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Disease Mechanisms > Ch 17: GI Tract > Flashcards

Ch 17: GI Tract Flashcards

1
Q

what are the two types of organs of the digestive system

A

ailmentary canal organs
accessory organs

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2
Q

what do acessory organs do

A

assist in digestive but have no direct contact with food

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3
Q

what are 5 examples of accessory organs

A

teeth
tongue
salivary glands
pancreas
gallbladder

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4
Q

what two things are absorbed in the stomach

A

water
alcohol

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5
Q

what are the three main things absorbed in the duodenum

A

iron
calcium
fats

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6
Q

what are the two things absorbed in the jejunum

A

sugars
proteins

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7
Q

what are two things absorbed in the ileum

A

bile salts
vitamin B12

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8
Q

what are three things absorbed in the colon

A

water
electrolytes
vitamin K

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9
Q

the sympathetic nervous system provides innervation to the GI tract through which nerves

A

splanchnic nerves

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10
Q

the parasympathetic nervous sytem innervates the GI tract through which nerve

A

vagus nerve

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11
Q

what are the two plexi of the enteric nervous system

A

myenteric (auerbach) plexus
submucosal (meissner) plexus

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12
Q

where is the myenteric (auerbach) plexus located

A

muscularis externa (propria)

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13
Q

where is the meissner plexus

A

within the submucosa

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14
Q

what is malaborption syndrome

A

defective absorption of fats, vitamins, proteins, carbs, electrolytes, minerals, and water

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15
Q

what causes malabsorption syndrome

A

disturbance in one of four phases of nutrient absorption

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16
Q

what are the four phases of nutrient absorption

A

intraluminal digestion
terminal digestion
transepithelial transport
lymphatic transport

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17
Q

celiac disease, a type of malabsorption syndrome, is caused by defects in which two phases of nutrient absorption

A

terminal digestion
transepithelial transport

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18
Q

disaccharidase deficiency, a type of malabsorption syndrome, is caused by defects in which phase of nutrient absorption

A

terminal digestion

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19
Q

inflammatory bowel disease, a type of malabsorption syndrome, is caused by defects in which three phases of nutrient absorption

A

intraluminal digestion
terminal digestion
transepithelial transport

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20
Q

what is celiac disease (celiac sprue/gluten sensitive enteropathy)

A

immune mediated disorder triggered by ingestion of gluten like wheat, rye, or barley

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21
Q

what genetic component is involved in celiac disease

A

mutations in:
HLA-DQ2
HLA-DQ8

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22
Q

what are three characteristics of celiac disease

A

intraepithelial lymphocyte activation
loss of absorptive villi
crypt hyperplasia (crypts get deeper)

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23
Q

explain the celiac sprue mechanism

A

gliadin causes epithelial cells to make IL-15
IL-15 causes proliferation of cytotoxic T cells that express NKG2D receptors
stress causes enterocytes to express surface MIC-
A
cytotoxic T cells destroy enterocytes
damage allows passage of other gliadin peptides
gliadin has amino group removed by a transglutaminase
deaminated gliadin binds to HLA(DQ2 or DQ8) on APC to activate helper T-cells
helper T cells release IFNy and activate B cells
B cells make antibodies which cause tissue damage

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24
Q

what are some clinical manifestations of celiac disease

A

diarrhea
bloating
fatigue
anemia - malabsorption of iron/vitamin B12
dermatitis herpetiformis

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25
Q

what is dermatitis herpetiformis

A

itchy, blistering skin lesions seen in 10% of those with celiac disease

26
Q

what is hirschsprung disease

A

a birth defect characterized by the absence of the intramural neural plexus (ganglion cells) in the distal colon which causes a blockage

27
Q

what is another name for hirschsprung disease

A

congenital aganglionic megacolon

28
Q

hirschsprung disease is associated with what other disease

A

down syndrome

29
Q

who, males or females, are most affected by hirschsprung disease

A

males
if in females, aganglionic segment is longer

30
Q

what is the mechanism of hirschsprung disease

A

mutation in tyrosin kinase causes failure of ganglion cells of the Meissner and auerbach plexuses to migrate to wall of rectum or they undergo premature death
both lead to loss of peristaltic contractions

31
Q

where will you see dilation in hirschprung disease

A

proximal to the affected segment cause everything backs up

32
Q

what portion of colon is always affected in hirschsprung disease

A

rectum

33
Q

what are the clinical mainfestations of hirschsprung disease

A

can’t pass meconium after birth
leads to abdominal distention and bilious vomit

34
Q

what are the 4 complications of hirschsprung disease

A

enterocolitis
fluid and electrolyte disturbances
perforation
peritonitis

35
Q

what is an aquired megacolon

A

abnormal dilation and enlargment of the colon due to underlying conditions that affect the colon’s ability to move stool efficiently

36
Q

what is the main symptom of chagas disease

A

acquired megacolon - dilation of colon

37
Q

which two bugs cause chagas disease which leads to aquired megacolon

A

kissing bug
trypansoma cruzi parasite

38
Q

what is inflammatory bowel disease (IBD)

A

group of diseases that are characterized by chronic inflammation of the GI tract

39
Q

who are most at risk for IBD

A

young people in teens and 20’s
caucasians

40
Q

what are the two main types of IBD

A

crohn disease
ulcerative colitis

41
Q

which part of the bowel is affected in both crohn and ulcerative colitis

A

crohn: ileum, ICV, and cecum
ulcerative colitis: colon and rectum

42
Q

what is the distribution like of crohn and ulcerative colitis

A

crohn: skip lesions
ulcerative colitis: diffuse

43
Q

do crohn and ulcerative colitis have strictures

A

crohn: yes
ulcerative colitis: rare

44
Q

what is the wall appearance of crohn and ulcerative colitis

A

crohn: thickened
ulcerative colitis: normal

45
Q

what is the inflammation pattern of crohn and ulcerative colitis

A

crohn: transmural (entire thickeness)
ulcerative colitis: mucosa and submucosa

46
Q

what are the ulcers like in crohn and ulcerative colitis

A

crohn: deep, knife like
ulcerative colitis: superficial

47
Q

do crohn and ulcerative colitis have granulomas

A

crohn: yes, noncaseating
ulcerative colitis: no

48
Q

do crohn and ulcerative colitis have malabsorption

A

crohn: yes
ulcerative colitis: no

49
Q

do crohn and ulcerative colitis have malignant potentials

A

crohn: if colon invovlement, yes
ulcerative colitis: yes

50
Q

do crohn and ulcerative colitis have toxic megacolon

A

crohn: no
ulcerative colitis: yes

51
Q

what is the mechanism of IBD

A

interactions between gut microbes and immune system in predisposed individuals leads to improper mucosal immune activation

52
Q

what are the three genetic and environmental elements that contribute to IBD

A

altered mucosal immunity
defects in autophagy and cellular stress response
host microbial interactions

53
Q

what is an example of altered mucosal immunity leading to IBD

A

helper T17 cells expand in diseased intestine

54
Q

what are two gene examples of defects in autophagy and cellular response which leads to IBD

A

mutations in:
ATG16L1
IRGM

55
Q

what percentage of crohn disease cases affect the small intestine (ileum)

A

40%

56
Q

what percentage of crohn disease cases affect the small intestine and colon

A

30%

57
Q

what percentage of crohn disease cases only involve the colon

A

30%

58
Q

which disease can be characterised by irregular cobblestone appearance of mucosa

A

crohn disease

59
Q

what are three things that can trigger reactivation of crohn disease

A

physical emotional stress
specific dietary items
smoking

60
Q

which disease is characterized by slightly red and granular colonic mucosa with a line of demarkation

A

ulcerative colitis

61
Q

what is toxic megacolon

A

dilation of the colon due to inflammation of muscularis propria and neuromuscular dysfunction

62
Q

what are three clinical manifestations of ulcerative colitis

A

blood diarrhea with string mucoid material
lower abdominal pain
cramps relieved by defecation

Disease Mechanisms (19 decks)

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