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NPLEX I > Anderson Digestive > Flashcards

Anderson Digestive Flashcards

1
Q

What condition is parotitis and orchitis associated with?

A

Mumps

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2
Q

What is the difference in muscle between the lower and upper esophagus?

A

Upper: striated muscle
Lower: smooth muscle

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3
Q

What is the most common type of hiatal hernia?

A

Sliding

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4
Q

What are some common causes of esophageal varices?

A

Portal HTN, alcoholic cirrhosis

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5
Q

What is a sequelae of GERD that can lead to adenocarcinoma?

A

Barrett’s esophagus - squamous cells converted to columnar gastric cells

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6
Q

What are the three muscle layers of the stomach? What are the two attachments?

A

Internal - Oblique
Middle - Circular
External - Longitudinal

Lesser and greater omentum (METS can go here)

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7
Q

Main artery to stomach? Veins?

Innervation of stomach?

A

Celiac a.
Gastric v. to portal v.

Sympathetic, splanchnic preganglionics, celiac plexus, parasympathetic (vagus)

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8
Q 
Chronic or acute gastritis: 
NSAIDs, ETOH, smoking, stress
Autoimmune w/ loss of parietal cells and IF 
Erosion of superficial epithelium
H. pylori
Most asymptomatic, without erosion
A 
Acute
Chronic
Acute
Chronic
Chronic
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9
Q 
Gastric or duodenal ulcer: 
25% of all PUD
H. pylori ~75% 
Better eating
Worse with food 
Burning epigastric pain 
Assoc w/ MEN or blood type O
NSAIDs, Smoking, Blood type A
A 
Gastric 
Both 
Duodenal
Gastric 
Both
Duodenal
Gastric
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10
Q

What is the respective portion of the duodenum, jejunum, and ileum?

A

D: 12 in
J: 40% of small intestine, less blood flow/lymph (peyer’s patches)
I: 60% of small intestine, more blood flow/lymph (peyer’s patches)

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11
Q

Name the pathology:
Paralysis of ileum, often due to vascular obstruction
Vascular compromise of intestine leading to necrosis
Vascular compromise of the GI leading to mucosal inflammation
One segment of SI telescopes into distal segment
General condition with inflammation of the GI

A 
Adynamic Ileus
Intestinal infarction
Ischemic enteritis
Intusesseption
Gastroenteritis
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12
Q

What is the name of the longitudinal smooth muscle in the large intestine? What are the pouches in the wall called?

A

Teniae coli

Haustra

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13
Q

Name the colon segments in order.

A

Ascending, hepatic flexures, transverse, splenic flexures, descending sigmoid

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14
Q

What type of muscle is the internal sphincter? how is it controlled?

What type of muscle is the external sphincter? how is it controlled?

A

Internal: smooth muscle, autonomic control
External: striated, pudendal nerve - conscious control

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15
Q

Name the pathology:
Herniation of colon mucosa through muscularis, submucosa, and adventitia.
Inflammation of above herniations
Varicosities inside and outside the anus
Giardia, ameba, viral/bacterial infection
Polypoid masses in proximal colon, METS, M>W, 60-70yo

A 
Diverticulosis
Diverticulitis
Hemorrhoids
Microbial colitis
Colorectal carcinoma
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16
Q 
Crohn's vs. UC:
Bloody stools
Skip lesions throughout the intestines
Cobblestoning/fistulas 
Limited to rectum/colon 
Pseudopolyps
Usu. more abdominal pain
A 
UC
Crohn's
Crohn's
UC
UC
Crohn's
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17
Q

T/F: 60% of pancreatic cancer is the head.

A

T

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18
Q

What is migratory thrombophlebitis/clots assoc. with pancreatic cancer?

A

Trousseau’s syndrome

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19
Q

Name the pathology:
inflammation of the exocrine pancreas, pain radiates to back
toxic damage from acetaminophen
hepatitis, cirrhosis, metabolic disorders
reduction of bile flow

A

Acute pancreatitis
Acute liver failure
Chronic liver failures
Cholestasis

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20
Q

What are some intrahepatic and extrahepatic causes of cholestasis?

A

Intra - viral, alcohol, drugs, sepsis

Extra - gallstones in common bile duct, neoplasm of pancreatic head, pancreatitis

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21
Q

Three sources of blood supply to stomach and their source:

A

Splenic a. -> short gastric a.
Celiac a. -> left gastric a.
Hepatic a. -> right gastric a.

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22
Q

Where does the inferior mesenteric vein drain? (hepatic v. or splenic v.)

A

Splenic!

Then hepatic

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23
Q

The short gastric v. drains into the ______ which drains in the _______.

A

Gastroepiploic v.
Inf. mesenteric v.

Breaks the rules!!

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24
Q

What conditions could lead to portal HTN? What are signs of portal HTN?

A

Liver cancer, alcoholism/cirrhosis, pregnancy.

Hemorrhoids, esophageal varices, caput medusae

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25
Q

What two plexuses make up the enteric nervous system?

A

Meissner’s - submucosal - secretion

Myeneteric (Auerbach’s) - motility

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26
Q

What does each cell secrete? What is the effect?
G - cells
I - cells
S - Cells

A

Gastrin - stimulates H+
CCK - stimulates GB contraction, pancreatic enz secretion, inhibits gastric emptying
Secretin - stimulates GB and pancreatic secretions, inhibits gastric emptying

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27
Q

What are the two main hormones in the stomach that stimulate H+?

A

Gastrin and Histamine (type 2 receptors)

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28
Q

What stimulates and inhibits gastrin?

A

(+) amino acids, stomach distention, vagal input

(-) enough H+, secretin, GIP

29
Q

What are the three hormones of the duodenum/jejunum involved in digestion? What stimulates their release?

A

CCK: (+) AA, fatty acids
Secretin: (+) H+ and fatty acid
Gastrin Inhibitory Peptide (GIP): (+) oral glucose, AA, fatty acid

30
Q

What does gastrin inhibiting peptide (GIP) accompish?

A

Stimulates insulin secretion, inhibits gastric acid secretion - regulates/balances gastrin/histamine.

31
Q

Compare endocrine, paracrine, and neurocrine.

A

Endocrine: global - secretion, circulation, systemic, target cell
Paracrine: local - diffusion, target cell
Neurocrine: local - action potential, target cell

32
Q 
More cells! What do they secrete and where in the stomach are they: 
Chief cells
Parietal cells
Mucus cells (goblet cells) 
G-cells
A

Fundus/corpus - Pepsinogen
Fundus/corpus - HCl, Intrinsic factor
Fundus/corpus/antrum - Mucus
Antrum - Gastrin

33
Q

T/F: GI motility consists of slow waves superimposed by action potentials which propagate the contraction through the GI.

A

T

34
Q 
Where is it aborbed? 
Carbs
AA
Iron
Vit B12
Bile Salts
A 
Duodenum/jejunum
Duodenum/jejunum
Duodenum
Terminal ileum
Terminal ileum
35
Q

The combination of the hepatic and bile duct is called the _________.

A

The common bile duct.

36
Q

What controls bile release?

A

Choledochus sphincter - smooth muscle around common bile duct.

37
Q

What comprise the major and minor papilla in the duodenum?

A

Major: Sphincter of Oddi - pancreatic/hepatic/GB secretions
Minor: Accessory pancreatic duct

38
Q

T/F: The liver mixes venous and arterial blood.

A

T

39
Q

What are the immune cells of the liver called?

A

Kupffer (Littoral) cells

40
Q 
Primary or secondary bile acid: 
Cholic acid 
Deoxycholic acid
Lithocholic acid
Chenodeoxycholic acid
A

Primary - synthesized by the body from cholesterol
Secondary - converted from primary by SI bacteria
Primary
Secondary

41
Q

Bile acids vs. bile salts.

A

Acids - conjugated to AA, glycine or taurine

Salts - cholesterol product

42
Q

What is reticuloendothelial tissue?

A

Spleen, liver, bone marrow

43
Q

What is the form of bilirubin that goes into the stool? into the urine?

A

Sterocobilin

Urobilin

44
Q

Name the Hepatitis:
Fecal-oral, self-limiting, no chronic state
Chronic, risk for hepatic cancer
Acute and chroic, can lead to hepatic carcinoma, vertical transmission

A

Hep A
Hep C
Hep B

45
Q 
Name the CN(s): 
Constrictor muscles (swallowing)
Palate elevation and tension
Deglutination, open auditory tube
Elevate larynx
A

9 & 10
5 & 10
10
9

46
Q

How is glucose and galactose absorbed at the brush border? Fructose?

A

Na+ cotransporter

Facilitated diffusion

47
Q

Chylomicron or micelle:
In lumen of GI
Exocytosed into lymphatics

A

Micelle

Chylomicron

48
Q

Which side of lymphatics drains 3/4 of the body? 1/4?

A

Left

Right

49
Q 
Name the vitamin deficiency: 
Night Blindness
Beriberi
Cheilosis/glossitis
Scurvy 
Macrocytosis/Glossitis/Colitis
Burning feet/HA/nausea
Microcytosis/neuropathy
A 
A
B1
B2
C
Folate (B9)
B5
B6
50
Q 
Name the vitamin deficiency:
Pellagra 
Pernicious anemia/neuropathy
Rickets
Ataxia 
Seborrheic dermatitis/nervous disorders
Factor 2,7,9, 10 bleeding disorder
A 
B3
B12
D
E (antiox)
Biotin 
K
51
Q 
Name the vitamin and what they do: 
B1 
B2
B3
B5
B6
B12
A

Thiamin - oxidative carboxylation
Riboflavin - FMN/FAD
Niacin - NAD/NADH, dehydrogenase reactions
Pantothenic acid - Acety-CoA
Pyridoxine (P5P active) - Mg cofactor, used for AA metabolism
Cyanocobolamin - activates conversion of Homocystiene to Methionine

52
Q

What is the active methyl-transfer enzyme made from folate?

A

Tetrahydrofolate

53
Q 
Name the vitamin and what they do: 
Vit C
Folate
Biotin 
Vit E
A

Ascorbate - hydroxylation reaction, reducing agent
B9 - part of methylation cycle
Carboxylase reactions - raw eggs inactive biotin
Tocopherol - minimized peroxide damage to cells

54
Q

What are the key vitamin-K dependent proteins?

A

Coagulation proteins: factors 2,7,9, and 10
Anticoagulation proteins: C, S, and Z
Others: Osteocalcin and matrix-Gla protein

55
Q

What are the fat soluble antiox? water soluble antiox?

A

Vit E

Asc, Glutathione

They all recycle each other.

56
Q

Where are the two cell types carotenoids can be broken down into retinol?

A

Liver and GI cells

57
Q

T/F: Carotenoid breakdown is dependent on thyroid hormone.

A

T

58
Q

What is the active vitamin A hormone?

A

Retinal

59
Q

What three tissues use vitamin A?

A

Eyes, epithelial tissues, gonads - acts as nuclear activator

60
Q

What form is Vitamin A carried in the chylomicron/lymph system?

A

Retinyl-ester

61
Q

What two forms of vitamin D are created in the kidney and what are their effects?

A

1,25 Dihydro D3 - Increase Ca resorption, absorption, reabsorption.

24,25 Dihydro D3 - Increase Ca deposition, absorption

62
Q

What are the three organs involved in the creation of active vitamin D?

A

Skin - U.V. light converts to cholecalciferol

Liver - 25-hydroxylase converts to 25-hydro-D3

Kidney - 1-alpha-hydroxylase converts to 1,25-dihydro-D3
24-hydroxylase converts to 24,25-dihydro-D3

63
Q

What pituitary hormone stimulates the production of one or the other D3 in the kidney?

A

+ PTH: 1,25-dihydro-D3 - increase serum Ca

- PTH: 24,25-dihydro-D3 - decrease serum Ca

64
Q

What substance acts as antioxidant stabilizer in nature/plants? In humans, what do these substances stabilize?

A

Flavonoids

Mast cells

65
Q

Where is Co-Q-10 made? What is it’s main use?

A

Formed in the cholesterol/HMG pathway (decreased w/ Statins)

Powerful antioxidant, preserves Vit E

66
Q

What are three uses of alph-lipoic acid?

A

1) Cofactor for mitochondrial energy reactions
2) Substrate for Kreb cycle
3) Antioxidant
4) Sulfur component- weak metal ion chelator

67
Q

What vitamin preserves/recycle glutathione for the methionine/homocysteine cycle?

A

Vitamin C

68
Q

Name the macromineral:
Most abundant cation in the body, mostly in bones
Second most abundant mineral, also in bones
Serves as cofactor, activates B vits, cAMP formation
Major extracellular ion, fluid balance, acid-base
Major intracellular ion, acid-base

A 
Ca++
Phos
Mg++
Na+
K+
69
Q

Name the micromineral:
Namely in Hg, O2 transport
Major cofactor, works with Vit A, needed for taste/vision
Part of cobalamin
Important for glutathione peroxidase, thyroid
Part of cartilage/bone matrix
Insulin function, glucose metabolism
Biosynthesis of thyroid hormone
Needed for cholesterol synthesis, normal brain fxn
In toothpaste, component of calcified tissues

A 
Fe++
Zn++
Cu++
Co++ (Cobalt) 
Se++ (Selenium)
Silicon
Cr+++ (Chromium) 
Iodine 
Manganese 
Fluoride

NPLEX I (12 decks)

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