Pancreas And Beyond- Fitz Flashcards

0
Q

How much substance is absorbed by the SI?

A

6700 mL

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1
Q

How much water and solids are ingested vs excreted per day?

A

1200 mL of water -> 100 mL of water

500-800 g of solids -> 50 g of solids

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2
Q

How much substance is absorbed by the LI?

A

1400 mL

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3
Q

What two things tell pancreas there’s food in the stomach?

A

Vagus nerve

Pacinian corpuscle receptors

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4
Q

How does CCK finish what the vagus started in the pancreas?

A

Stimulates acinar cells for secreting enzymes

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5
Q

How does pH increase in the pancreas?

A

Pancreatic bicarbonate secreted first via secretin stimulation

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6
Q

Why would gastrin inhibit the pancreas?

A

Too much fat or protein still present in food

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7
Q

What does the exocrine portion of the pancreas do?

A

Produces pancreatic juice that is rich in bicarbonate and digesting enzymes

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8
Q

Which ducts come together at the sphincter of Oddi?

A

Pancreatic duct

Common bile duct

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9
Q

What is the substrate for [trypsin, chymotrypsin, elastase]?

A

Proteins

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10
Q

What does [trypsin, chymotrypsin, elastase] do?

A

Break peptide bonds in proteins to form peptide fragments

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11
Q

What is the substrate for carboxypeptidase?

A

Proteins

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12
Q

What does carboxypeptidase do?

A

Splits off terminal AA from carboxyl end of protein

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13
Q

What is the substrate for lipase?

A

Fats

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14
Q

What does lipase do?

A

Splits off two FAs from triglycerides, forming free FAs and monoglycerides

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15
Q

What is the substrate for amylase?

A

Polysaccharides

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16
Q

What does amylase do?

A

Splits polysaccharides into glucose and maltose

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17
Q

What is the substrate for [ribonuclease, deoxyribonuclease]?

A

Nucleic acids

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18
Q

What does [ribonuclease, deoxyribonuclease] do?

A

Split Nucleic acids into free mononucleotides

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19
Q

What is the endocrine portion of the pancreas?

A

Islets of Langerhan

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20
Q

What are the primary hormones made by the islets of Langerhan?

A

Insulin and glucagon

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21
Q

What do alpha islet tumor cells result in?

A

Diabetes

-glucagon

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22
Q

What do beta islet tumor cells result in?

A

Hypoglycemia

-insulin

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23
Q

What do delta islet tumor cells result in?

A

Diabetes

  • somatostatin
  • inhibits insulin and glucagon
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24
Q

Islet configuration connections:

A

:tj, desmosomes, gj

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25
Q

How many islets of Langerhan do we have?

A

1-2 million

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26
Q

What does glucagon resemble?

A

Secretin 29 AAs
GIP
VIP

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27
Q

What does glucagon do?

A

Cleave glycogen

Makes new glucose

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28
Q

What are the target organs for glucagon?

A

Liver

Adipose cells

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29
Q

What stimulates alpha cells -> glucagon?

A
AAs
Ach
EP
NRE
VIP
CCK-PZ
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30
Q

What is insulin synthesized as?

A

A promolecule-> proinsulin

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31
Q

What does insulin look like?

A

Alpha chain with 21 AAs, Beta chain with 30 AAs

Linked by disulfide bonds

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32
Q

What was the first molecule made by recombinant DNA?

A

Insulin

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33
Q

What are insulin receptors like?

A

2 alpha chains bind to insulin
2 beta chains have tyrosine kinase domains
-phosphorylation and internalization

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34
Q

What inhibits beta cells -> insulin?

A

Somatostatin from delta cells
EP from sympathetic system
NRE from sympathetic system

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35
Q

What does pancreatic somatostatin do?

A

Regulates movement of nutrients
Regulates GH
Decrease acid secretion, motility
Slow absorption

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36
Q

What increases pancreatic somatostatin?

A

NRE - stimulates sympathetics

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37
Q

What decreases pancreatic somatostatin?

A

Ach - inhibits parasympathetics

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38
Q

What does pancreatic polypeptide do?

A

Suppresses pancreatic somatostatin

Inhibits gall bladder and pancreas secretion

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39
Q

Reasons for gall bladder removal:

A

:gall stones, cancer, dysfunctional (not enough bile ejected)

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40
Q

What side of the body is the liver on?

A

Right

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41
Q

What does the liver do?

A

Produce bile

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42
Q

What does the liver store?

A

Glucose as glycogen

43
Q

What vitamins are stored in the liver?

A

A, D, K, B12, folate

44
Q

What is the name of the specialized cells in the liver’s filter system?

A

Kupffer cells ingest and breakdown toxic matter

45
Q

Hepatic portal system

A

Specialized vasculature that delivers absorbed nutrients to the liver for processing before being delivered to the rest of the body

46
Q

All bile salts are derivatives of :

A

: cholesterol

47
Q

Where does the arterial supply to the liver originate?

A

Blood from heart

48
Q

Where does blood in the portal vein originate?

A

From the intestines

49
Q

Why is little bile lost in the feces?

A

Bile is reabsorbed by the portal system in the ileum

50
Q

How does bilirubin get to the liver?

A

Bound to albumin

51
Q

What does bilirubin do?

A

Breakdown RBC

52
Q

Neonatal jaundice causes

A

Too much fat from breast milk, not enough fluid

53
Q

Hepatitis A

A

Undercooked food

54
Q

Hepatitis B

A

Sexual transmission, needles

55
Q

Hepatitis C

A

Via blood transfusion or organ donors

Occurs years later

56
Q

Alcohol related jaundice

A

Cirrhosis of the liver

57
Q

Cancer related jaundice

A

Blockage of ductal areas, ie bile ducts

58
Q

How is bacteria related to bilirubin?

A

It aids in bilirubin processing

59
Q

How do bile salts get from primary to secondary?

A

Via bacteria

60
Q

What do bile salts do?

A

Emulsify fats by surrounding it and breaking it down so that it can diffuse across epi membrane

61
Q

What happens when fats come back together after they’ve crossed the epi membrane?

A

Form chylomicron -> enter central lacteal -> go thru portal system -> to liver

62
Q

How long is the SI?

A

20 feet long

1 inch diameter

63
Q

How long is the duodenum?

A

1 foot

64
Q

How long is the jejunum?

A

8 feet

65
Q

How long is the ileum?

A

11 feet

66
Q

What are plica circularis?

A

Permanent folds that contain part of submucosa

-none in lower ileum

67
Q

What are stomach villi?

A

Surface structure that has lampro core and has vascular and lymphatic capillaries

68
Q

What are stomach microvilli?

A

Surface structure known as brush border

Atop villi structure

69
Q

Where is the final enzyme for pancreatic breakdown found?

A

The glycocalyx

70
Q

From where is gastric enzyme secreted?

A

Crypts of Lieberkuhn

71
Q

What are enterocytes?

A

Internal cells of the SI

72
Q

Which brush border enzymes are located on the villi, are intrinsic to the glycocalyx, and are involved on final cleavage?

A

Aminopeptidase
Carboxypeptidase
Dipeptidase

73
Q

Disaccharides:

A

: maltose, sucrose, lactose

74
Q

The enzymes that break proteins down to their active form:

A

:enterokinases

75
Q

pH of the SI

A

8

76
Q

How do substances enter the SI?

A

Via channels at apical side

Nothing should come in between the cells

77
Q

What is the pancreatic bicarbonate output like with low pH?

A

Pretty high

78
Q

Pancreatic juice vs Plasma: bicarbonate

A

More in pj

79
Q

Pancreatic juice vs Plasma: Cl ion

A

More in plasma

80
Q

What form do small peptides need to be in to get to the interstitial fluid from the interstitial epithelial cell basolateral membrane?

A

Small peptide -> peptidase -> amino acids

81
Q

Why do people undergoing chemotherapy experience GI problems?

A

Chemotherapy kills all mitotically-active cells. Thus, GI epi is affected

82
Q

How does one contract E. coli 103?

A

Poorly cooked hamburgers

83
Q

What is HUS, and what triggers it?

A

Hemolytic uretic syndrome
Triggered by E. coli 103
Causes body to attack RBC-> renal failure

84
Q

What are paneth cells?

A

Secrete enzyme and are capable of phagocytosis

85
Q

How often does mitotically renewal occur in GI cells?

A

24-36 hours

86
Q

What is the function of the crypt?

A

Mitosis

87
Q

What are the fates of GI stem cell?

A

Paneth cell

Progenitor cell

88
Q

What side of the body is the appendix?

A

Right side

89
Q

Absorbed nutrients from the thoracic duct goes to the :

A

: left subclavian vein

90
Q

Risk factors for gall bladder disorder:

A

:FFF
Hormone replacement therapy
Obesity

91
Q

What is gall bladder disorder?

A

Ineffectiveness of gall bladder constriction

92
Q

What is Crohn’s disease?

A

Genetic disorder

Incurable

93
Q

What is ulcerative colitis?

A

Ulcer within epithelium, and epithelium bleeds

Just take out colon

94
Q

How long is the LI?

A

5 feet long

2 inch diameter

95
Q

Transverse colon innervation

A

Vagus nerve (first 2/3)

96
Q

Descending colon innervation

A

Splenic nerve

97
Q

Internal sphincter

A

Smooth muscle

Involuntary

98
Q

External sphincter

A

Striated muscle

Voluntary

99
Q

LI mucosa

A

No villi or plica
Lots of glands fill it
Simple columnar cells

100
Q

What is a GI stricture?

A

A bend or fold around scar tissue, nothing can pass in this area

101
Q

How does absorption occur in the LI?

A

Via osmosis

102
Q

What can you expect when you don’t have a colon?

A

Dehydration because there is no water absorption

103
Q

What happens during diarrhea?

A

Chyme passes too quickly thru intestine

Water not absorbed

104
Q

What happens during constipation?

A

Decreased intestinal motility

Too much water reabsorbed

105
Q

Remedies for constipation:

A

: Fiber
Exercise
Water

106
Q

Total dehydration from diarrhea?

A

Cholera