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Physio U4 > Gastric, Pancreatic, and Intestinal Secretion > Flashcards

Gastric, Pancreatic, and Intestinal Secretion Flashcards

1
Q

Pepsinogen Function

A

digest 10-20% of proteins into peptides

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2
Q

Pepsinogen as inactive proenzyme

A

pH <5 and autocatalyzes pepsinogen to pepsin

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3
Q

Optimal pH for pepsin activity

A

1.5-2

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4
Q

Factors that increase pepsinogen secretion

A

ACh, pH <3, Gastrin

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5
Q

Gastric Lipase Function

A

digests 15% triglycerides to 2-monoglyceride and 2FFA

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6
Q

Optimal pH for gastric lipase activity

A

3-8

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7
Q

Gastric lipase in infants

A

more important bc pancreatic lipase is not abundant

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8
Q

Factors that increase gastric lipase

A

ACh

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9
Q

Intrinsic Factor Function

A

Binds Vitamin B12 in duodenum and transporting it to ileum for absorption

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10
Q

Gastric mucosal barrier

A

mucin glycoproteins and water with trapped HCO3

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11
Q

Function of Gastric mucosal barrier

A

Protect mucosa from pepsin and H+, slow-back diffusion of H+ into enterocytes, Trap any luminal H+ and buffer with HCO3

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12
Q

Mucin Function

A

protect mucosa from pepsin, HCl, bacterial invasion, and physical damage, and lubricate food

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13
Q

Mucin secretion

A

from surface mucus cells and mucus neck cells via exocytosis (continuous) and cell exfoliation (cells replaced every 3 days)

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14
Q

Factors that increase mucin secretion

A

ACh, gastrin, and prostaglandins

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15
Q

Bicarbonate Secretion Function

A

buffer H+ that enters the gastric mucosal barrier

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16
Q

Bicarbonate Secretion

A

from surface mucus cells and mucus neck cells using HCO-Cl antiporter (CA generates HCO)

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17
Q

Factors that increase Bicarbonate Secretion

A

prostaglandins, H+ in lumen, ACh

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18
Q

ALL surface mucus cells and mucus neck cells secrete

A

Mucus and HCO

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19
Q

What is the pH at the apical cell surface (beneath the gastric mucosal barrier)?

A

7

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20
Q

Prostaglandins are cytoprotective, function is

A

Decrease H+ secretion, increase mucus and HCO secretion, and increase gastric blood flow

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21
Q

Pepsin is inactive within the mucosal barrier, Why? and why is this important

A

mucosal barrier has a pH of 7 (pepsin inactive at 7), important to avoid digesting stomach lining

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22
Q

Peptic Ulcer Disease

A

loss of mucosal surface, imbalance of gastric acid and pepsin, and protective elements (mucus, HCO, and prostaglandins)

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23
Q

Causes of PUD

A

H. pylori, NSAID use

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24
Q

Zollinger-Ellison Syndrome

A

gastrinoma producing elevated levels of gastrin, causes PUD

25
Q

H. pylori infection

A

adheres to and colonizes gastric-type epithelium causing an inflammatory and bacterial response altering cell characteristics

26
Q

Chronic H. Pylori + pangastritis

A

results in hypochlorhydia, high levels of gastrin normal level of H+ (cytokines inhibit H+ secretion)

27
Q

Chronic H. Pylori + antral gastritis

A

results in hyperchlorhydia, high levels of gastrin AND H+, due to somatostatin dysfunction

28
Q

H. pylori produces urease

A

splits urea into ammonia CO2 and HCO3, increasing pH and allowing survival of bacteria and weakening the mucosal barrier

29
Q

NSAIDs and peptic ulcers

A

COX inhibitor prevents synthesis of prostaglandins, allowing increased H+ secretion, decreased mucus and HCO secretion, and decreased gastric blood flow

30
Q

COX2

A

does not effect GI, but will reduce swelling and pain

31
Q

Misoprostol (prostaglandin agonist)

A

treatment for peptic ulcers because it decreases H+ secretion, increases mucus and HCO

32
Q

Zollinger-Ellison Syndrome

A

H+ hypersecretion and gastrinoma, diarrhea and steatorrhea due to low pH in sm intestine and inability to absorb B12

33
Q

In patients with ZES, gastrin release from G cells is

A

LOW; gastrin is released from gastrinoma

34
Q

Function of pancreatic secretion

A

neutralize HCl to protect mucosa, maintain activity of giestive enzymes, secrete digestive enzymes

35
Q

Pancreatic acinar cell function

A

electrolytes, amylolytic, lipolytic, nucleolytic, and proteolytic enzymes

36
Q

Pancreatic acinar cell amylolytic enzymes

A

amylase (active form) pH 7

37
Q

Pancreatic acinar cell lipolytic enzymes

A

Lipase, Pro-phospholipase A2, cholesterol esterase pH 3-8

38
Q

Pancreatic acinar cell nucleolytic enzymes

A

ribonucleases, deoxyribonucleases

39
Q

Pancreatic acinar cell proteolytic enzymes (INACTIVE)

A

Trypsinogen, Chymotrypsinogen, proelastase, procarboxypeptidase A, procarboxypeptidase B

40
Q

ALL proteolytic enzymes secreted by the pancreatic acinar cells are secreted as

A

zymogens, activated by trypsin

41
Q

what activates trypsin

A

enterokinase located on the apical membrane of small intestinal enterocytes

42
Q

pancreatic ductal cell function

A

modify acinar secretion, secrete Cl, HCO3, and not reabsorb Na, K

43
Q

What is trypsinogen was active in the pancreas

A

pancreatitis

44
Q

Pancreatic Acinar cell secretes peptides that are not enzymes

A

trypsin inhibitor, procolipase, monitor peptide

45
Q

Autonomic control of pancreatic secretion

A

PNS increases secretion (ACh), SNS will decrease secretion (NE)

46
Q

Hormonal control of pancreatic secretion

A

CCK (CCK-releasing protein and monitor peptide) and secretin both increase pancreatic secretion

47
Q

Trypsin

A

activates all peptidases at start of digestion and inactivates peptides (CCK-RP and monitor protein) at conclusion of digestion to reduce CCK

48
Q

Pancreatitis

A

impairment pf endocrine function

49
Q

Causes of Pancreatitis

A

alcohol consumption and gall stones blocking pancreatic duct

50
Q

Small intestine secretion

A

HCO, Cl, mucus, Secretin

51
Q

Crypts of Lieberkuhn secrete

A

HCO and Cl

52
Q

Brunners glands and goblet cells in crypts secrete

53
Q

Cholera toxin

A

causes diarrhea by increasing intracellular cAMP (excessive Cl secretion)

54
Q

Secretory diarrhea causes

A

adenylate cyclase system, not adenylate cyclase system, mucosal injury, neoplasms

55
Q

adenylate cyclase system

A

enterotoxin-producing bacteria (e. coli, cholera) and caffeine

56
Q

Non- adenylate cyclase system

A

Bacterial endotoxins (staph, shigella, clostridium)

57
Q

Mucosal injury

A

IBS, salmonella, e.coli, shigella

58
Q

Neoplasm

A

gastrinoma

59
Q

If a patient’s diarrhea ceases with fasting, is it secretory?

A

NO - osmotic

Physio U4 (9 decks)

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