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Medicine P1 > GI > Flashcards

GI Flashcards

1
Q

Which vitamins are fat soluble?

A

Vitamins A, D, E & K

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2
Q

What substance is secreted by D cells?

A

Somatostatin

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3
Q

Which vitamins are water soluble?

A

Vitamins B & C

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4
Q

How are fat soluble vitamins absorbed?

A

Follow the pathway of fat absorption*

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5
Q

How are water soluble vitamins absorbed?

A

By diffusion or mediated transport

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6
Q

Where is vitamins C absorbed?

A

Jejunum

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7
Q

Where are the B vitamins absorbed?

A

Ileum

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8
Q

What does vitamin B12 require for absorption?

A

Intrinsic factor

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9
Q

What is the role of vitamin A?

A

Vision (makes rhodopsin in rods cells of retina)
Reproduction (spermatogenesis, prevention of foetal reabsorption)
Growth
Stabilisation of cell membranes

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10
Q

What is the role of B vitamins?

A

Involved in cell metabolism - mainly coenzymes

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11
Q

What is the role of vitamin C?

A

Synthesis of collagen, NT, acts as antioxidant, aids non-heme iron absorption

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12
Q

What is the role of vitamin D?

A

Enhances intestinal absorption of calcium, phosphate
Resorption and formation of bone
Reduced excretion of calcium

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13
Q

What is the role of vitamin E?

A

Antioxidant

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14
Q

What is the role of vitamin K?

A

It is needed for blood clotting (clotting factors 2, 7,9 and 10) & healthy bones

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15
Q

What are the sources of vitamin A (Retinoids)?

A

Retinols:
Liver, Diary products, Oily fish
Carotenoids:
Carrots, tomato

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16
Q

What are the sources of B vitamins?

A 
Pulses
Beans
Grains
Potatoes 
Bananas
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17
Q

What are the sources of vitamin C?

A

Fresh citrus fruits

Green veg

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18
Q

What are the sources of vitamin D?

A 
SUNLIGHT
Cheese (and some other diary products)
Egg yolks
Cereals
Fatty fish e.g. tuna or salmon
19
Q

What are the sources of vitamin E?

A 
Sunflower seeds
Almond
Spinach
Safflower oil
(stored in non-adipose cells of liver and plasma and adipose cells)
20
Q

What are the sources of vitamin K?

A 
K1:
Green leafy vegetables e.g. kale, spinach, turnip greens or Vegetables e.g. brussel sprouts, broccoli, cauliflower
K2:
Intestinal bacteria
Synthetic K3 or4
21
Q

What can happen if you are deficient in vitamin A?

A

May occur due to Fat malabsorption
Features: Night blindness, xerophthalmia, blindness
(rare in affluent countries as vit A levers only drop when liver stores are severely depleted)

22
Q

What can happen if you are deficient in B12?

A

Caused by:
Autoimmune destruction of parietal cells/IF-producing cells. Lack of stomach acid. Pancreatic disease. Small bowel disease. Veganism
Causes:
Macrocytic anaemia
Peripheral neuropathy in prolonged deficiency

23
Q

What can happen if you are deficient in vitamin C? (scurvy)

A

Easy bruising and bleeding
Teeth and gum disease
Hair loss

24
Q

What can happen if you are deficient in vitamin D?

A

Demineralisation of bone

e.g. Rickets in children, osteomalacia in adults

25
Q

What can happen if you are deficient in vitamin E and what are causes of this?*
(Note vitamin E is relatively safe in excess)

A

Caused by:
Fat malabsorption, Premature infants, rare congenital defects in fat metabolism
Causes:
Haemolytic anemia, Retinopathy, Ataxia (cerebellum problem), Neuropathy

26
Q

What can happen if you are deficient in vitamin K?

A 
Haemorrhagic disease (of newborns)
(Rare in adults, unless on warfarin)
27
Q

How is vitamin B12 absorbed?

A

(Aka Cobalamins)
Released from food by acid in the stomach.
Binds to R-protein to protect from stomach acid.
Released from R-proteins by pancreatic polypeptide.
Binds to intrinsic factor (IF) produced by parietal cells in stomach.
IF-B12 complex absorbed in the terminal ileum.
B12 stored in liver.

28
Q

What is folate?

A

Coenzyme in methylation reactions, DNA synthesis, synthesis of methionine from homocysteine.
Found in foods with folic acid.

29
Q

What if have a folate deficiency?

A

Caused by:
Malabsorption, drugs interfering with folic acid metabolism, disease that increase cell turnover
Causes:
High homocysteine levels
Macrocytic anémia
Foetal development abnormalities (neural tube defects)

30
Q

What if have a folate deficiency?

A

Caused by:
Malabsorption, drugs interfering with folic acid metabolism, disease that increase cell turnover
Causes:
High homocysteine levels
Macrocytic anemia
Foetal development abnormalities (neural tube defects)

31
Q

What is secreted by Enterochromaffin (ECL) cells?

A

Histamine

32
Q

What is secreted by G cells?

A

Gastrin

33
Q

How do NSAIDs irritate stomach?

A

Inhibiting GI mucosal cycle-oxygenase (COX) activity.

*note that NSAIDs lead to production of prostaglandins

34
Q

How many layers of muscle are present in stomach wall?

A

3
Outer longitudinal
Middle circular
Inner oblique

35
Q

After prolonged reflux of acid, what is the change in cell type seen in lower oesophagus?

A

Stratified squamous to columnar

This is Barrett’s Oesophagus

36
Q

What is the action of the proton pump of parietal cells?

A

K+ into cell, H+ out of cell

37
Q

How does Vagus nerve act on parietal cells?

A

Vagus nerve is part of the parasympathetic system and releases Each onto parietal cells…

38
Q

Where does Gall-Bladder drain into?

A

Duodenum

39
Q

Which blood vessel supplies most arterial blood to midgut (e.g. jejunum)?

A

Superior Mesenteric Artery

40
Q

What is the function of Omeprazole on GI tract?

A

Proton pump inhibitor
Inhibits pump proton to reduce acid secretion.
Helps treat symptoms of gastroesophageal reflux disease (GERD)

41
Q

Where is fat first acted upon by lipase enzymes when passing through the GI tract?

A

Oral cavity

Has lingual lipase

42
Q

What is present in Porta Hepatis?

A 
Left and Right Hepatic Ducts
Left and Right Hepatic Arteries
Portal Vein
Hepatic branch of Vagus nerve
*
43
Q

What classifies the foregut?

A

Oesophagus to proximal 2 parts of duodenum (includes gallbladder and pancreas)

Medicine P1 (7 decks)

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