GI Flashcards
What are adipocytokines?
Cytokines secreted by adipose tissue
What is the difference between marasmus and kawashiorkor disease?
Marasmus is deficiency of both calories and protein. Affects somatic compartment.
Kawashiorkor is deficiency of protein with adequate calories. Affects visceral compartment.
Which neurotransmitters can stimulate the vomiting center?
Dopamine, Ach, serotonin, and opioid receptors
How does procholrperazine work to treat N/V?
It is a dopamine agonist
How does scopolamine work to treat N/V?
It is an anticholinergic drug (blocks Ach receptors) that treats motion sickness caused by Ach receptors in the vestibular center.
Ondansetron (Zofran) is most likely used to treat N/V caused by what?
Cancer therapies
Is achalasia a mechanical or functional problem?
Functional because the sphincter does not relax making it difficult to move food down the esophagus
What is a H2 receptor antagonist?
Histamine causes inflammation because it promotes the release of acid.
So the H2 receptor antagonist blocks acid production
Which condition increases the risk of Barrett’s esophagus a precursor to adenocarcinoma.
GERD
What does arachidonic acid break down into?
Leukotrienes and prostaglandins and thromboxanes
What are prostaglandins?
Inflammatory mediators that are important in vasodilation, promoting platelet aggregation, and bronchoconstriction.
In the stomach they stimulate mucous and bicarbonate . Vasodilate nearby blood vessels increasing blood flow to the stomach promoting new epithelial cell growth and inhibits acid secretion.
What is gastrin?
A protein that is secreted in response to food entering the stomach. It stimulates the parietal cells to produce HCl and aids in gastric motility.
What are parietal cells?
Secrete HCl to help maintain low pH in the stomach in response to gastrin.
What are chief cells?
Secrete pepsinogen to digest proteins
Which peptic ulcer disease is associated with weight gain?
Duodenal ulcers because pain decreases with eating.
Which peptic ulcer is associated with weight loss?
Gastric ulcer because pain increases with food d/t the physical presence of food as well as HCl production.
What is peptic ulcer disease?
Ulcer formation in the upper GI tract that affects the lining of the stomach or duodenum.
What is a gastric ulcer?
Ulcer located in the stomach
What is a duodenal ulcer?
Found inside the duodenum which is the 1st part of the small intestine.
What are some risk factors for peptic ulcer disease?
Heavy drinking, smoking, hx of COPD, chronic NSAIDs, H pylori, genetic predisposition, cirrhosis, elderly over 65, and acute pancreatitis
What is Zollinger Ellison syndrome?
Peptic ulcer disease d/t hyper secretion of gastrin by tumor called gastrinoma resulting in excess amt of HCl.
What are the 2 types of stress ulcers?
Curling and Cushing
How does chronic NSAID use put someone at risk for developing peptic ulcers?
It blocks prostaglandins, breaking down the defense of our stomach lining
What does it mean that Crohn’s disease is transmural?
The damage and inflammation extends from the mucosa all the way down to the last layer known as the serosa.
Why is important for our digestive system to absorb folic acid and vitamin B12?
They are essential for DNA synthesis of RBCs in their early production. If we can’t absorb these things we can become anemic.
Which IBD has a cobble stone appearance?
Crohns because the inflammation is scattered with areas of healthy tissue
With which IBD is bloody diarrhea more common?
Ulcerative colitis because as the mucosa and epithelium are destroyed blood and serum might be released into the lumen.
With which IBD is the development of cancer more common?
Ulcerative colitis
What 2 complications can occur as a result of E. Coli infection ?
Hemolytic uremic syndrome and thrombotic thrombocytopenia purpura.
The overgrowth of C diff can lead to what other colitis?
Pseudomembranous colitis-toxic dilation of the colon (life threatening form of c diff colitis)
What is the difference between diverticulosis and diverticulitis?
Diverticulosis is simply having the diverticula (bulging pouches) and diverticulitis is when the diverticula are inflamed.
What kind of diarrhea is caused by celiac disease and lactase deficiency?
Osmotic
How does Mg, sulfates, and phosphates cause osmotic diarrhea?
They are not absorbable so they pull fluid with them
What is osmotic diarrhea?
When water is pulled into the bowel by the hyperosmotic nature of its contents in large quantities so that the colon is unable to reabsorb the excess fluid.
What is short bowel syndrome?
When there isn’t enough time to absorb water in the large intestine leading to osmotic diarrhea. Often seen s/p colectomies.
What is secretory diarrhea?
Caused by excess mucous secretion
What are the 2 defecation reflexes?
Intrinsic myenteric and parasympathetic reflex.
What is the difference between primary and secondary constipation?
Keywords
Primary-bad diet
Secondary- to other disease
What is an example of a functional intestinal obstruction?
Paralytic ileus
What is borborygmus?
Loud gurgling rumbling heard with bowel obstruction
What is vitamin A important for?
Vision
Vitamin K plays a role in what?
Clotting factors
Vitamin E deficiency can lead to what 2 things?
Testicular atrophy and neurologic defects in children
A lack of lipase, amylase, trypsin, and/or chymotrypsin is called what?
Pancreatic insufficiency
What are possible causes of pancreatic insufficiency?
Pancreatitis, pancreatic cancer, pancreatic resection, and cystic fibrosis
Why do we need conjugated bile salts?
To emulsify and absorb fats
What are 2 possible causes of bile salt insufficiency?
Liver disease or bile obstruction
Why does albumin take unconjugated bilirubin to the liver?
It is lipid soluble and it needs to become conjugated water soluble
What is hemolytic jaundice?
When RBCs are destroyed at a rate in excess of the livers ability to remove the bilirubin from the blood.
What is asterixis?
Tremor of the hands
What is a severe consequence of portal hypertension?
Esophageal and stomach varices
What is the role of the lower esophageal sphincter (LES)?
Prevents regurgitation from the stomach
Which valve controls the rate of stomach emptying and regurgitation of intestinal contents?
Pyloric sphincter
What segment of the intestinal tract is responsible for nutrient absorption?
Small intestines
What are the divisions of the large intestine?
Cecum, rectum, and anal canal
What is the primary task of the large intestine?
Absorbs water
What’s the nervous system of the GI?
Enteric
Which ANS increases activity of the enteric NS?
Parasympathetic innervation
T/F. The intestinal smooth muscle has its own intrinsic slow wave activity led by specialized pace maker cells.
True
What are gastric pits?
Depressions in the epithelial lining of the stomach
Why is intrinsic factor important?
Combines with vitamin B12 in the stomach and allows it to travel safely to the ileum so it can be absorbed
How do prostaglandins and nitric oxide protect the mucosal layer of the stomach?
By stimulating the secretion of mucous and bicarbonate
And
Inhibiting the secretion of acid
What is the role of prostaglandin E2?
Protects mucosal surface by inhibiting acid secretion and stimulates mucous
What is the sphincter of odi?
Where the common bile duct and pancreatic duct connect to dump into the duodenum
Where is bile stored?
Gallbladder
Why is the liver important?
Produces bile
Metabolizes hormones and drugs
Synthesizes plasma proteins and blood clotting factors
Stores vitamins and minerals
Maintains blood glucose levels
Regulates very low density lipoprotein (VLDL) levels
Why is the liver known as an excretory organ?
Because it metabolizes drugs and hormones
Why is albumin important for GI?
Helps give us oncotic pressure
Why does our liver clear ammonia?
Toxic to the neurons
What are the 2 most common causes of acute pancreatitis?
alcohol abuse and gall stones
Which lab values can given us an insight on liver function?
AST, ALT, bilirubin, GGT, and ALP
