Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Tim's Cards > Gastrointestinal II > Flashcards

Gastrointestinal II Flashcards

1
Q

What are the 2 functions/divisions of the pancreas?

A

Endocrine

Exocrine

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

What 2 hormones make up the Endocrine Pancreas?

A

Insulin

Glucagon

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

What does the Exocrine pancreas produce?

A

Pancreatic Juice

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

What makes up pancreatic juice?

A

Bicarb (neutralizes gastric acid)

Digestive enzymes

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

What is pale in a pancreatic slide?

A

Islets, alpha cells (insulin and glucagon)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is darker in a pancreatic slide?

A

Exocrine cells

*90%

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

What is the pH of pancreatic juice?

A

7.6-8.2

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

How does pancreatic juice exit the pancreas into the duodenum?

A

Main Pancreatic Duct

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

How much pancreatic juice is secreted each day?

A

1500 mL

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

What is the pH of duodenal contents after exposure to pancreatic juice?

A

6.0-7.0

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

What are the 3 control points for Bile and Exocrine secretions from the Pancreas?

A

Bile duct sphincter
Pancreatic duct sphincter
Sphincter of Oddi

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

T/F

Sphincter of Oddi controls release of bile and pancreatic juice.

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the opening of bile/pancreatic juice into the duodenum?

A

Papilla of Vater

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

Pancreatic juice enzymes that break down carbs and lipids include:

A

Pancreatic amylase
Pancreatic lipase
Colipase

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

4 Proteases in Pancreatic juice.

A

Trypsinogen
Chymotrypsinogen
Procarboxypeptidase (A/B)
Proelastase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

2 enzymes in pancreatic juice that break down nucleic acids:

A

Ribonuclease

Deoxyribonuclease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What catalyzes Trypsinogen > Trypsin?

A

Enterokinase

aka enteropeptidase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Where is enterokinase found?

Function?

A 
Brush border (enzyme)
Trypsinogen > Trypsin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What enzyme converts chymotrypsinogen, proelastase, and procarboxypeptidase (A/) into its active forms?

A

Trypsin

*via Enterokinase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What congenital abnormality can lead to protein malnutrition?

A

Enterokinase deficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

As a protective measure, what does pancreatic tissue contain?

A

Trypsin inhibitors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

2 hormones that stimulate pancreatic secretion:

Difference in secretion?

A

Secretin - high HCO3-, low in Enzymes

CCK - high enzyme, low HCO3-

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Aside from CCK, what is another high enzyme pancreatic stimulant?

A

Vagal parasympathetic

*reflex, much lower amount than CCK

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

T/F

Small amounts of pancreatic digestive enzymes normally leak into the circulation

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What does increased plasma pancreatic amylase and lipase indicate?
What’s wrong at the level of the tissue?

A

Acute pancreatitis

Inflammation/necrosis pancreatic acinar cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What do enzymes do in pancreatitis to pancreatic tissue?

A

Fat necrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What do most cases of acute pancreatitis result from?

2 things

A

Gallstones

Alcohol abuse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What condition might activate pancreatic enzymes whilst still in pancreas?

A

Gall stones/pancreatic obstruction

exact mechanism unknown

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

T/F

Alcohol damage to pancreas by unknown mechanism

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What 2 effects does alcohol have on the pancreas?

A

Stimulates secretions

Contracts Sphincter of Oddi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Other than alcohol and gallstones, what is acute pancreatitis associated with?
(5 things)

A 
Hyperlipidemia
Hyperparathyroidism
Infections (viral)
Trauma (abdominal/surgical)
Drugs (steroids/thiazide diuretics)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Tachycardia, hyptotension, cool and clammy skin, and fever and indicative of what?
(also hypocalcemia and jaundice)

A

Acute pancreatitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What is the most common symptom of acute pancreatitis?

A

Severe epigastric and abdominal pain

radiates to the back

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What does “pancreatic cancer” usually refer to?

A

Ductal Adenocarcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What cell does more than 95% of malignant neoplasms in the pancreas arise from?

A

Exocrine cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What are the most common symptoms of exocrine pancreatic cancers?

A

Pain
Jaundice
Weight loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

How are cancers in the head of the pancreas different from those in the tail?
4 things

A

most numerous (60-70%)
jaundice
steatorrhea (fat in feces)
weight loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What are 3 major risk factors for pancreatic cancer?

A

Smoking
High mass/low activity
Chronic pancreatitis

*also 5-10% familial risk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What is the most common lethal genetic disease among caucasions?

A

Cystic Fibrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What causes Cystic Fibrosis symptoms in cell?

Genetic?

A

Cl- channel defect

CTFR gene

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What does the Cl- channel defect cause in Cystic Fibrosis?

A

Exocrine gland malfunction

  • increases viscosity in mucus and Cl- concentration in sweat and tears
  • *sweat test for diagnosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

3 Clinical manifestations of Cystic Fibrosis.

A

Chronic pulmonary disease
Pancreatic insufficiency
Meconium ileus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What is a liver lobule?

A

Hexagonal structure of Portal triads, Sinusoids, and Central vein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

How many triads (tetrads) are in a liver lobule?

A

6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

What 4 structures are in a triad

A

Portal Vein
Hepatic artery
Bile duct
Lymphatic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

What travels from the Portal vein to the Central vein in a liver lobule?

A

Sinusoid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Where are the Hepatic macrophage?

Another name?

A

Sinusoid lining

Kupffer cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

What runs parallel to the sinusoids?

A

Bile canaliculi

*drain bile produced by hepatocytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

What is the term for the arrangement of hepatocytes within lobules?

A

Hepatic cords

*sinusoids separate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

What is unique about the liver’s bloodflow?

A

Mixing of blood from Hepatic artery and Portal vein in the Central vein in lobes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Trace blood from the sinusoidal mixing:

A

Central vein
Hepatic vein
Inf. vena cava
Right atrium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

What’s special about the fenestrated endothelium in sinusoids?

A

No basement membrane

*blood washes freely over hepatocytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Where does blood wash freely over hepatocytes?

2 names

A

Space of Disse

perisinusoidal space

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Sinusoidal blood flows in what direction?

A

Toward Central Vein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

What could happen in pressure increases drastically in the portal vein and sinusoids?

A

Ascites

56
Q

Because of the spaces of Disse, the liver must…

A

have high Lymph flow

57
Q

What is the term for drugs entering the portal vein first?

A

First Pass Effect

58
Q

Normal pathway into Bile duct:

A

Rt/Lt Hepatic ducts
Common Hepatic Duct

Gall bladder or Bile duct

59
Q

What % of liver cell weight can be glycogen?

A

8%

*more than muscle at 1-3%, but less total glycogen

60
Q

T/F

Protein degradation occurs alost exclusively in the liver

A

True

61
Q 
What class of enzymes is required for deamination?
What are they (2)?
A

Aminotransferases

AST and ALT

62
Q

Other than deamination, what can AST and ALT do?

A

Synthesize non-essential AA’s within hepatocytes

63
Q

What can too much ammonia in the blood cause?

A

Hepatic coma

Hepatic encephalopathy

64
Q

2 terms for too much urea in the blood.

A

Azotemia
Uremia

*toxic to other tissues

65
Q

What is the normal Blood Urea Nitrogen (BUN) level?

A

5-26 mg/dL

66
Q

T/F

GI bleeding can cause Uremia

A

True

*due to bacteria creating nitrogenous wastes

67
Q

4 contents in the protein coated chylomicron:

A

FFA
Cholesterol
Phospholipids
TG’s

68
Q

What is the important liver enzyme in endogenous cholesterol synth?

A

HMG-CoA reductase

69
Q

What is the only way the body can eliminate excess cholesterol?

A

Bile

70
Q

In what 2 conditions is Ketogenesis likely to occur?

A

Fasting

Type I diabetes

71
Q

What hormones are degraded by the liver?

A

All steroid hormones

T3 and T4

72
Q

Name 4 steroid hormones degraded by the liver:

A

Cholesterol
Aldosterone
Cortisol
Progesterone

73
Q

How is iron stored in the liver?

Before stored is called?

A

Ferritin

Apoferritin

74
Q

How is iron taken up in the stomach?

Transferred in the blood?

A

Gastroferritin

Transferrin

75
Q

What vitamins are stored in large quantities in the liver?

A

A
B12
D

76
Q

What is the most important enzyme system for metabolism/drug detox in the liver?

A

Cytochrome P450

77
Q

What happens between Phase I and Phase II in drug pathways?

A

Metabolism

78
Q

What is the difference between Phase I and Phase II in drug metabolism?

A

Phase I - drug unchanged, modified, or inactive

Phase II - Conjugate is eliminated

79
Q

Cytochrome P450 enzymes are denoted by…

A

CYP (letter, number, letter)

80
Q

What type of enzyme is Cytochrome P450?

A

Phase I

81
Q

Conjugative enzymes are what type?

A

Phase II

82
Q

What do conjugative enzymes do?

How?

A

Make metabolites more polar/hydrophilic

Endogenous substrate added

83
Q

What is the most common/important conjugation rxn?

A

Glucuronidation

84
Q

What can lead to decreased metabolism of drugs?

A

CP 450 inhibition

85
Q

What can increase metabolism of drugs?

A

CP 450 induction

86
Q

What step of Vitamin D activation is taken in the Liver?

A

Cholecalciferol > 25-Hydroxycholecalciferol

*Hydroxylation

87
Q

What are the 3 major plasma proteins?

Where are they formed?

A

Albumin (liver)
Globulin (liver, lymphoid)
Fibrinogen (liver)

88
Q

T/F

Albumin supplies 50% buffering capacity of the blood.

A

False

15%

89
Q

What blood clotting factors aren’t made in the liver?

A

III
IV
XIII

90
Q

What are the 4 organic constituents of Bile?

%’s?

A

bile salts - 50
phospholipids - 40
cholesterol - 4
bile pigments (like bilirubin) - 2

91
Q

Where does bile pick up electrolytes and water?

A

Bile duct lining secretions

92
Q

What are the 2 primary bile acids produced by hepatocytes?

A

Cholic acid

Chenodeoxycholic acid

93
Q

What are the secondary bile acids a portion of primaries are converted into by intestinal bacteria?

A

Deoxycholic acid

Lithocholic acid

94
Q

Why is bile converted into bile salts?

A

Amphipathic

both hydrophobic/hydrophilic

95
Q

What is converted into a Bile Salt?

with what?

A

Secondary bile acids
(deoxycholic acid and Lithocholic acid)

Glycine and Taurine

96
Q

What is the most common Phospholipid in the bile?

A

Lecithin

also amphipathic

97
Q

What accounts for the majority of cholesterol breakdown in the body?

A

Synth bile acids

500 mg/day

98
Q

T/F

cholesterol is eliminated in the bile as a waste product

A

True

*but only some

99
Q

What is the waste product of hemoglobin degradation?

A

Bilirubin

100
Q

How is free bilirubin (Unconjugated bilirubin) transported in the blood?

A

Albumin

101
Q

What does the liver do with Free Bilirubin?

A

Conjugates

Excretes into bile

102
Q

What is attached in the conjugation of Bilirubin?

What enzyme catalyzes this rxn?

A

Glucuronic Acid

Glucoronyl transferase

103
Q

What is more water soluble, conjugated or unconjugated bilirubin?

A

Conjugated

104
Q

T/F

Bile contains lipophilic drug and antigen-antibody complex waste products

A

True

105
Q

What doesn’t flow into the central canal?

A

Bile ducts

106
Q

3 steps of Bile Synthesis:

A

Secretion into canaliculi
Pick up HCO3-, ions, and water
(this accounts for 900 mL/day)

1/2 bile stored in Gall Bladder btwn meals

107
Q

By how much is Bile concentrated in the Gall Bladder?

A

10-20 fold

108
Q

T/F

Bile that reached the duodenum is a mixture between dilute and concentrated

A

True

from gall bladder and liver

109
Q

What are the 2 important functions of Bile?

A

Alternate Excretory route (other than kidney)

Lipid Digestion/Absorption
bile salts and Lecithin

110
Q

What duct connects the Hepatic Duct to the Gallbladder?

A

Cystic Duct

111
Q

CCK 2 actions concerning bile:

A

Contracts gall bladder

Relaxes Sphincter of Oddi

112
Q

What stimulates ion and water secretion in bile ducts?

A

Secretin

113
Q

What neurotransmitter contracts Gall Bladder via Parasympathetic response?

A

Ach

114
Q

What mechanism dominates during the “interdigestive” periods concerning the gall bladder?

2 functions?

A

SNS Beta-2

Fills gall bladder and closes sphincter of Oddi

115
Q

What is the term for inflamed Gall bladder wall?

A

Cholecystitis

116
Q

Steady severe pain URQ radiating to shoulder or back indicates what?
*also fever, leukocytosis, nausea, vomiting, anorexia

A

Acute cholecystitis

*gallstone disease

117
Q

Chronic cholecystitis is almost always associated with what?

A

Gall stones

118
Q

What is the most common complication associated with Cholecystitis?

A

Gangrene (20%) followed by Perforation (2%)

119
Q

Presence of gallstones is called:

A

Cholelithiasis

120
Q

Most gallstones in US and Europe (90%) are what type?

A

Cholesterol stones

121
Q

What 3 factors are involved in gallstone formation?

A

Bile Stasis (from stone in gall bladder)
Supersaturation
Inflammation (cholecystitis)

122
Q

What size gallstone usually passes?

A

less than 8 mm

123
Q

What can large gallstones cause?

A

Jaundice

obstructed flow

124
Q

What increases intra-gallbladder pressure and causes RUQ pain?
(pain can radiate)

A

Biliary colic

125
Q

T/F

Oral contraceptives and rapid weight loss can cause gallstones

A

True

126
Q

T/F

Pregnancy can cause cholelithiasis

A

True

127
Q

T/F

Cholecystectomy can cause duodenal emptying to decrease

A

False

*common bile duct dilates, more bile after meals

128
Q

What is the cure for Physiological Jaundice of the newborn?

A

Light breaks bili

129
Q

Why would Liver disease cause osteomalacia?

A

No VitaD

No Ca++

130
Q

Bilirubin levels in Hepatic disease would be what in the blood?

A

Increased

UN-bili and CON-bili

131
Q

In liver disease, what would the Albumin and Total protein levels be in the blood?

A

Low

*not making

132
Q

T/F

Gamma-glutamyl transferase decreases in liver failure

A

False

133
Q

What does Prothrombin time do in liver failure?

A

Increase

*no more clotting factors

134
Q

UN-bili increases

CON-bili same

A

Pre-hepatic disease

135
Q

UN-bili increases

CON-bili increases

A

Intra-hepatic disease

Post-hepatic disease

136
Q

What tumor can cause an increase of UN-bili and CON-bili?

A

Pancreatic tumor (in head)

Tim's Cards (140 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions