GI Flashcards
1
Q
Intestine wall layers include..
A
mucosa
submucosa
muscle layers
serosa
2
Q
Mucosa is the….
It is made of …. including …. cells
It functions as …. and ….
A
inner layer
epithelium, mucus-producing
lubricant and protectant
3
Q
Submucosa is ….
It has embedded …, …., …, ….
A
connective tissue embedded blood vessels lymphatics nerves secretory glands
4
Q
Muscle layers include …. and ….
They are responsible for …
A
circular smooth muscle layer
longitudinal smooth muscle layer
peristalsis
5
Q
Serosa is the … or …..
It is made up of ….
A
outer layer
visceral peritoneum
connective tissue
6
Q
What are the sphincters associated with esophagus?
A
upper
lower
7
Q
The initial digestions in the stomach is by … and …
A
pepsin
HCl
8
Q
Pepsinogen is created by …. cells which is a precursor to pepsin.
A
chief cells
9
Q
HCl is produced by... cells. Is activated by... Creates optimal ... for pepsin activity. Denatures ... to ease digestion. Protects against.....
A
parietal cells pepsinogen pH proteins microbes
10
Q
Production of intrinsic factor is by …
Intrinsic factor is essential absorption of …
A
parietal cells
vitamin B12 in ileum
11
Q
Production of gastrin is by the …. cells.
Its initiated by ….
It stimulates … and …. cells.
A
G
food entering stomach
chief and parietal
12
Q
Lower GI tract:
Duodenum is where ….continues and ….begins.
It containes …., ….enzymes, and bile salts from … and ….ducts.
A
digestion absoprtion bicarbonate pancreatic pancreatic bile
13
Q
Lower GI tract:
Jejunum is the major site for …
It is highly …
It contains … and … to increase surface area for absorption.
A
absorption of nutrients
vascularized
villi and microvilli
14
Q
Lower GI tract:
Ileum is where … continues
There are less ….
…, and bile salts are absorbed here.
A
absorption
blood vessels
B12
15
Q
Small intestines produce mucus, fluid with neutral pH, enzymes (….,….,…,….,….) and hormones (…,….)
A
enterokinase peptidases nucleases lipases sucrases, maltases, lactases secretin cholecystokinin
16
Q
Enterokinase activates…
A
trypsinogen into trypsin
17
Q
Lower GI tract:
Large intestine is where there is a …. of digestion and nutrient absorption.
There is … and …. reabsorption which maintains the fluid and acid-base balance.
Resident flora …. certain food materials and vitamin …. is synthesized here by bacteria.
Movement is …. to allow for absorption of water and formation of solid feces.
A
cease fluid electrolyte breaks down K slow
18
Q
Liver is where metabolism of …,….,…. happen.
Liver receives blood from … artery which brings oxygen.
Hepatic portal vein transports …. from intestine.
A
carbs proteins lipids hepatic nutrients
19
Q
Liver stores nutrients (9)
A
iron
copper
vitamins A, B6, B12, D, K, folic acid
glycogen
20
Q
Liver maintains blood glucose level through which processes?
A
glycogenolysis
gluconeogenesis
21
Q
Glucose–> glycogen is called
A
glycogenesis
22
Q
Glycogen –> glucose is called
A
glycogenolysis
23
Q
Proteins, fat –> glucose is called
A
gluconeogenesis
24
Q
Liver is a blood reservoir, it can ….
A
release blood in general circulation when needed
25
Liver is site for metabolic processes like conversion of .... into urea, detox, and utilizing products of breakdown of old/damaged.... (examples).
ammonia
erythrocytes
iron recycled
bilirubin conjugated and excreted into bile
26
Liver produces... proteins, ... and lipoproteins, and ....
plasma
cholesterol
bile
27
Plasma proteins produce ...,....,...
blood clotting factors
albumin
immunoglobulins
28
Bile is a mixture of...
```
water
conjugated bilirubin (gives pigment)
electrolytes (bicarbonate ion)
cholesterol
bile salts
```
29
Bile ..... fat and fat soluble vitamins (...,....,....,...)
It neutralizes acid from .... by increased pH in small intestine.
It is stored in ....
emulsifies
A, D, E, K
stomach
gallbladder
30
Gallbladder squeezes bile into .... through ....duct to aid in food digestion. It is connected with common bile duct through .... duct.
duodenum
common bile
cystic
31
Pancreas is an exocrine and endocrine gland how?
exocrine through ducts
| endocrine through circulation
32
Exocrine pancreas secretes .... which are precursors of pancreatic proteases like .... and ....
Some examples of these enzymes....
Exocrine pancreas also secretes...like ...ions.
```
digestive enzymes
trypsinogen
chymotrypsinogen
carboxypeptidase
ribonuclease
pancreatic amylase
lipase
electrolytes
bicarbonate
```
33
Neural control to the GI system is by ... and ...
PNS
| SNS
34
How does the PNS impact GI?
| How does SNS?
PNS- primarily through vagus
it increases motility and secretions
SNS- inhibits GI activity
35
Hormones that control GI:
| One secreted by stomach and two from small intestine
gastrin
secretin
cholecystokinin
36
```
Gastrin is secreted by
It is initiated by .... of stomach.
It stimulates ... and ... cells.
It increases gastric ....
Promotes ....by relaxing pyloric sphincter.
```
```
G cells
distention
chief and parietal
motility
stomach emptying
```
37
Secretin decreases ....
| It increases .... ion in pancreatic secretions and bile to increase ...
gastric secretions
bicarbonate
pH
38
Cholecystokinin inhibits ....
| It stimulates digestion of ... and ...with this ... secretion is stimulated and contraction of ... is stimulated.
gastric emptying
proteins and fat
pancreatic
gallbladder
39
Carbs are broken down into ....
Digestion of them starts in the ... by ....
It continues in the small intestine by ....
monosaccharides
mouth
salivary amylase
pancreatic amylase
40
Proteins are broken into ... then ....
Digestion of these starts in the ... by ...
It continues in the small intestine-... by ...,...,....
```
peptides
amino acids
stomach
pepsin
duodenum
trypsin
chymotrypsin
peptidases
```
41
Lipids are emulsified by .. prior to chemical breakdown in intestines.
They are broken down by lipases to ... and ...
bile
glycerol
free fatty acids
42
Water soluble vitamins are ... and ...
They diffuse in blood.
.... requires intrinsic factor for absorption.
B, C
| B12
43
Minerals ... in blood.
diffuse
44
Electrolytes are absorbed by ... or ... into blood.
active transport
| diffusion
45
Drugs are primarily absorbed in ...
| Some like ... are absorbed in stomach.
intestine
| aspirin
46
Early stage of vomiting induce metabolic ....
| Late stages induce...
alkalosis
| acidosis
47
Steatorrhea is...
fatty diarrhea
48
Two types of diarrhea...
large volume or small volume
49
Large volume diarrhea is caused by ....
| Small volume diarrhea is caused by...
increased secretions into intestines
| IBD
50
In dehydration, fluid shifts from blood to digestive tract which leads to .... and over time this can lead to .... and ultimately ...
hypovolemia
decreased tissue perfusion
hypovolemic shock
51
Sodium can be lost in ...
Potassium..
Chloride..
both vomiting and diarrhea
both vomiting and diarrhea
in vomiting
52
Outpouching of the esophageal wall can be due to ... or ...
| Food can accumulate in these pouches which leads to ...
congenital defects
inflammation
obstruction of food flow, irritation, inflammation, scarring of the wall, ulcers
53
In gastritis, stomach mucosa is ....
It loses ... glands and there is a reduced production of ....
....infection is often present.
atrophied
secretory
intrinsic factor
helicobacter pylori
54
Gastroenteritis is the ....
Caused by ...
Examples...
Can also be caused by..
```
stomach and intestine
infection, microbes transmitted by fecally contaminated food, soil and/or water
staph aureus
e coli
salmonella
allergic reactions to foods or drugs
```
55
Ulcer is the .....
Can appear as a single, small ....
Develops due to ... or ...
Most common locations...
```
erosion in mucosa
round cavities
H. pylori infection
acid-pepsin gastric juice irritation
antrum of stomach (gastric ulcers)
proximal duodenum (duodenal ulcers)
```
56
Peptic ulcer development:
Exposure to .. or ... which causes inflammtion, which causes ....of mucosa so that there is ...diffusion into the submucosa which deepens the ulceration into the muscular layer and finally a ...of the wall which can lead to food in the peritoneal cavity.
```
H. pylori infection
gastric juice
erosion
acid
perforation
```
57
An increase in acid-pepsin secretions can be due to ...
increased gastrin secretion, vagal stimulation, sensitivity to vagal stimuli, number of acid-pepsin secretory cells in stomach, alcohol, caffeine, certain foods.
58
Some additional factors that lead to damage of the mucosa and form ulcers can be ...., ...., ....
inadequate blood/oxygen supply
excessive meds and ulcerogenic substances
atrophy of gastric mucosa
59
Inadequate blood/oxygen supply with peptic ulcers is due to...
This will interfere with ....
```
vasoconstriction
circulatory impairment in older adults
scar tissues
anemia
rapid regeneration of epithelium
```
60
Erosion from peptic ulcers can damage ... and later develop ...
blood vessels
| scar tissue
61
Stress ulcers have a ... onset.
Multiple ... may form within hours. This is due to reduced blood flow that leads to ....,...
The first indicator is ... and ...
rapid
ulcers
reduced mucus secretion, epithelium regeneration
hemorrhage and severe pain
62
Gastric cancer is mostly in the ...
The early stages are confined to ... and ...
Later stages involved the .... and it will eventually invade ... and spread to ... nodes.
It is often ... in early stages and the prognosis is ... on diagnosis.
```
antrum
mucosa
submucosa
muscular layer
serosa
lymph
asymptomatic
poor
```
63
Wheat allergy is determined by what Ig?
IgE
64
Celiac disease is a small intestine disorder where the intestinal lining is ....
It is a .... syndrome.
It's onset is primarily in ...
It may occur in ...
It is an ... disease in genetically susceptible people.
```
atrophied
malabsorption
childhood
middle age
autoimmune
```
65
Gluten sensitivity is usually a sensitivity to ...
| Once this accumulates it causes inflammation, ... and ...
gliadin
| malabsorption and malnutrition
66
Cholecystitis is inflammation of .... and ...
Cholangitis is ...
Cholelithiasis is ...
Choledocholithiasis is ...
gallbladder and cystic duct
bile ducts due to infection
presence of gallstones
obstruction of biliary ducts by gallstones
67
Gallstones are formed in ...
| They may consist of ...
bile
cholesterol and bilirubin
calcium salts
68
Jaundice is called ...
| It is caused by ...
hyperbilirubinemia
| increased levels of bilirubin in blood
69
Prehepatic jaundice is ... in blood.
It is the result of ...
It is a characteristic of ..
unconjugated bilirubin elevated in blood.
excessive destruction of RBCs
hemolytic anemias or transfusion reactions
70
Intrahepatic jaundice is ...
| It occurs with ... like ... and ..
both unconjugated and conjugated bilirubin in blood
disease or damage to hepatocytes
hepatitis and cirrhosis
71
Posthepatic jaundice is ...
| It is caused by .... like ...
conjugated bilirubin in blood
obstruction of bile flow into gallbladder or duodenum
tumor, cholelithiasis
72
Blood tests for liver function usually tests enzymes....
```
alanine aminotransferase
aspartate aminotransferase
alkaline phosphatase
albumin
total protein
total bilirubin
unconjugated bilirubin (or indirect)
conjugated bilirubin (or direct)
```
73
Alanine aminotransferase is found mostly in ... but small amts in kidneys, heart, muscles and pancreas.
Aspartate aminotransferase is found in ...
Alkaline phosphatase is related to..
liver
liver, heart, muscles
bile ducts
74
Albumin is a ...
It is decreased in..
It is increased in...
protein made in the liver
malnutrition, liver disease, pregnancy, overhydration
dehydration
75
Mild hepatitis results in ...
| Sever results in ...
impaired hepatocyte function
| necrosis due to obstruction of blood flow and bile flow
76
Viral hepatitis can cause damage by direct action like in ... or cell-mediated immune response like in ...
C
| B
77
Hep A is called ...
It is a small ... virus
It is transmitted by ... in areas of inadequate sanitation or hygiene.
Vaccine available.
infection hepatitis
RNA
fecal-oral route
78
Hep B was formerly called ...
It is a ... virus.
There is a long ... period.
Transmission is primarily by ...
serum hepatitis
DNA
incubation
infected blood
79
Hep C is a ... virus.
It is the .... type transmitted through blood transfusion.
Half of the cases enter ... state.
Increases risk of ...
RNA
most common
chronic
hepatocellular carcinoma
80
Hep D is also called ...
It is incomplete ... (requires ... to replicate and produce active infection).
HDV infection increases severity of HBV infection.
Transmitted by..
delta virus
RNA
HBV
blood
81
Hep E is a ... virus.
| It is transmitted by ... route.
RNA
| oral-fecal
82
Chronic hepatitis can be treated with ...
interferon
83
Hepatotoxins cause ... of liver.
Mode of action...
Types...
May result from ....
inflammation and necrosis
direct effect of toxins, immune response
drugs, chemicals
sudden exposure to large amounts or from lower dose and long-term exposure
84
Biliary cirrhosis is common in ...
Post-necrotic cirrhosis is linked with ...
Metabolic cirrhosis is usually caused by...
autoimmune disease
chronic hepatitis or long-term exposure to toxins
genetic metabolic storage disorders
85
Structural changes of cirrhosis includes..
fibrosis and loss of lobular organization
86
In cirrhosis there is a decrease in production of ... which causes a decrease in digestion and absorption of nutrients. There is decrease in... and removal of bilirubin. There is decrease in production of .... mostly blood clotting factors. There is decrease in detoxification of ... and ...
...and ... metabolism. Decrease in conversion of .... to urea. Decrease in storage of .. and ...
```
bile
conjugation
proteins
drugs
toxic substances
glucose and glycogen
ammonia
iron and vitamin B12
```
87
Most common tumor of liver ...
Secondary or metastatic cancer of liver arises from areas served by ....
Initial signs are .. and ...
Diagnosis usually occurs with ...
hepatocellular carcinoma
hepatic vein
mild and general
advanced stages
88
Inflammation of pancreas in acute pancreatitis results from ... which is caused by ...
autodigestion of tissue
| premature activation of pancreatic proenzymes
89
Acute pancreatitis spreads to surrounding tissue because ..
pancreas lacks fibrous capsule
90
Acute pancreatitis is
a medical emergency
91
Most common form of pancreatic cancer..
| Arises from ... in ducts.
adenocarcinoma
| epithelial
92
Crohns affects ... of GI. Most frequently ...
It is progressive ... and ... which obstructs .... and thick .. .walls develop. There is impaired .... and inflammation stimulates ....
```
any area
small intestine (ileum)
inflammation and fibrosis
lumen
fibrotic
processing and absorption of food
intestinal motility
```
93
Inflammation in Crohns occurs in characteristic distribution...
Other complications include..
skip lesions
| adhesions between loops may form and fistulas may develop
94
UC, inflammation starts in the ... it progresses through the ... the mucosa and submucosa are inflamed and ... develop. The tissue destruction interferes with ... of ... and ... in colon.
rectum
colon
ulcerations
absorption of fluid and electrolytes
95
IBS is a .... disorder.
It affects ....
It does not cause ...
Affects ... more.
chronic, long-term disorder
large intestine
change in bowel tissue
women
96
Diverticula development is most common in ...
Weaker areas ... when pressure increases.
Stasis of material in diverticulum leads to ... and ...
....is asymptomatic diverticular disease.
...is inflammation of diverticula.
```
sigmoid colon
bulge
inflammation and infection
diverticulosis
diverticulitis
```
97
Most malignancies of colon cancer develop from ....
adenomatous polyp
98
Chemical peritonitis may result from..
```
enzymes released with pancreatitis
urine leaking from ruptured bladder
chyme spilled from perforated ulcer
bile escaping from ruptured gallbladder
blood
```
99
Bacterial peritonitis is caused by
direct trauma affecting intestine
ruptured appendix
intestinal obstruction and gangrene
