Digestive system Review

Question 1

what is the incretin effect?

Answer 1

• increased insulin secretion from oral glucose intake, when compared to IV glucose administration

Question 2

What molecules mediate the incretin effect?

Answer 2

• glucagon-like-peptide 1 (GLP1)

- glucose-dependent insulinotropic polypeptide (GIP)

Question 3

end effect of gastrin release into blood stream?

Answer 3

• acid secretion into lumen of stomach

Question 4

• How does gastrin work to induce acids secretion into stomach lumen?

Answer 4

• stimulates enterochromaffin like cells to release histamine -> in turn stimulates parietal cells to release HCL into stomach lumen

Question 5

function of CCK and what does it stand for?

Answer 5

• Cholecystokinin

- stimulates gall bladder contraction and sphincter of oddi relaxation to excrete bile into duodenal lumen

Question 6

normal PO intake volume

Answer 6

2000 mL in one day

Question 7

saliva production in a given day

Answer 7

1500 mL

Question 8

daily volume produced by stomach

Answer 8

1500-2000 mL

Question 9

daily biliary volume produced

Answer 9

500 mL

Question 10

daily pancreatic volume production

Answer 10

500-1500 mL

Question 11

daily small bowel volume production

Answer 11

1500 mL

Question 12

what is the major cause of mortality in refeeding syndrome?

Answer 12

• cardiac events

Question 13

what happens to unabsorbed sugars in the digestive tract?

Answer 13

fermented by bacteria into short chain fatty acids, the main source of fuel for colonocytes

Question 14

small intestine mass, biopsy showing prominent nucleoli and CD-20 positive staining

Answer 14

Diffuse large B-cell lymphoma

Question 15

treatment for diffuse large B-cell lymphoma?

Answer 15

chemotherapy

Question 16

Mass in a the GI system, biopsy shows reactive follicles with CD-20 positive staining, follicles occupy the marginal zone

Answer 16

MALToma

Question 17

patient with chronic bloating, diarrhea, and weight loss has a small bowel mass next to villous atrophy…what is that mass?

Answer 17

enterophathy-associated T-cell Lymphoma

Question 18

man with vague abdominal pain, dyspepsia and anemia. biopsy shows lymphocytic infiltration with cells staining for CD20

Answer 18

MALToma

• treat with antibiotics

Question 19

where is B12 absorbed in the body?

Answer 19

terminal ileum

Question 20

how long should the Roux limb in a roux-en-y to prevent bile reflux?

Answer 20

at least 40 cm

Question 21

main source of fuel for enterocytes

Answer 21

glutamine

Question 22

when would you do a segmental resection for a Mekel’s diverticulum

Answer 22

• base > 2cm
• palpable abnormality
• unhealthy tissue visible

Question 23

main fuel source for colonocytes

Answer 23

Butyrate (short chain fatty acid)