GI 3

Question 1

what are the two general functions of the pancreas?

Answer 1

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

exocrine - secretion of digestive enzymes

Question 2

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

Answer 2

true - through common bile duct and then sphincter of Oddi

Question 3

how can gallstones / biliary colic cause pancreatitis?

Answer 3

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

Question 4

who is Ashcroft?

Answer 4

the face of pancreatitis - a politician who had it

Question 5

how do you cure gallbladder pancreatitis?

Answer 5

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

Question 6

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

Answer 6

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

Question 7

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

Answer 7

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

Question 8

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

Answer 8

colon - 1-2 litres reaches

stool - 100ml reaches

Question 9

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

Answer 9

false

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

Question 10

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

Answer 10

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

Question 11

explain sensitization and primed immune cells in the GI tract?

Answer 11

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

Question 12

what major cells carry out immediate responses in the intestine

Answer 12

mast cells

Question 13

what us Celiac disease?

Answer 13

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

Question 14

How does celiac disease cause weight loss and anemia?

Answer 14

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

Question 15

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

Answer 15

false

gluten intolerance is NOT genetic nor immune cell based

Question 16

what is gluten intolerance?

Answer 16

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

Question 17

true or false, lactose intolerance is an allergy

Answer 17

FALSE - simply a deficiency in lactase enzyme

Question 18

what race has an unusally high level of lactase?

Answer 18

caucasion

Question 19

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

Answer 19

bacterial response to the undigested lactose in the lumen

Question 20

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

Answer 20

• 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

Question 21

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

Answer 21

a state of hyper-awareness

this is just a theory

Question 22

what is atopy?

Answer 22

genetic tendancy to develop an allergic disease

Question 23

which E. coli is bad for you?

Answer 23

O157 H7 is the BAD strain of E. coli

most E. coli is fine or even good for you

Question 24

O157 H7 is what?

Answer 24

the bad strain of E. coli

Question 25

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

Answer 25

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

Question 26

what may occur if normal flora balance is thrown off

Answer 26

C. difficile bacterium will flourish e.g. we may take anti-biotics which disturbs the normal flora and allows this to propogate

Question 27

t or f for C difficile colitis 1. infection 2. treatment 3. re-infection 4. resistance

Answer 27

true

Question 28

how do you treat a C difficile infection?

Answer 28

fecal transplant given by a highly screened relative | - very effective

Question 29

who is Elaine Petroff, what has she discovered?

Answer 29

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

Question 30

how does C. difficile cause diarrhea?

Answer 30

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

Question 31

what other bacterium causes severe diarrhea?

Answer 31

Cholera --> can be fatal this was introduced to Haitii - killed many people

Question 32

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

Answer 32

damaged mucosa - e.g. Celiac disease

Question 33

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

Answer 33

sodium, potassium, and bicarbonate

Question 34

what is traveler's diarrhea?

Answer 34

- 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

Question 35

what does EHEC stand for?

Answer 35

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

Question 36

what does E. coli O157 H7 cause?

Answer 36

- 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

Question 37

What is Walkerton, Ontario?

Answer 37

town who had a terrible outbreak of O157 in their water - 7 people died - now very clean water

Question 38

what is hamburger disease

Answer 38

O157 contamination of burger meat

Question 39

what is the appendix, where is it found?

Answer 39

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

Question 40

what is an appendicitis? how does it occur?

Answer 40

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

Question 41

what occurs if the apendix ruptures?

Answer 41

- 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