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3 - GI > deck_1667780 > Flashcards

deck_1667780 Flashcards

1
Q

Outline 7 different “toxins” which we willfully put into our GI tract

A

• Chemical • Bacteria • Viruses • Protozoa • Nematodes (Roundworms) • Cestodes (Tapeworms) • Trematodes (flukes)

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2
Q

What are the two overall defence mechanisms available to the GI tract to defend it from toxins

A

• InnateAdaptive

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3
Q

What are the two parts of the innate immune system?

A

• Physical • Cellular

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4
Q

Describe 8 physical innate defences

A

• Sight/smell • Memory • Saliva • Stomach acid • Small intestine secretions • Colonic mucus • Anaerobic environment • Peristalsis/Segmentation

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5
Q

How does sight/smell work as a physical innate defence?

A

• If food looks or smells bad you won’t eat it

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6
Q

How does memory work as a physical innate defence?

A

• If food tastes bad, you won’t eat it next time

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7
Q

Give three reasons saliva is an integral part of the physical innate defence of the GI tract?

A

• pH 7.0 • Contains lysozyme, lactoperoxidase, complement, IgA and polymorphs • Washes toxins down into the stomach

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8
Q

What is the clinical condition in which there is reduced salivary flow?

A

Xerostomia

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9
Q

Give two causes of xerostomia

A

• Severe illness • And/or dehydration

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10
Q

What does xerostomia cause?

A

• Microbial overgrowth in the mouth and dental caries • Parotitis

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11
Q

What organism causes parotitis?

A

• Staph aureus

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12
Q

How does stomach acid serve as a physical innate defence?

A

• Low pH kills the majority of bacteria and viruses

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13
Q

What condition can make the stomach a less effective defence?

A

• Achlorhydria • Makes more susceptible to shigellosis, cholera and salmonella infection

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14
Q

What can cause achlorhydria?

A

• Pernicous anaemia • H2 antagonists PPIs

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15
Q

What are people taking PPI’s more at risk of if they have achlorhydria if in hospital?

A

Clostridium difficile infection

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16
Q

Name three organisms resistant to stomach acid

A

• Mycobacterium Tuberculosis is resistant to gastric acid (Acid and alcohol fast bacterium) • Enteroviruses - Hep A, Polio and Coxsackie are resistant to gastric acid • Helicobacter Pylori produces urease which acts on urea to produce a protective cloud of pneumonia

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17
Q

What four properties of small intestinal secretions allow it to repel GI invaders

A

• Bile • Proteolytic enzymes • Lack of nutrientsShedding of epithelial cells

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18
Q

How does the colonic mucus protect the GI system?

A

Separates epithelial wall from its contents

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19
Q

How does peristalsis/segmentation prevent GI disease?

A

• Normal intestinal transit time is 12-18 hours. If peristalsis slow, gut infections are prolonged.

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20
Q

Give five cellular innate defences of the GI tract

A

• Neutrophils • Macrophages ○ Kupfer cells in the liver • Natural killer cells • Tissue Mast Cells • Eosinophils ○ Parasitic infections

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21
Q

How does the hepatic portal system aid in GI defence

A

• All venous blood from the GI tract passes through the liver before returning to systemic circulationKupffer cells are specialised macrophages in the liver which clear debris and toxins

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22
Q

Outline three adaptive cellular defences of the GI tract

A

• B lymphocytes • T lymphocytes • Lympatic tissue

23
Q

What do B lymphocytes do?

A

• Produce antibodies including IgA and IgE that are particularly effective against extracellular microbes

24
Q

What do T lymphocytes do?

A

• Directed against intracellular organisms

25
Q

What is mucosal associated lymphoid tissue in the GI tract called?

A

• GALT (Gut associated Lymphoid Tissue)

26
Q

Give three locations of GALT

A

• Tonsils • Peyer’s patches • Appendix

27
Q

How can the recruitment of mast cells at the site of an infection in the GI tract cause damage?

A

• Mast cells release histamine • Massive vasodliation and increase in capillarly permeability • Fluid loss and dehydration

28
Q

Give a condition where mast cell release of histamine (along with intrinsic toxins) causes massive fluid loss

A

• Cholera

29
Q

Give three conditions associated with GALT

A

• Tonsilitis • Ilecaecal lymphatic tissue • Appendicitis

30
Q

Give two infections of the ileocaecal lymphatic tissue

A

• Mesenteric adenitis Typhoid fever

31
Q

What is mesenteric adenitis and what is it caused by?

A

• Inflammation of mesenteric GALT tissue Caused by adenovirus/coxsackie virus

32
Q

What are the main symptoms of mesenteric adenitis, and what can it be mistaken for?

A

• Right iliac fossa pain in children • Appendicitis

33
Q

What is typhoid fever?

A

• Caused by Salmonella Typhi • Inflamed peyer’s patches in terminal ileum, can perforate and kill patients • Intestinal peyer’s patches haemorrhage

34
Q

Give three causes of appendicitis

A

• Lymphoid hyperplasia at the appendix base • Faecolith obstruction • Worm obstruction

35
Q

Why is there a higher incidence of appendicitis during outbreaks of chicken pox?

A

• Lymphoid hyperplasia causes obstruction

36
Q

Give three causes of gut ischaemia

A

• Arterial disease • Systemic hypotensionIntestinal venous thrombosis

37
Q

What does gut ischaemia lead to?

A

• Overwhelming sepsis and rapid death

38
Q

What does liver failure increase one’s susceptibility to?

A

• Infections • Toxins • Drugs • Hormones

39
Q

What is an intrinsic affect of liver failure?

A

• Increased blood ammonia due to failure of the urea cycle • Ammonia produced by colonic bacteria and deamination of amino aids Can cause hepatic encephalopathy

40
Q

Give five major causes of hepatic liver failure

A

• Viral hepatitis • Alcohol • Drugs ○ Paracetamol, halothane • Industrial solventsMushroom poisoning

41
Q

What is the main cause of liver failure in the UK?

A

• Alcohol

42
Q

What is cirrhosis?

A

• Hepatocellular necrosis followed by fibrosis

43
Q

What does liver cirrhosis lead to?

A

• Portal venous hypertension, leading to prosystemic shunting and therefore toxin shunting

44
Q

Give three conditions portosystemic shunting leads to

A

• Oesophageal varicies • Haemorrhoids • Caput medusa

45
Q

Give the main tributaries of the hepatic portal vein

A

• Superior mesenteric vein • Splenic vein • Inferior mesenteric

46
Q

What are bile pigments?

A

• Produced as a result of the break down of haemoglobin (bilirubin)

47
Q

What is the lifecycle of bilirubin?

A

• Conjugated in the liver and secreted in the bild ot be excreted in the faeces

48
Q

What occurs if bilirubin cannot be excreted?

A

• Accumulated in the tissues, causing jaundice

49
Q

Give one hormone the liver breaks down

A

• Insulin

50
Q

What is the most abundant plasma protein?

A

• Albumin

51
Q

What is albumin essential for?

A

• Maintaining oncotic pressure for the distribution of body fluids

52
Q

Name 7 coagulation factors produced by the liver

A

• I – Fibrinogen • II – Prothrombin • V • VII • IX • X • XI • Protein C + S • Antithrombin

53
Q

What is thrombopoietin?

A

• A glycoprotein hormone that regulates the production of platelets by the bone marrow

54
Q

How does the liver generate aminoacids?

A

• Transamination

3 - GI (36 decks)

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