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Year2 GI Exam I > Choudhury II > Flashcards

Choudhury II Flashcards

1
Q

proximal portionof stomach secretes what

A

HCl, pepsinogen, IF, mucus, bicarb, water

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2
Q

distal portion of stomach secretes what

A

gastrin, mucus, somatostatin (endocrine paracrin actions)

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3
Q

parietal or oxyntic cells secrete what

A

HCl, IF

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4
Q

chief cells secrete what

A

pepsinogen, renin

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5
Q

endocrine cells in stomach secrete what

A

ECL cells that secrete histamine
G cells secrete gastrin
D cells secrete somatostatin

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6
Q

what is role of HCl

A

protein breakdown, pepsinogen activation, kills most microbe

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7
Q

peptic chief cells secrete what

A

pepsinogen and its converted to pepsin

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8
Q

what is the purpose of the mucus that is secreted by mucous cells

A

lubrication to protect epithelial cells

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9
Q

pyloric glands are where

A

antrum and pyloric regions of the stomach

have G cells

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10
Q

what does gastrin do

A

stimulates pareital cells HCl and peptic cells (pepsinogen)

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11
Q

describe the mucus secreted by surface epithelial cells in stomach and the neck cells

A

surface is thick alkaline mucus

neck cells secrete thin watery mucus

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12
Q

chief cells secrete what

A

pepsinogen and gastric lipase

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13
Q

what stimulates D cells to secrete somatostatin

A

acid in the stomach

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14
Q

how do H+ and Na+ levels in the stomach change as the rate of gastric secretion increases

A

inverse relationship, more H+ less Na+ the faster the secretion

and- always high in Cl, always low in K

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15
Q

H+ concentration in gastric lumen compared to blood

A

3M fold higher

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16
Q

key player in maintaining low pH in gastric lumen

A

H-K ATPase on the parietal membrane facing gastric lumen

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17
Q

What stimulate parietal cells to secrete acid

A

ACh, gastrin and histamine

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18
Q

What R does ACh bind to

A

M3

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19
Q

what R does gastrin bind to

A

CCKb

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20
Q

what R does histamine bind to

A

H2

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21
Q

what are the inhibitors on parietal cells

A

somatostatin and PGs

22
Q

what are the phases of gastric secretion

which has most acid secretion?

A

cephalic phase
gastric phase- most acid secretion
Intestinal phase

23
Q

What is a vagotomy and what is it used for?

side effects?

A

cutting vagus nerve
inhibits gastric acid secretion
used to Tx peptic ulcers
side effects: delay in gastric emptying, diarrhea

24
Q

what is a selective vagotom=y

A

cutting vagal nerves supplying parietal cells

25
Q

what occurs in cephalic phase

A 
conditioned reflexes from impulses to medulla stimulate vagus n
Ach release
gastrin release
pepsinogen release
inhibition D cells
26
Q

what hormones does the duodenum release in intestinal phase?

role?

A

secretin
GIP
CCK
inhibit acid secretion

27
Q

what stimulates cephalic phase

A

sight, smell, taste, chewing

28
Q

what is rennin or chymosin

A

made by gastric chief cells in infants

proteolytic enzyme that causes milk to curdle in stomach so that it is retained and released more slowly

29
Q

what replaces rennin in adults

A

pepsinogen

30
Q

What converts pepsinogen to pepsin

A

pepsin and HCl

31
Q

what stimulates secretion pepsinogen

A

vagal sitmulation, mediated by Ach

Direct response to gastric acid

32
Q

what is pernicious anemia

A

absence of IF or B12 leading to neurological disturbances like paresthesias

33
Q

what can cause B12 deficiency

A 
decreased dietary intake
decreased absorption (decreased IF or autoAb)
34
Q

the mucus layer on gastric surface is a diffusion barrier for what

A

H and pepsin

35
Q

how does aspirin lead to ulcer formation

A

suppresses the protective mucosal barrier production

36
Q

cycle of acid causing mucosal damage

A

acid and pepsin break through mucosal barrier and the acid stimulates histamine release which then causes more acid release = viscous cycle

37
Q

what is more common gastric or duodenal ulcer disease

A

duodenal

38
Q

what is zollinger ellison syndrome

A

gastrin secreting tumor

39
Q

What pathogen causes gastric ulcers and how

A

H pylor because increases gastrin secretion

40
Q

what is used to evaluate gastric function

A

serum gastrin levels and gastric acid secretion

41
Q

what is used clinically to stimulate acid secretion

A

pentagastrin

42
Q

what is atrophic gastritis

A

chronic inflammation, with lack of parietal cells, of gastric mucosa from H pylori

43
Q

serum gastrin way elevated by basal acid output and after pentagastrin remain zero
most likely?

A

pernicious anemia

44
Q

serum gastrin super elevated with increased before and after pentagastrin aci output
most likely?

A

gastric ulcer

45
Q

what part of H pylori leads to gastric ulcers

A

mucosal damage

46
Q

what component of H pylori escapes pH

A

urease neutralizes gastric acid

47
Q

What muscarinic antagonists are used in PUD

A

atropine and scopolamine

48
Q

what H2 antagonists are used in PUd

A

cimetidine ranitidine

49
Q

what PPI are used in PUD

A

omeprazole and lansoprazole

50
Q

what drug is a PGE1 analog

A

misoprostol

51
Q

How is sucralfate useful in PUD

A

polymerizes on GI luminal surface to form protective gel like coating on ulcers

52
Q

what Antacids are usedul in PUD

A

Al(OH)3
Mg (OH)2
CaCo3

Year2 GI Exam I (18 decks)

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