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Liver + GI > General GI > Flashcards

General GI Flashcards

1
Q

`steatorrhoea

A

passage of pale bulky stools that contain fat + indicates fat malabsorption as a result of small bowel, pancreatic disease or cholestatic liver/biliary disease

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2
Q

a feacal marker of intestinal inflammation + tissue damage

A

feacal cal protein

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3
Q

what does OGD stand for

A

oesophagogastroduodenoscopy, ‘gastroscopy’

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4
Q

how to investigate the small bowel? given that its so long

A

balloon-assisted enteroscopy

video (wireless) capsule endoscopy

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5
Q

what are oral white patches associated with

A

smoking, candida infection, lichen plants, trauma + syphilis

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6
Q

what may cause a smooth sore tongue with loss of filiform papillae?

A

vit b12 deficiency

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7
Q

what may cause mouth dryness?

A

anxiety, drugs such as tricyclic anti-Ds, Sjogren’s syndrome + dehydration

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8
Q

whats dysphagia?

A

difficulty swallowing

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9
Q

achalasia

A

a motility disorder

muscles of the lower part of the oesophagus fail to relax, preventing food from passing into the stomach

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10
Q

Odynophagia

A

pain during swallowing particularly with alcohol and hot liquids

suggests oesophagitis due to GORD, infections of the oesophagus to drugs such as slow release potassium or bisphosphonates

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11
Q

Muscle type distribution in the oesophagus

A

pros 3rd = skeletal –> mixed –> smooth

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12
Q

What phase of swallowing is it when the soft palate closes of the nasopharynx and elevation of the hyoid bone shortens and widens the pharynx?

A

Phase 2: involuntary

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13
Q

whats the voluntary phase of swallowing?

A

the 1st phase.

the tongue compresses food against the roof of the mouth + pushes it towards the oropharynx

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14
Q

in swallowing, what phase is it when the constrictor muscles sequentially contact, and what’s it followed by?

A

phase 3: involuntary

the 2nd part of this phase is the return/depression of the hyoid bone and pharynx

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15
Q

whats the gag reflex?

A

elevation of the pharynx
caused by irritation of the oesophagus
reflex arc between IX (sensory) and X (motor)

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16
Q

4 functions of saliva

A
  1. contains mucus
  2. amylase
  3. dissolves
  4. antibacteria
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17
Q

what type of acini have a small central duct and what do they secrete?

A

serous acini

water and alpha-amylase

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18
Q

what connects acini to larger striated ducts?

A

intercalated interlobular ducts

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19
Q

which gland does the facial nerve pass through?

A

the parotid

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20
Q

which nervous system stimulates salivary secretion?

A

parasympathetic nervous system

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21
Q

BMR

A

metabolic rate when a person is at mental + physical rest but not sleeping. at a comfortable temp
fasted at least 12 hrs

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22
Q

functions of the stomach

A 
storage
mixing
dissolving
continuing digestion
regulate emptying
kill microbes
secrete + lubrication
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23
Q

PC HIP pneumonic for stomach cell secretions

A

Parietal cells secrete HCl and IF

Chief cells secrete pepsinogen

24
Q

where are chief cells located? (stomach)

A

F + B + P

25
Q

which cell type is located just in the fundus and body of the stomach

A

parietal cells

26
Q

which stomach cells secrete gastrin?

A 
enteroendocrine cells (G cells)
located in the antrum
27
Q

which cells secrete histamine

A

ECL cells

28
Q

what do D cells secrete?

A

somatostain

29
Q

mediators of acid secretion

A

ACh - increases
Gastrin - increases
Histamine - increases
Soamtostain - decreases

30
Q

what does the vagus nerve secrete (stomach)

A

ACh

31
Q

cephalic phase

A

sight, smell taste and chewing lead to ACh release
ACh (enteric) acts directly on parietal cells

also triggers gastrin + histamine release

32
Q

what happens in the gastric phase

A
  1. gastric distension, presence of peptides and AAs increases HCl secretion (gastrin + histamine release, and somatostatin inhibiton)
  2. low luminal pH inhibits gastrin directly. also stimulates somatostatin release, indirectly inhibiting parietal cells
33
Q

intestinal phase

A

duodenal distension, low luminal pH, hypertonic contents and AA/FA presence lead to CCK and secretin release as well as neural reflexes

34
Q

what are enterogastrones and what do they lead to?

A

CCK and secretin are. they increase pancreatic exocrine secretion

35
Q

what does somatostatin turn off?

A

the process of forming proton pumps that gastrin, histamine and ACh stimulate via 2nd messengers

36
Q

what parallels the secretion of HCl?

A

pepsinogen - its also mediated by ACh

37
Q

what does pepsin come from?

A

when pepsinogen is activated in acidic conditions

pepsin also catalyses its own production - +ve feedback loop

38
Q

function of pepsin?

A

breaks protein down into peptides

39
Q

how is pepsin inactivated?

A

irreversibly by HCO3- in the small intestine

40
Q

what increases gastric peristaltic waves?

A

gastrin and gastric distension

41
Q

what decreases gastric peristaltic waves?

A

duodenal distension, duodenal fat, osmolarity, decrease pH, increased sympathetic drive

42
Q

function of the duodenum

A

mixes stomach contents, bile and pancreatic exocrine secretions

43
Q

3 important duodenal secretions

A

mucus (Brunner’s gland), CCK and secretin

44
Q

what does jejunum absorb?

A

actively: glucose, AAs, small peptides, vitamins
passive: fructose

45
Q

what does the ileum absorb?

A

bile salts, B12

46
Q

where is calcium actively absorbed?

A

duo + jej

47
Q

how is ileum different to jej?

A

payer’s patches and more mesenteric fat

48
Q

2 types of motility in small intestine

A

segmentation

peristalsis

49
Q

function of large intestine?

A

to complete absorption of water + few remaining carbs

movement: contraction in the circular muscle

50
Q

how and where is vitamin b12 absorbed?

A

in the terminal ileum after pairing with IF

51
Q

where is folate absorbed?

where is iron absorbed?

A

folate - jejunum

iron - duodenum

52
Q

what do bile salts to do fat?

A

emulsify them into emulsion droplets

53
Q

what does lipase break down?

A

breaks down emulsion droplets into free FAs and bile salts, which then combine to form micelles

54
Q

where are micelles formed into chylomicrons?

A

in enterocyte cells, for transport in blood - released by exocytosis

55
Q

what does lipoprotein lipase do?

A

breaks down triglycerides in chylomicrons into fatty acids and glycerol in the capillaries

56
Q

what’s CCK and what stimulates it?

A

cholecystokinin

stimulated in the presence of fat in the duodenum, to release bile from GB and pancreatic enzymes from the pancreas

57
Q

2 nerve plexuses of the intestine

A

Meisneer’s - submucosal

Auerbach’s (myenteric)

Liver + GI (34 decks)

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