Digestion & Absorption Processes in the GI Tract Flashcards

1
Q

Small Intestine Structure is ideal for absorption

A

Folds of Kerckring that are arranged longitudinal folds with villi & microvilli to INCREASE the surface area of the small intestine
**Villi are longest in the DUODENUM + shorter in the Terminal Ileum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Where is the site of membrane (contact) site of activity?

A

Microvillar surface where there is a # of digestive enzymes (called the Brushborder)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the 3 different types of cells in the intestinal epithelium?

A

1.) Enterocytes:
+normal epithelial cells that are there for digestion,
absorption, & secretion
2.) Goblet Cells:
+ mucus secreting cells
+ give physical barrier from pathogens, chemical
barrier (mucosal barrier), immunologic protection
(macrophages)
3.) Paneth Cells:
+ part of the mucosal defenses against infection
-secrete agents that destroy bacteria or
produce inflammatory responses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How does the Enterocyte membrane regulate the control the flux of solutes between the lumen and the blood?

A

Pinocytosis- at the base of the microvilli, major mechanism in the uptake of protein

Passive Diffusion- particles move through pores in the cell membrane or through intercellular spaces

Facilitated Diffusion

Active Transport

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Transmural Movement during absorption in small intestine

A
Unstirred Layer of Fluid
Glycocalyx
Apical Membrane
Cytoplasm of the cell
Basolateral Membrane
Basement Membrane
Wall of the Blood Capillary/ Wall of the Lymphatic Vessels
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

The GI System is good at adaptation. Why?

A
  • Adaptations alter the function to maintain homeostasis
  • Capacity of the intestine to adapt is key in many scenarios like:
    a. ) small bowel resection
    b. ) bypass of the stomach (duodenal switch)

Limitations to Adaptations:
a.) Resection of the distal ileum- abolishes bile and
vitamin B12 absorption
b.) Certain genetic abnormalities lead to a loss of adaptation (lactase deficiency)
+ dysfunctional lactase enzyme that causes major
problem with the breakdown of lactose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Only monocytes are absorbed by enterocytes. What are they?

A

Glucose, Galactose, & Fructose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the key absorption sites from the lumen of the duodenum?

A

Apical Lumen Side:
SGLT 1- Na+/Glucose symporter
SGLT1- Na+/Galactose symporter
GLUT5- Fructose

Basolateral Side:
GLUT 2 Transporter- Glucose, Galactose, Fructose
Na+/K+ ATPASE- Na+ ion into the blood and K+ out into the enterocyte

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is lactose intolerance? Where does the usual breakdown occur and with what carbohydrate breakdown?

A

Lactose Intolerance- due to deficiency in the lactase enzyme in the brush border of microvilli

Undigested Lactose-> OSMOTIC DIARRHEA-

**Lactose-> glucose + galactose

Sx of Lactose intolerance: bacteria-produced methane gas, osmotic diarrhea (to equalize the concentrated lactose product on luminal side)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How are proteins digested?

A

Proteins are digested into digestable forms in the stomach and the small intestine.

Stomach: Pepsinogen-> Pepsin

Small Intestine:
Trypsinogen-> Trypsin (enterokinase)
a.) trypsinogen-> trypsin (activated trypsin)
b.) chymotrypsinogen-> chymotrypsin (activated
trypsin)
c.) Proelastase-> elastase (activated trypsin)
d.) Procarboxypeptidase A-> carboxypeptidase A
(activated trypsin)
e.) Procarboxypeptidase B -> carboxypeptidase b
(activated trypsin)

***All of these enzymes create oligopeptides

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Which proteases create building block AAs, Dipeptides, and tripeptides?

A

Peptidase enzymes along the brush border

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

The type of transport mechanisms of the AAs are the same as the carbohydrate transporters

A

4 separate cotransporting symporters (APICAL SIDE):

Na+/Neutral
Na+/Basic AA
Na+/Acidic AA
Na+/Imino AA

4 Separate single transporters on the BASOLATERAL SIDE:
 Neutral AA transporter
 Acidic AA transporter
 Basic AA transporter 
 Imino AA transporter
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Disorders of Protein Assimilation

A

a.) Deficiency of Pancreatic Enzymes
b.) Congenital Trypsin Absence (causes the lack of the trypsin protein)
c.) Cystinuria- defect in or absence of dibasic a.a. transporter (cystine, lysine, arginine, ornithine)
+ Cystinuria is a problem with dibasic transporter
(cystine(C), lysine (K), arginine (R), ornithine)
- Absent transporter so it is urinated OUT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Hartnup Disease

A

*inability to absorb neutral AAs; TRYPTOPHAN ESPECIALLY
+ Sx include: diarrhea, mood changes, neurological
problems, skin rash, photosensitivity, short stature,
uncoordinated movements

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Cystic Fibrosis

A
  • CFTR Mutation causes inability to secrete Cl- into the lumen and causes the absorption of H20 into the ductal cells of the pancreas
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Digestion of the lipids in the stomach and small intestine

A

Triglycerides-> Monoglycerides + FAs (lingual lipases, gastric lipases, pancreatic lipases)

Cholesterol Ester–> Cholesterol + FAs (cholesterol ester hydrolase)

Phospholipids–> Lysolecithin + FAs (phospholipase A2)

17
Q

How is the problem with pancreatic lipase solved when there is exposure to bile?

A

Pancreatic lipase-Bile Attachment is removed by the activation of Colipase via TRYPSIN

18
Q

Describe the activity of pancreatic lipase

A

Pancreatic Lipase breaks down the TAG–> DAG + 1 FA

19
Q

What is the optimum pH of pancreatic lipase?

A

pH=6

20
Q

What is the process for the processing of lipids?

A
  1. ) Cholesterol, Monoacylglyceral, LysoPL, and FFA are created via Bile Salts
  2. ) Cholesterol Esters, Phospholipids, TAG are all formed back into creating a micelle that is secreted into the bloodstream into the lymph
21
Q

What is the importance of ApoB protein during Fat absorption?

A

ApoB causes the ability of the formed chylomicron to move across the basolateral side of the enterocyte membrane.

NO APO-B PROTEIN LEADS TO ABETALIPOPROTEINEMIA*

sx: steatorrhea

22
Q

What causes steatorrhea?

A

Problem with pancreatic enzyme secretion, bile acid secretion, emulsification, micelle formation, diffusion of lipids into intestinal epithelial cells, chylomicron formation, transfer of chylomicrons into the lymph

23
Q

What are factors that cause deficits in bile salt secretions?

A

Ileal resection

small intestinal bacterial overgrowth (SIBO)

24
Q

What are the main causes of small intestine bacterial overgrowth?

A

Decreased Gastric Acid Secretion (gives more ability for the bacteria to grow into the intestinal mucosa and the overgrowing bacteria causes deconjugated bile salts, impaired micelle formation, and fat malabsorption

***the decreased H+ secretion-> bacterial overgrowth-> deconjugation of the bile salts-> impaired micelle formation-> fat malabsorption because of impaired micelle formations

25
Q

What is Tropical Sprue?

A

decreases the number of intestinal epithelial cells, reduces the microvillar surface area; lipid absorption is impaired because the surface area for absorption is decreased!

sx: cramps, nausea, weight loss, gas, indigestion
tx: tetracycline + folate for 6 months

26
Q

What is Celiac Sprue?

A

Autoimmune Disorder that leads to the destruction of small intestine villi as well as hyperplasia of the intestinal crypts

27
Q

What is the importance of Cobalamin (Vitamin B12)?

A
* important in creating DNA as it reduces ribonucleotides 
  to deoxyribonucleotides (needed for DNA synthesis)
  • Especially important in the synthesis of Red Blood Cells
    -Leads to Pernicious Anemia (due to failure of Red
    Blood Cell Maturation)
28
Q

What causes the disruption of the absorption of Vitamin B12?

A

Gastrectomy- loss of parietal cells (source of IF deficiency that binds to Vitamin B12/Cobalamin)

Gastric Bypass- exclusion of the stomach, duodenum, proximal jejunum can lead to alterations in absorption vitamin B12

Atrophic Gastritis- chronic inflammation of the stomach mucosa that leads to loss of parietal cells

Autoimmune Metaplastic Atrophic Gastritis- immune system attacks IF protein or gastric parietal cells

29
Q

How does intestinal iron absorption work?

A

1.) DCYTB receptor reduces non-heme Fe3+-> Fe2+
2.) DMT transports Fe2+ into the cell
3.) Fe2+ in transferred onto Mobilferrin
4.) Fe2+ leaves through Ferroportion Channel on the
basolateral side
5.) Fe2+ gets transferred by the plasma transferrin from
the blood