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PGHY 350 > GI 3 > Flashcards

GI 3 Flashcards

1
Q

what are the two general functions of the pancreas?

A

endocrine - secretion of insulin (beta) and glucagon (alpha)

exocrine - secretion of digestive enzymes

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2
Q

t or f, the pancreatic pre-proteases (zymogens) and the bile from the gallbladder enter the SI through the same duct

A

true - through common bile duct and then sphincter of Oddi

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3
Q

how can gallstones / biliary colic cause pancreatitis?

A

gallstones can block the outflow of pancreatic digestive enzymes. these enzymes are zymogens. however, if they are stuck there long enough, they may activate and attack your own tissues - inflammation

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4
Q

who is Ashcroft?

A

the face of pancreatitis - a politician who had it

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5
Q

how do you cure gallbladder pancreatitis?

A

remove the gallbladder - bile is continuously made and therefore, the gallbladder is not actually needed.

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6
Q

other than gallbladder pancreatitis - what other forms are there? explain each. (4)

A
  1. alcoholic - alcohol can inappropriately activate zymogens
  2. infectious - microbe can activate zymogens –> complications arise with sepsis (systemic altered immune response), perforations, and potentially peritonitis due to auto-digestion
  3. cystic fibrosis - cannot produce enough water secretions, makes fluid thick and gets trapped. stuck proteases activate
  4. cancer
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7
Q

what are the components of the SI and LI. What are the functions of each (SI - 4)

A

SI - duodenum, jejunum, and ileum

  • removes acidity from tract
  • secretions for digestion/action of enzymes
  • absorption
  • mixing and propulsion

LI - cecum, ascending colon, transverse, descending, and the rectum

  • water reabsorption
  • storage
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8
Q

if the normal fluid load for the GI tract in one day is 9 litres, how many reach the colon, how many in stool?

A

colon - 1-2 litres reaches

stool - 100ml reaches

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9
Q

t or f, the water absorption in the SI is at maximum absorption normally.

A

false

  • normal function is well-below maximum
  • increased absorption - constipation
  • decreased - diarrhea
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10
Q

t or f, the immune cells of the GI system are always present and ready to fight an attack - they sit in the lamina propria

A

true - these cells are in the villi just under the epithelial cells

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11
Q

explain sensitization and primed immune cells in the GI tract?

A

early exposure to different microbes and even food allergies ensures we are primed to become either tolerant to these or have ab’s that can mount an immediate response
- may become tolerant to innocuous food allergens

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12
Q

what major cells carry out immediate responses in the intestine

A

mast cells

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13
Q

what us Celiac disease?

A

Celiac disease is a genitcally inherited, incurable disease related to being intolerant to glucose (specifically gliadin in glucose). When gluten is eaten, Celicac patients mount a major immune response

  • it is an AI disease - WBC’s attack mucosa
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14
Q

How does celiac disease cause weight loss and anemia?

A

if a celiac patient eats enough glucose, the immune response damages the intestinal villi and causes a major decrease in their surface area (creates a ‘flat mucosa’) –> decreased absorptive abilities - weight loss
- also decreases secretions

celiac disease is mainly a pathology of the upper SI tract which is needed for Iron uptake. lack of iron uptake can cause anemia

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15
Q

t or f gluten intolerance is genetic but not immune cell based

A

false

gluten intolerance is NOT genetic nor immune cell based

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16
Q

what is gluten intolerance?

A

typically a self-diagnosed conditon in which people get discomfort after eating too much gluten –> symptoms seem to disapear if you stop eating gluten.

it is rarely accurately diagnosed and is promoted by comercial advertising

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17
Q

true or false, lactose intolerance is an allergy

A

FALSE - simply a deficiency in lactase enzyme

18
Q

what race has an unusally high level of lactase?

A

caucasion

19
Q

what causes the symptoms of lactose intolerance - diarrhea, malaise, gas, bloating etc

A

bacterial response to the undigested lactose in the lumen

20
Q

what causes food allergies? what is the response during a food allergy

A
  • exposed to some food allergen which causes antibody prouction (IgE)
  • IgE on mast cell detects allergen - degranulation
  • first starts in GI then becomes systemic
  • inflammation, hives, diarrhea, anaphylaxis

note: allergies are not always forever

21
Q

food allergens may be a result of ‘ cloud-sourced-anxiety’ which is?

A

a state of hyper-awareness

this is just a theory

22
Q

what is atopy?

A

genetic tendancy to develop an allergic disease

23
Q

which E. coli is bad for you?

A

O157 H7 is the BAD strain of E. coli

most E. coli is fine or even good for you

24
Q

O157 H7 is what?

A

the bad strain of E. coli

25
Q

what GI tract function is efficient at killing off pathogenic microbes? What occurs if a pathogenic microbe makes it into the SI?

A

gastric sterilization through acid kills microbes

if a microbe makes it into the SI, it may throw off the balance of the normal flora. it also may secrete toxins

26
Q

what may occur if normal flora balance is thrown off

A

C. difficile bacterium will flourish

e.g. we may take anti-biotics which disturbs the normal flora and allows this to propogate

27
Q

t or f for C difficile colitis

  1. infection
  2. treatment
  3. re-infection
  4. resistance
A

true

28
Q

how do you treat a C difficile infection?

A

fecal transplant given by a highly screened relative

- very effective

29
Q

who is Elaine Petroff, what has she discovered?

A

Elaine Petroff has discovered a way to make synthetic stool for C. difficile transplant therapy.

30
Q

how does C. difficile cause diarrhea?

A

it secretes toxins which cause increases water secretion

diarrhea occurs due to

a. increased water secretion
b. decreased absorption
- the underlyning issue is with ion transport problems

31
Q

what other bacterium causes severe diarrhea?

A

Cholera –> can be fatal

this was introduced to Haitii - killed many people

32
Q

diarrhea arises via a. altered secretory processes (C. diff and Cholera) and b. ??

A

damaged mucosa - e.g. Celiac disease

33
Q

what are three solutes which may be immensly lost by diarrhea?

A

sodium, potassium, and bicarbonate

34
Q

what is traveler’s diarrhea?

A
  • when we encounter an E. coli strain very similar to our own but not similar enough to live with
  • causes diarrhea and malaise
  • self-limiting - do NOT need anti-biotics
35
Q

what does EHEC stand for?

A

enterohemorrhagic E. coli –> this is the bad kind of E. coli

36
Q

what does E. coli O157 H7 cause?

A
  • extreme diarrhea
  • resident in cattle intestines –> therefore, we get infected through poorly prepared meat
  • the bacteria release a toxin which gets into the blood
  • this can lead to kidney failure and retinopathies

this causes a serious threat to anyone who has it, not just the young and elderly

37
Q

What is Walkerton, Ontario?

A

town who had a terrible outbreak of O157 in their water

  • 7 people died
  • now very clean water
38
Q

what is hamburger disease

A

O157 contamination of burger meat

39
Q

what is the appendix, where is it found?

A

it is a small pouch that sits at the junction of the SI and the LI. like the LI’s tail near the cecum
- it has unknown function

40
Q

what is an appendicitis? how does it occur?

A

appendicitis occurs when there is blockage of the lumen of the appendix –> by bad luck, food, seeds, deposits enter the lumen and clog it. this elicits inflammation which can cause pain, swelling, and even the bursting of the appendix - very bad

41
Q

what occurs if the apendix ruptures?

A
  • it will be met by the host immune system
  • it may be resolved and sealed off by alterations in the periotneal cavity
  • or peritonitis will occur

pain is felt in the right lower quadrant - in self-perspective

PGHY 350 (10 decks)

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