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Clinical Chemistry > Gastro > Flashcards

Gastro Flashcards

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1
Q

What are the four main functional parts of the stomach?

A
  1. Cardia - cardiac gland: mucus-rich secretion
  2. Fundus - fundic gland: HCl secretion by parietal cells, pepsinogen secretion by peptic chief cells
  3. Body
  4. Pylorus - pyloric gland: Gastrin secretion by goblet cells called G-cells, mucus secretion.
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2
Q

HCL secretion by ____ is stimulated by ____

A

parietal cells
caffeine

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3
Q

What is Pepsinogen and how is it activated?

A

Pepsinogen is a zymogen that is converted to an active enzyme under the acidic conditions of the stomach. It cleaves peptide bonds involving aromatic amino acid residues and is inactivated in the small intestine.

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4
Q

At what pH range is Gastric Lipase active and what does it work on?

A

Gastric Lipase is active at a pH of 4 to 7 and its substrate is short-chain fatty acids.

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5
Q

What is the purpose of mucus in the gastric fluid?

A

Mucus protects the mucosal epithelium from mechanical damage during the passage of food and acts as a lubricant.

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6
Q

What electrolytes are present in gastric juice? Are they secreted in equal amounts?

A

The main electrolytes found in gastric juice include Na+ K+ Cl- and H+. No, An increased rate of secretion results in increased H and decreased Na.

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7
Q

What cells secrete the intrinsic factor and what is its role?

A

Intrinsic factor is secreted by parietal cells and is necessary for Vitamin B12 absorption.

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8
Q

What is Gastrin and its function? What is it stimulated by?

A

Gastrin is produced by and stored in G cells. It stimulates acid secretion by parietal cells and its secretion is induced by vagal stimulation local reflexes and the presence of food.

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9
Q

What are the major functions of the small intestine?

A

The small intestine serves as the major site for digestion and absorption specifically: 1. Digestion 2. Selective absorption of nutrients and water 3. Passage of unabsorbed material.

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10
Q

What is the total absorptive area of the small intestine?

A

The total absorptive area of the small intestine is 300 m².

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11
Q

How is water absorbed in the small intestine?

A

Most water absorption occurs in the first region of the small intestine with ions absorbed through both active processes (Na Cl-) and passive processes (lithium iodide bromide potassium). Solutes are absorbed along with water flow.

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12
Q

Describe calcium absorption in the small intestine.

A

Calcium is actively absorbed in the ileum. The synthesis of calcium-binding protein is regulated by calcitriol (125-dihydroxyvitamin D3) which is absorbed as a calcium-protein complex. Calcium absorption is regulated by plasma calcium concentration via PTH and synthesis of vitamin D3.

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13
Q

What is the role of the liver and gallbladder in digestion?

A

Liver and gallbladder play a role in digestion through exocrine secretions via the biliary tract. Bile is stored in the gallbladder during fasting and secreted into the GI tract during digestion serving as an excretory pathway for hemoglobin cholesterol lipid metabolic waste and toxic metabolites.

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14
Q

What is the function of cholecystokinin (CCK)?

A

Cholecystokinin is synthesized by mucosal cells of the small intestine and secreted in the duodenum. It stimulates the release of digestive enzymes and bile from the pancreas and gallbladder; is released in the presence of essential amino acids and partially digested fats; inhibits gastric acid secretion; and stimulates gallbladder contraction.

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15
Q

What is the function of secretin in the gastrointestinal tract?

A

Secretin is secreted mainly by the duodenum in response to hydrogen ions regulating pH and inhibiting gastrin release.

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16
Q

What is the role of somatostatin in the gastrointestinal tract?

A

Somatostatin is the major inhibitor of endocrine secretions and suppresses the release of gastrointestinal hormones.

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17
Q

What are the risk factors for gastric carcinoma? Which sites of the stomach does it commonly affect?

A

Risk factors include dietary and genetic factors with common affected sites being the distal portion and pre-pyloric region.

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18
Q

What is achlorhydria?

A

Achlorhydria is the absence of hydrochloric acid in gastric secretions.

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19
Q

What are the factors that lead to the development of peptic ulcers?

A

Factors leading to peptic ulcer development include aspirin non-steroidal anti-inflammatory agents (NSAIDs) corticosteroids smoking and Helicobacter pylori triggering an inflammatory reaction.

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20
Q

What is pernicious anemia?

A

Pernicious anemia is caused by the absence of intrinsic factor in gastric juice leading to no absorption of vitamin B12.

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21
Q

What is Zollinger-Ellison syndrome?

A

Zollinger-Ellison syndrome is characterized by a gastrin-secreting tumor (gastrinoma) that leads to continuously high levels of gastrin resulting in increased gastric acid secretion and peptic ulcers.

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22
Q

What symptoms are associated with carcinoid syndrome?

A

Symptoms of carcinoid syndrome include diarrhea and flushing due to increased bradykinin synthesis leading to vasodilation.

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23
Q

What is celiac disease?

A

Celiac disease is a condition where the immune system attacks its own tissues when gluten is consumed leading to damage in the small intestine and causing malabsorption.

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24
Q

What are the symptoms of lactase deficiency? What leads to these symptoms?

A

Symptoms of lactase deficiency include abdominal pain and diarrhea due to undigested lactose being fermented by intestinal bacteria leading to gas and lactic acid.

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25
Q

What is the role of the D-Xylose absorption test?

A

The D-Xylose absorption test assesses the intestinal mucosal transport function as xylose is absorbed passively and is not metabolized by the liver.

26
Q

What parameters are measured in the diagnosis of gastric hyperacidity or anacidity?

A

Parameters measured include basal acid output (BAO), maximal acid output (MAO), free acid output , peak acid output (PAO)

27
Q

What is the significance of determining urinary 5-hydroxyindoleacetic acid (5-HIAA)?

A

The measurement of urinary 5-HIAA is significant in diagnosing carcinoid syndrome which involves neuroendocrine cells that secrete serotonin.

28
Q

What is the oral lactose tolerance test used for?

A

The oral lactose tolerance test is used to determine the presence of lactase deficiency measuring the increase in blood glucose after ingestion of lactose.

29
Q

What role does the Schilling test play in the diagnosis of pernicious anemia?

A

The Schilling test is used to determine the absorption of vitamin B12 and identify causes of vitamin B12 deficiency specifically looking for intrinsic factor deficiency.

30
Q

What are steatorrhea and its significance in malabsorption?

A

Steatorrhea is characterized by fat in stools causing yellowish floating specimens and is significant as it indicates fat malabsorption.

31
Q

What treatment options are available for ulcerative colitis?

A

Treatment options for ulcerative colitis include blood transfusions liquid diet and corticosteroids.

32
Q

What is the role of the guaiac-based fecal occult blood test (FOBT) in colon cancer diagnosis?

A

The guaiac-based FOBT is used to identify occult blood in stool which is essential for monitoring and diagnosing colon cancer.

33
Q

What is the procedure for D-Xylose testing?

A

D-Xylose is administered urine is collected over the next 5 hours and a blood sample is collected after 2 hours (and 1 hour in children).

34
Q

What factors can affect the D-Xylose assay?

A

Factors affecting the assay include renal insufficiency which increases levels in blood only and malabsorption which results in decreased D-Xylose in urine.

35
Q

What should be addressed next if D-Xylose test results are normal?

A

If D-Xylose test results are normal pancreatic insufficiency should be addressed next.

36
Q

What is one method for screening fecal fat?

A

One method for screening fecal fat is visual inspection.

37
Q

What is another method for screening fecal fat?

A

Another method for screening fecal fat is microscopic visualization of fat droplets stained with oil.

38
Q

What is the quantitative measurement method for fecal fat?

A

The quantitative measurement method for fecal fat is titration with NaOH to measure fatty acids.

39
Q

What is the time frame for urine collection after administering D-Xylose?

A

Urine is collected over the next 5 hours after administering D-Xylose.

40
Q

How long after D-Xylose administration is a blood sample collected in adults?

A

A blood sample is collected after 2 hours in adults.

41
Q

How long after D-Xylose administration is a blood sample collected in children?

A

A blood sample is collected after 1 hour in children.

42
Q

What does an increase in blood levels of D-Xylose indicate?

A

An increase in blood levels of D-Xylose indicates renal insufficiency.

43
Q

What does a decrease in urine levels of D-Xylose indicate?

A

A decrease in urine levels of D-Xylose indicates malabsorption.

44
Q

What is the importance of the D-Xylose test in diagnosing intestinal pathology?

A

The D-Xylose test is important for assessing intestinal absorption; normal results suggest pancreatic insufficiency should be considered.

45
Q

What is the significance of fecal fat testing in malabsorption diagnosis?

A

Fecal fat testing is significant for diagnosing malabsorption helping to determine the presence of fat in feces.

46
Q

When does Mucus secretion increase?

A

Following food ingestion

47
Q

What are the 7 components of gastric fluid?

A

1) HCl
2) Pepsinogen
3) Gastric lipase
4) Mucus
5) Electrolytes
6) Intrinsic Factor
7) Gastrin

48
Q

What are the major risk factors of colon cancer?

A
  • Diet low in fiber high in fats.
  • Mutations in DNA repair gene Adenomatous polyposis coli (APC) is associated with increased risk.
49
Q

What is Crohn’s disease and what is it caused by?

A

Chronic inflammation of the small intestine with increased risk of cancer progression. Unknown etiology.

50
Q

What is a key feature associated with Crohn’s disease?

A

It is associated with the formation of fistulas which connect the intestine to other organs

51
Q

What are the causes of malabsorption?

A
  • Abnormalities of the intestinal mucosa
  • Maldigestion (pancreatic disease)
  • Altered bacterial flora
  • Diminished mucosal surface area
52
Q

What are the consequences of malabsorption?

A
  • Vitamin and nutrient deficiency
  • Anemia
  • Weight loss
  • Edema
  • Osteomalacia
  • Ascites
53
Q

What are the symptoms of malabsorption? How is it assessed?

A
  • Watery, bulky, frequent stools
  • Steatorrhea (fatty stool) floating yellow specimen
  • Nausea and vomiting

Assement: need to identify underlying cause (intestine, pancreas) (D-Xylose absorption test) for correct treatment

54
Q

What is ulcerative colitis?

A

Inflammation of colon mucosa

• Repetitive inflammation —> formation of polyps, necrotic cells
• Severe chronic damage results in blood accumulation at site
• Unknown etiology; symptoms very similar to those of Crohn’s disease

55
Q

Symptoms of colon cancer are ____

A

Intestinal bleeding and weight loss

56
Q

What part of the intestine does Crohn’s disease affect?

A

Ileocecal area

57
Q

____ disease puts the patient at an increased risk of cancer progression

A

Crohn’s disease

58
Q

What is ulcerative colitis and what are its consequences?

A

Inflammation of the colon

If we have repetitive inflammation, formation of polyps and necrotic cells result. If we have severe chronic damage, we will have accumulation of blood at the site.
Consequences: Anemia, hypoalbuminemia, electrolyte imbalance

59
Q

What are the causes and symptoms of ulcerative colitis?

A

Unknown etiology, symptoms similar to that of Crohn’s disease (diarrhea, weight loss, vitamin deficiency).

60
Q

What tests are used for the diagnosis of Lacrase deficiency?

A

1- Oral lactose tolerance test
2- Meaurement of breath hydrogen
3- Histological examination of intestinal epithelium

Clinical Chemistry (1 decks)

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