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Medicine 2 > G.I > Flashcards

G.I Flashcards

1
Q

During the fasting state what movements occur in the stomach and what induces them and how regular are they?

A

Migratory Motor Complex

Motilin

every 90 -120mins

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2
Q

What are the Enterogastrones that reduce acid secretion?

A

Secretin

CCK

GIP

Peptide YY

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3
Q

What are the main mechanisms that allow the stomach to accomodate more food?

A

Vagas Vagal Reflex

Entero - Gastric Reflex

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4
Q

What is the muscle contractions that happen in the stomach to force chyme through the pyloric sphincter?

A

Pyloric Pump Contractions - 20% of the Basic Electrical Rate

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5
Q

What is the term for the electrical activity that occurs in the stomach when food is present that helps mix?

A

Basic Electrical Rate

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6
Q

Where does Secretin come from and how does it work to inhibit HCl?

A

S cells of the dudoneum

Increases:

  • somatostatin
  • Reduces Gastrin
  • Directly inhibits Parietal cells
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7
Q

What are the stages of Migratory Motor Complex?

A

Stage I: Quiescence

Stage II: Increased frequency of contraction

Stage III: Peak electrical and mechanical activity

Stage IV: Decline in activity leading to stage I

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8
Q

What are the movements in the Large intestines?

A

Mass movements

Haustra movements

Segmental propulsion

Main action is to mix the content well

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9
Q

What is the reflex that stimulates mass movement? can be triggered by intake of food.

A

Gastro- Coelic reflex

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10
Q

How do D cells work to control acid secretion?

A

If the pH drops they release somatostatin which acts directly on the G cells and parietal cells

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11
Q

When HCO3 is produced from HCl production, how is it transported out of the cell?

A

Cl- transporters. The Cl- which comes in is then used to make the HCl.

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12
Q

During swallowing what substances cause relaxation of the esophagus?

A

Nitric oxide

Vaso active peptide

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13
Q

During swallowing what substances cause constriction of the esophagus?

A

ACh

Substance P

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14
Q

How long does swallowing take?

A

8 - 10 seconds

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15
Q

What cranial nerves are involved in afferent stimulation of swallowing?

A

Trigeminal : V

Glossopharangeal : IX

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16
Q

What cranial nerves are involved in efferent stimulation of swallowing?

A

Trigeminal: V

Glossopharangeal: IX

Vagus: X

Hypoglossol : XII

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17
Q

What is the enzyme that converts Non Heme (Fe3+) into Heme Iron (Fe2+)

A

Duodenal Cytochrome B

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18
Q

Which transporter moves Fe2+ out of the lumen and into the cell and what cell is this?

A

Divalent Metal Transporter - 1

Enterocyte

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19
Q

What is the Transporter that moves Fe2+ out of the enterocyte and into the blood?

A

Ferroportin -1

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20
Q

What hormone released by the liver inhibits the movement of Fe2+ from the enterocytes into the blood and what transporter does it work on?

A

Hepcidin

Ferroportin - 1

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21
Q

What is the fate of Fe2+ when it enters the enterocyte?

A

Transported out of the cell into blood via ferroportin- 1

stored as:
Hemosiderin
Ferritin

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22
Q

What is the transporter of Fe2+ in the blood, and what happens if the levels of Fe2+ are sensed to be higher? and what if sensed to be lower?

A

Transferrin

if high levels of Fe2+ , the synthesis of transferrin decreases

if levels are sensed to be low then synthesis of transferrin increases

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23
Q

What are the two major movements of the small intestines?

A

Segmentation

Peristalsis

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24
Q

What controls peristalsis with brief overview

A

Myenteric plexus

Ascending: circular constriction - ACh and Substance P

Descending - dilation and longitudinal - NO and VIP

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25
Q

What is the electrical activity that governs the contractions in the small intestines?

A

Basic Electrical Rhythm

26
Q

What is the BER in the small intestines?

A

Duodenum: 12/ min

Jejunum: 10/ min

Ileum: 9/ min

27
Q

What are the folds in the Intestine called?

A

Plicae Circularis / Valves of Kerkring

28
Q

What is at the bases of the Villi and where are they most prominent?

A

Intestinal Glands

Most commonly seen in Jejunum

29
Q

What cells are found in the intestinal Glands?

A

Stem Cells

Entero - endocrine cells

Panath cells

30
Q

What do Entero - endocrine cells release?

A

CCK

Secretin

5 - hydroxytryptamine - serotonin

31
Q

In the ileum what defensive structure is found in the submucossa and what cells are present?

A

Peyer’s patch’s

M - cells

Dentritic cells

lymphocytes

32
Q

What is the most potent stimulation for pancreatic enzyme release?

A

CCK - stimulation of pancreatic enzymes release

Secretin - stimulation of Bicarbonate

VIP - relaxation of ampulla of vater

33
Q

What is the stimulator for bicarbonate secretion from the pancreas?

A

Secretin
and
Vagus reflex

34
Q

What cells in the pancreas produce Bicarbonate?

A

Intercalated duct cells

35
Q

What Can be a useful distinguishing feature of duodenum?

A

Lack of mesentery

36
Q

What nerve controls the external anal sphincter?

A

Pudendal Nerve

37
Q

What is the transporter than secretes Cl- into the lumen called?

A

Cystic Fibrosis Transmembrane Regulator

38
Q

At the intestinal glands Cl- is secreted, with Na2+ and H2O following. These are then reabsorbed with more. what is the process of secretion and re absorption called?

A

Fluid Circuit Hypothesis

39
Q

For the absorption of di and tri peptide chains - what is the driving force?

A

H+ ions which were pumped out in order to create a gradient to allow their absorption

40
Q

Single amino acids are co-absorbed with?

A

Na2+

41
Q

What is the protein that regulates Cl- secretion in the G.I system?

A

Cystic fibrosis trans-membrane regulator

42
Q

What GLUT receptors are present on the small intestines? and what does each transport?

A

GLUT 1:
co transporter with NA2+ and glucose

GLUT 5:
Fructose

GLUT 2:

on basal lateral aspect. transports glucose etc into blood

43
Q

What is the functions of the greater omentum?

A
  1. Fat disposition
  2. infection and wound localisation control
  3. Immune contribution

Can be used during surgery of pelvic cavity to reduce spread of infection

44
Q

What do the I cells release?

A

CCK

45
Q

What is the normal LOS pressure?

A

10-15mmHg

46
Q

How long is the normal oesphagus?

A

~25cm long

47
Q

What receptor does Gastrin on the parietal cells stimulate?

A

Cholecytokinin - 2 receptor

48
Q

What type of protease is pepsin and trypsin?

A

Endopepsidases

49
Q

What glucose transporter found in the small intestines?

A

SGLT-1

50
Q

Through which intracellular processes does ACh and Gastrin produces HCl?

A

Activation of Phospholipase C > IP3 and DAG > Protein kinase > activation of tubular vesicles

51
Q

Through which intracellular processes does Histamine Activate HCl production?

A

Adenly cyclase > cAMP > Protein kinase A

52
Q

What hormone is related to Gastrin?

A

CCK

53
Q

What cells release CCK?

A

I cells of the duodenum

54
Q

Where does GIP come from?

A

K cells of the duodenum

55
Q

Outwith reducing reducing the stomach activity, what else will GIP do, and why?

A

Stimulate insulin from pancreas.

this is because it is an incretin.

56
Q

What are the layer’s of the external muscle of the stomach from inside to outside?

A

Oblique > circular > longitudinal

57
Q

Name some disease which cause unconjugated bilirubin in the blood.

A

Anemia haemloylsis - malaria

Gilbert’s syndrome

Viral Hepatitis

Yellow fever

58
Q

What protects the stomach from acid?

A

Mucus production

tight junctions

bicarbonate release

59
Q

What are the non-proteolytic enzymes from the pancreas?

A

Lipases
Amylase
Ribonucleases
Deoxyribosnucleases

60
Q

How much Iron is needed to be absorbed per day?

A

20mg

61
Q

With regard to the muscle, how does peristalsis work?

A

First: Circular contract behind bolus

Second: longitudinal contract in front shortening the tube

Medicine 2 (28 decks)

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