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Tim's Cards > Gastrointestinal III > Flashcards

Gastrointestinal III Flashcards

1
Q

Border between the duodenum and jejunem:

A

Duodenojejunal flexure

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2
Q

How long is the duodenum?
Jejunem?
Ileum?

A

10-12 inches
8 feet
12 feet

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3
Q

What are the 3 surface levels of the small intestine?

A

Plicae curculares (macrovilli)
Villi
Microvilli

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4
Q

What is at the bottom of a villus?

A

Crypt of Liberkuhn

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5
Q

What type of cell is generally found on the surface of the vili?
What’s found on their surface?

A

Surface absorptive cells

Brush border enzymes

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6
Q

Name 4 cell types in a Crypt of Liberkuhn.

A

Goblet
Enteroendocrine
Regenerative
Paneth

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7
Q

What does an enteroendocrine cell secrete?

3 things

A

CCK
Secretin
GIP

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8
Q

What do Paneth cells secrete?

A

Lysozyme

and other bacterial agents

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9
Q

What morphological cell type is found in the intestine?

A

Columnar epithelial

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10
Q

T/F

Enzymes in the stomach can break down carbs

A

False

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11
Q

3 disaccharides:

A

Sucrose
Lactose
Maltose

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12
Q

What degrades polysaccharides into disaccharides and oligosaccharides?

A

Pancreatic amylase

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13
Q

How are glucose and galactose absorbed in the gut?

What type of transport is this?

A

SGLT-1 cotransporter (w/ Na+)

Secondary active transport
this goes against conc. gradient

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14
Q

How does Fructose enter the intestinal cell?

What type of transport is this?

A

GLUT5

Facilitated diffusion

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15
Q

Once in the enterocyte, how do monosaccharides exit to the capillaries?

What type of transport is this?

A

GLUT2

Facilitated diffusion

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16
Q

What does SGLT1 require?

A

Na+ cotransporter

enters with - goes same direction as glc/galactose

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17
Q

What is absent is Lactose Intolerance?

A

Lactase

*leads to fermentation

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18
Q

How does the stomach break down proteins?

A

Incompletely denatures with Pepsin

not broken down into single AA’s

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19
Q

Where does protein break down into individual AA’s?

What does this? (2 things)

A

Brush border

Aminopeptidases and Proteases

*proteases = active pancreatic enzymes

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20
Q

Name 3 secondary brush border enzymes that break down protein?

A

Amino-oligopeptidase
Aminopeptidase
Dipeptidyl aminopeptidase

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21
Q

How are single AA’s and small peptides transported into the enterocyte?
(2 ways)

A

SGLT1
(with Na+)

GLUT5 Facilitated diffusion
(same as Frc)

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22
Q

What is the 1st step a Fat Globule goes through once in the duodenum?

A

Emulsification

by bile acids

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23
Q

What 2 things coat an emulsification droplet?

A

Lecithin (phospholipid)

Bile acids

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24
Q

What breaks down an emulsification droplet into 2 FFA’s and a monoglyceride?

A

Pancreatic Lipase

Colipase

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25
Q

What do FFA’s and Monoglycerides combine with to form micelles?
What coats the micelle?

A

Cholesterol
Fat soluble vitamins (ADEK)

Bile acids coat

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26
Q

Once the Micelle enters enterocyte, how are they repackaged into Chylomicrons?
(4 ingredients)

A

FFA’s and monoclycerides re-form triglycerides

phospholipids
cholesterol
protein shell

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27
Q

What is a lacteal?

A

Lymphatic capillary opening

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28
Q

How are chylomicrons secreted into lacteals?

A

Golgi packages and exocytosis

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29
Q

How does all fat enter the bloodsteam?

A

Thoracic duct

juncture subclavian and jugular veins

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30
Q

How long does it take after eating a fatty meal for fat to travel through lymph and enter blood?

What is this called?

A

Within an hour

Lipemia

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31
Q

What is the half-life of a chylomicron?

A

Less than 60 minutes

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32
Q

Where are chylomicrons removed from the blood?

A

Adipose

Liver

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33
Q

What do adipose and liver contain large quantities of that allows for fat absorption?

A

Lipoprotein Lipase

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34
Q

What does Lipoprotein Lipase do to a chylomicron?

A

Hydrolyzes Triglycerides into FA’s and glycerol

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35
Q

What are the 5 classes of lipoproteins?

A 
Chylomicrons
VLDL
IDL
LDL
HDL
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36
Q

What does the “density” refer to in categorizing lipoproteins?

A

Protein coat

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37
Q

VLDL, IDL, LHL, and HDL are sythesized by the…

A

Liver

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38
Q

What type of lipoprotein contains low levels of TG’s and high cholesterol and phospholipid?

A

LDL

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39
Q

What type of lipoprotein contains high TG’s and moderate cholesterol and phospholipids?

A

VLDL

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40
Q

What are the only lipoproteins generally monitored?

A

LDL and HDL

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41
Q

How do Statins work?

A

HMG CoA Reductase inhibitors

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42
Q

All statin drugs end in…

A

statin

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43
Q

What is an adverse effect of statins?

A

Myopathy

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44
Q

What statin side effect refers to muscle pain or weakness without increased creatine kinase?

A

Myalgia

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45
Q

What statin side effect entails:
muscle pain/weakness
no increase creatine kinase
elevated CK

A

Myositis

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46
Q 
What entails:
very high CK
increased creatinine
dark urine
myoglobunuria
A

Rhabdomyolysis

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47
Q

What is the prevalence of muscle complaints while taking statins?

A

1 in 10

48
Q

7 risk factors for statin myopathy:

A 
Age
Small size
High dose
Liver/renal disease
Diabetes
Hypothyroidism
other meds
49
Q

What is the function of high dose Nicotinic Acid/Vita B3/Niacin?

A

Lowers lipid levels

50
Q

What are the 3 preparations of Niacin used to lower lipid levels?

A

Immediate release
Sustained release
No-flush (inositol hexaniacinate; nicinamide)

51
Q

Niacor is a _____ Niacin.

A

Immediate release

52
Q

Niaspan and slo-niacin are _____ Niacins

A

Sustained/extended release

53
Q

What is the most potent agent for raising HDL levels?

A

Niacin

54
Q

T/F

The exact mechanism of Niacin’s lowering lipid levels is poorly understood

A

True

55
Q

By how much does Niacin Lower LDL and increase HDL?

Reduce TG’s?

A

LDL - reduce 5-25%
HDL - increase 15-35%
TG’s - 20-50%

56
Q

What percentage of population is intolerant to Niacin?

This is mediated by?

A

50-60%

Prostaglandin

57
Q

What blunts the Niacin flushing effect?

A

NSAID 30 minutes prior

58
Q

Name 3 Bile Acid Binding Resins:

A

Colestipol
Cholestyramine
Colesevalam

59
Q

What 2 effects to Bile Acid binding resins have in the small intestine?

A

Decreased emulsification
Bile acid reabsorption prevention

*liver increases production because of latter

60
Q

T/F

Resins have little effect on HDL/TG’s in blood

A

True

61
Q

By how much can Resins decrease Plasma HDL?

A

30% with max dose

62
Q

6 side effects of Bile Acid binding resins:

A 
Constipation
Bloating
Flatulence
Nausea
Vomiting
Dyspepsia (indigestion)
63
Q

What can relieve resin side effect symptoms?

A

Increased dietary/supplemental fiber

64
Q

7 drugs/substances Bile Acid binding Resins bind:

A 
ADEK
Folate
Thiazides
Tetracyclines
Warfarin
Propanolol
Penicillin
65
Q

How can drug-drug interactions be reduced when using Resins?

A

Stagger time

(take hours after taking medications0

66
Q

Water absorption in the gut is ______ to solute movement.

A

Secondary

67
Q

How is K+ absorbed?

A

Passively via solvent drag

68
Q

What is the active form of Vitamin D that is responsible for Calcium absorption?
What does it do?

A

1,25 dihydroxycholecalciferol

Stimulated enterocyte Calbindins

69
Q

How are fat soluble vitamins absorbed?

A

Similar to fat

70
Q

How are most water soluble vitamins absorbed?

A

Simple diffusion

71
Q

What absorbs IF-Vitamin B12 complexes?

A

Ileal cells

72
Q

How much time does chyme spend in the small intestine?

A

3-5 hours

73
Q

How are peristalsis and segmentation controlled?
What inhibits?
What excites?

A

Autonomic
Sympathetic
Parasympathetic

74
Q

The Vagus nerve regulates what in the intestine?

in pancreas?

A

Parasympathetic segmentation/peristalsis

Secretion pancreatic enzymes

75
Q

What are the longitudinal bands of the large intestine called?

A

Teniae coli

76
Q

What are the outpouchings of the large intestine called?

A

Haustra

77
Q

What exists between the Teniae coli?

A

Haustra

78
Q

Where is the appendix?

A

Cecum

79
Q

T/F

Large intestine lack villi on the mucosa.

A

True

80
Q

What 4 cells exist in the Crypts of Lieberkuhn of the Large Intestine?

A

Absorptive
Goblet
Endocrine
Regenerative

81
Q

Histologically, the luminal surface of the Large intestine is….

A

Flat

82
Q

How many different species of bacteria live in the Large intestine?

A

500

83
Q

What accounts for the slightly acidic nature of stool?

A

Organic acids produced by bacterial fermentation in Large intestine

84
Q

T/F

Many normal intestinal flora have a low pH optimum, while many pathogens favor neutral environments.

A

True

85
Q

T/F

Bile salts and certain drugs are metabolized in the Large intestine

A

True

86
Q

T/F

Vitamin K, B12, and folic acid are all made by intestinal flora.

A

True

87
Q

4 Mechanisms producing diarrhea:

A

Increased osmotic load
Increased secretion
Inflammation
Decreased absorption time

88
Q

What causes osmotic diarrhea?

A

Unabsorbable substances

*think lactose intolerance

89
Q

What type of diarrhea does Cholera produce?

A

Secretory

90
Q

What type of diarrhea includes mucosal diseases?

A

Exudative

91
Q

T/F

Parkinson’s, MS, hypothyroidism, diabetic neuropathy can all cause constipation

A

True

92
Q

T/F
Calcium channel blockers, opiates, anti-cholinergics, diuretics, Fe supplements, aluminum antacids all cause constipation.

A

True

93
Q

T/F

There are no structural or biochemical abnormalities in IBS

A

True

94
Q

What is the proposed cause of IBS?

A

Dysregulation of intestinal motor/sensory functions modulated by CNS

*also stress a factor

95
Q

What bowel disease can manifest in the mouth?

What does not?

A

Crohn’s

Ulcerative colitis

96
Q

2 Inflammatory bowel diseases:

A

Crohn’s

Ulcerative colitis

97
Q

T/F

Both Crohn’s and Ulcerative Colitis have a causative agent

A

False

98
Q

Where does Ulcerative Colitis usually occur?

A

Colon only

99
Q

Where does Crohn’s disease usually occur?

A

Ileum and Colon

100
Q

In Crohn’s disease, the bowel wall appears thick but the inflammation is _____
In Ulcerative colitis the bowel wall appears thin but the inflammation is _____

A

Transmural

Limited to mucosa/submucosa

101
Q

What condition results from high intraluminal pressure on weak areas of the bowel wall?

A

Diverticulosis

*refers to bumps on the outer colon

102
Q

In Diverticulosis, the _____ layer herniates through the _____ layer.

A

mucosal

muscularis

103
Q

When diverticulosis becomes inflamed:

A

Diverticulitis

104
Q

What is associated with complaints of pain in the LLQ?

also nausea, vomiting, tenderness, fever, elevated WBC

A

Diverticulitis

105
Q

What defining characteristic does acute appendicites have?

A

Rebound tenderness

106
Q

Name 4 mechanical intestinal obstructions:

A

Herniation
Adhesion
Volvulus
Intussusception

107
Q

What is associated with the Valsalva maneuver?

A

Defecation

glottis voluntarily closes, abs and diaphragm contract

108
Q

T/F

Peptic ulcers, esophageal varices, hemorrhoids, blood clotting disorders all can cause GI tract bleeding

A

True

109
Q

What refers to blood in the vomit?

A

Hematemesis

110
Q

What type of odorous stools originate from bleeding high in the GI tract?

A

Melena

111
Q

4 Predisposing factors for Adenocarcinoma of the Colon and Rectum:

A

Polyps
Long-standing UC
Genetic factors
Low fiber, high animal fat diet

112
Q

T/F

Taking Niacin at night can reduce negative side effects

A

True

113
Q

T/F

Increased dental caries is associated with Crohn’s

A

True

114
Q

T/F
The ulcerations associated with Colitis can be expressed on the face during a flare up.
Also, oral lesions pop up during symptomatic phase

A

True

115
Q

T/F

GERD leads to caries.

A

False

*although demineralization does

116
Q

T/F
Chronic liver disease can lead to dearth of clotting factors that manifest as petechia in the mouth. It can also present as jaundice. Hep B is major factor.

A

False

Hep C is the major factor worldwide

Tim's Cards (140 decks)

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