bladder

34
Q

icterus

A

jaundice

35
Q

painless jaundice, old age and weight loss

which cancer?

A

pancreatic more likely than cholangiocarcinoma

36
Q

which IBD has transmural/ mucosal involvement

A

t- crohns

m- UC

37
Q

crypt abscess with which IBD

A

UC

Question corrections (17 decks)

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