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2nd Year Medicine > Gastrointestinal > Flashcards

Gastrointestinal Flashcards

1
Q

What cells produce hydrochloric and and release intrinsic factor in stomach?

A

Parietal cells

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2
Q

What chemicals/Hormones are responsible for triggering/inhibiting gastric acid secretion?

A

Acetylcholine (Neural), Histamine (Hormone), Gastrin (Hormone) and Somatostatin (Hormone)

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3
Q

Which arteries supply the stomach?

A

Right and Left gastroepiloic (Greater curvature) and right and left gastric arteries (Lesser Curvature)

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4
Q

Which gastric cells produce Histamine

A

Enterochromaffin like cells (ECL cells)

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5
Q

Which nerve is involved in controlling release of Acetylcholine in the stomach?

A

Vagus Nerve

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6
Q

What are the 3 phases of digestion?

A

Cephalic phase - looking at food causing Vagus nerve stimulation

Gastric phase - food is inside stomach and stretching stomach. Cells sense protein and fat content causing release of gastrin and Histamine

Intestinal phase - food is stretching Duodenum causing enterogastric reflex . Somatostatin released by D cells and if fat detected then cholecystokinin released to induce gallbladder contraction

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7
Q

Where does alcohol and aspirin get absorbed

A

Stomach tissue

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8
Q

How many layers of muscle does the stomach have and what are they called?

A

The stomach has 3 layers

Outermost - longitudinal

Intermediate - Circular

Innermost - Oblique

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9
Q

What is the range of P.H of the stomach?

A

Resting 4 to 5

During digestion 1 to 2

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10
Q

What is the condition where the stomach acid causes metaplasia of oesophagus

A

Barrett’s oesophagus - conversion of oesophagus simple squamous epithelium into stomach columnar epithelium

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11
Q

What is the condition where the oesophagus will abnormally tighten around a bolus during peristalsis?

A

Nutcracker oesophagus

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12
Q

What is the ring of muscle that usually prevents backflow of stomach contents

A

Cardiac sphincter and lower oesophageal sphincter

Diaphragm helps prevent backflow

Angle of oesophagus to stomach helps prevent backflow

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13
Q

What is the condition where the stomach passes through the diaphragm

A

Hiatus hernia

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14
Q

What is the name of the condition where stomach acid will consistently travel up the oesophagus causing heartburn

A

Gastro reflux disease

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15
Q

Most common cause of gastric ulcers

A

Heliobacter pylori bacteria

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16
Q

What is Ranitidine

A

A competitive Histamine inhibitor which reduces hydrochloric acid secretion

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17
Q

What is Omeprazol

A

A proton pump inhibitor which stops secretion of HCl by 90% by inhibiting parietal cells

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18
Q

What cells prevent gastric tissue from being damaged by gastric acid

A

Mucosal neck cells which produce mucous layer to prevent acid touching stomach tissue

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19
Q

Names of the different sections of the small intestine

A

Duodenum, Jejunum and Illeum

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20
Q

Why is pepsin in the form of pepsinogen?

A

It’s to allow for pepsin to be stored in chief cells and allow activation when exposed to acid. Also prevents breakdown of stomach tissue

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21
Q

Which enzyme actives trypsinogen

A

Enterokinase

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22
Q

What does trypsin do?

A

It activates pancreatic digestive enzymes such as procarboxypeptidase or proelastase

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23
Q

Which type of enzymes do the duct and acinar cells of the pancreas release

A

Digestive enzymes

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24
Q

Which enzymes do the islets of langerhans release

A

Insulin, Glucagon and Somatostatin

25
Q

Which cells make up the liver?

A

Hepatocytes, endothelial cells, perisinusoidal cells (fat cells), liver associated lymphocyte and Kupfer cells

26
Q

What are the main function of hepatocytes

A

They regulate the metabolic functions of the liver and allow for veins and arteriolar blood to enter the liver

27
Q

What is the function of Kupfer cells

A

Immune protection for the liver

28
Q

What is the name of the duct that connects both the pancreas and gallbladder

A

Duct of ampulla

29
Q

What controls the release of both pancreatic and gallbladder contents

A

Sphincter of Oddi

30
Q

What gastro bacteria causes yellow blotches on the damn intestine

A

C. Difficule

31
Q

Symptoms of Haemolytic Uraemic Syndrome

A

Microangiopathic Haemolytic Anaemia - anaemia caused by damage to red blood cells

Acute renal failure

Thrombocytopenia - lack of platelets

32
Q

How much water is lost through insensible loss

A

700mL

33
Q

Where are most water and electrolytes reabsorbed

A

Duodenum

34
Q

Name of treatment for GORD involving a ring around the oesophagus

A

Linx treatment

35
Q

GORD treatment top of stomach is wrapped around the oesophagus

A

Nissen procedure

36
Q

AST > 3X and ALP < 2X

A

Hepatocellular Disease

37
Q

AST < 3X and ALP > 2X

A

Cholestatic Disease. Ultrasound determines if it’s Intrahepatic or Extrahepatic

38
Q

What is Gilbert Syndrome?

A

A genetic condition where there is a lack of Uridine diphosphate Glucorinic Transferase (UGT) causing build up of unconjugated bilirubin during stress

39
Q

Which lobe of the liver has the porta hepatis

A

Quadrate lobe

40
Q

Which zone in the hepatic acinus has mainly oxidative metabolic processs

A

Zone 1. Includes gluconeogenesis, beta oxidation of fatty acids

41
Q

What does zone 3 at the hepatic acinus do?

A

Mainly non oxidative processes such as xenobiotic metabolism, glycolysis

42
Q

Which 3 vessels form the portal vein

A

Splenic vein, superior mesenteric vein

43
Q

What’s a common sign of portal hypertension

A

Spider navei, varicose veins, caput medussae, ascites (fluid in abdomen)

44
Q

What is physiological saline?

A

0.9% saline sodium chloride

45
Q

What is given in I.V if patient needs fluid with no electrolytes

A

5% Dextrose Fluid

46
Q

What is cirrhosis?

A

End stage liver failure. Result of chronic inflammation over many years.

Persistent scarring and hyperplastic nodules which causes fibrosis and hepatocytes loss

47
Q

What is a common cause of cirrhosis?

A

Alcoholic damage

48
Q

What causes coeliac disease

A

An autoimmune reaction to gluten and an inability to digest gluten due to a lack of protease

49
Q

How is iron absorbed

A

Ferric iron absorbed directly into entetocytes through divalent metal transporter

Non-ferric iron gets reduced by cytochrome B into ferric iron and then goes through DMT into enterocyte

50
Q

What are Paneth cells and where are they found?

A

Paneth cells are found in the bottom of the crypts of liberkuhn in the small intestine.

They provide immune cells which prevent colonisation of bacterial in the small intestine

51
Q

What epithelium does the large intestine have?

A

Columnar absorptive cells

52
Q

What is Taenia coli?

A

Longitudinal bands of smooth muscle which help provide motility

53
Q

How are fats absorbed in the small intestine?

A

They are broken down into small fatty acids by pancreatic lipases and then converted into Micelles - small droplets of fat with a hydrophilic lecithin outer layer.

Micelles enter small intestine and are then converted into chylomicrons by being combined with proteins. They are then brought into lacteals and taken to the liver

54
Q

How are proteins absorbed?

A

They are broken into short chain amino acids by pancreatic enzymes and then taken into enterocytes via active transport using H+ ions

55
Q

How much of the tongue is skeletal?

A

The superior 1/3

Other 2/3 are smooth muscle

56
Q

What are brunner glands and what do they do?

A

They are glands which produce a very alkaline mucus and help to neutralise the acid chyme produced in the stomach

Found in the duodenum

57
Q

What bacterial infection places a patient at risk of developing Gullain Baree syndrome

A

Campylobacter

58
Q

Which bacteria is known for causing secretory Diarrhoea

A

Cholera.

Cholera causes over activation of adenylyl Cyclase which increases cAMP concentration in small intestine crypts of liberkuhn enterocytes causing significant secretion of water into stool

2nd Year Medicine (6 decks)

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