GI + Metabolism ( 10% ) Flashcards
The following GI peptides are all distributed distal to the gastric antrum except
- Secretin
- CCK
- GIP
- Neurotensin
- Gastrin
Gastrin
- Secretin - Duodenum/jejunum (ileum to a small degree)
- CCK - Duodenum/jejunum (ileum to a small degree)
- The above two both release in response to fat/AA in intestine, and act by stimulating pancreatic enzymes/GB, and inhibiting gastric secretions
- GIP - duodenum/jejunum
- Neurotensin
Regarding HCl secretion by the parietal cells, which is false
- H is actively pumped out by ATPase
- After a meal the blood pH can rise
- H is exchanged for Cl
- Histamine and gastrin stimulate H secretion
- Parietal cells are rich in carbonic anyhdrase
H is exchanged for K+
- Hydrogen is pumped out in exchange for K+ by H-K-ATPase. Chloride ions are secreted seperately.*
- Hydrogen is derived from the hydration of CO2 (H20 + CO2 -> H2CO3 -> H+ + HCO3). This is catalysed by carbonic anhydrase*
- HCO3 is produced as a byproduct of the H+ formation - this diffuses into the blood stream (alkaline tide) and can later be used to buffer the acid once it is not needed.*
- Stimulants: gastrin, histamine, ACh*
- Inhibitors: VIP, GIP*
After complete hepatectomy, a rise would be expected in blood levels of
- Glucose
- Fibrinogen
- 25-hydroxycholecalciferol
- conjugated bilirubin
- oestrogens
oestrogens
All others are created by the liver
Gastric emptying occurs
- Via sympathetic mediation
- When pressure increases in the body of the stomach
- Due to stomach contractions lasting up to 30s
- With no regurgitation of contents from the duodenum
- With the passage of mixed solid and liquid gastric contents into the duodenum
With no regurgitation of contents from the duodenum
- Receptive relaxation occurs - the antrum and fundus relax to allow food to enter without an increase in pressure, whilst peristalsis begins mixing food in the lower portion of the stomach. This is vagally mediated.*
- Small, semi-liquid portions enter the duodenum (not solids)*
- Systolic waves last up to 10sec, 3-4/min*
- Osmotic pressure in the duodenum influences gastric emptying - high osmotic pressures -> slower emptying*
with respect to GI hormones (2 correct)
- gastrin stimulates insulin secretion after a carbohydrate meal
- secretin stimulates the secretion of gastric acid
- CCK is found in nerves of the distal ileum and colon
- GIP secretion is stimulated by glucose and fat in the duodenum
- VIP increases secretion of pancreatic enzymes and electrolytes
CCK is secreted by I cells in the upper small intestine, and also found in nerves of the distal ileum and colon, and brain.
GIP secretion is stimulated by glucose and fat in the duodenum
- gastrin stimulates glucagon secretion after a carbohydrate meal
- secretin inhibits the secretion of gastric acid
- Stimulates watery pancreatic secretions, with a high bicarb content
- CCK stimulates pancreatic enzyme release
- VIP increases secretion of intestinal electrolytes and water
- VIP is found in nerves in the GI tract, and is thus not a hormone
toxins that increase cAMP content of the intestinal mucosa cause diarrhea because they
- increase Cl secretion into the intestinal lumen
- increase Na absorption in the small intestine
- increase K secretion into the colon
- increase Na/K cotransport K secretion into the colon
- none of the above
increase Cl secretion into the intestinal lumen
- As well as reduced NaCl reabsorbtion*
- This is what occurs in Cholera*
Which cells secrete IF
- Chief cells
- G cells
- K cells
- S cells
- Parietal cells
Parietal cells
Parietal cells also produce gastric acid
- Chief cells - pepsinogen
- G cells - gastrin
- K cells - GIP
- S cells - secretin
- I cells - CCK
secretin causes
- increased gastric motility
- increased volume of secretions
- an enzyme rich secretion
increased volume of pancreatic secretions
- a bicarb-rich, watery, pancreatic secretion.
- CCK is enzyme rich
- increased gastric motility
gastric emptying
- is not related to pH in the duodenum
- duodenal pressure is not important
- normally takes 1-3 hours to empty
normally takes 1-3 hours to empty
Carbs fastest -> proteins -> fats (slowest)
-
is related to pH in the duodenum
- Low pH causes reduced emptying
- duodenal pressure is not important
the pH of pancreatic secretion is
- 5.0
- 6.0
- 7.0
- 7.5
- 6.5
7.5
Gangongs just states ‘alkaline’
Upon stretching intestinal smooth muscle
- It hyperpolarizes
- The tension is due to elastic forces only
- It depolarizes
- Relaxation occurs
- It is an example of a multi-unit smooth muscle
It depolarizes
Multiunit smooth muscle is foud
concerning pancreatic secretion
- the pancreas secretes gastrin
- pH is 6.0
- it contains anti-trypsin molecules
- it contains an enzyme converting polysaccharides to monosaccharides
it contains anti-trypsin molecules
- Trypsin is produced as trypsinogen and then converted into trypsin in the intestine, to stop auto-digestion of the pancreas itself. Pancreas also secretes anti-trypsin molecules to help in this regard.*
- pH is 7.5*
- Gastrin is secreted by the gastric antrum (G-cells)*
- Pancreatic amylase converts polysaccharides to disaccharides. Conversion to monosaccharides occurs via intestinal enzymes.*
With regard to the parasympathetic nerve supply to the gut, it is
- Essential
- Non-essential
- Modulatory
- Passive
Modulatory
parasympathetic increases activity of intestinal smooth muscle, whilst sympathetic relaxes it whilst causing sphincters to contract
Which is true of faeces
- 50mL is produced daily on average.
- it is chiefly formed from protein breakdown products
- solids form 75% of its composition
- the solid portion contains 30% bacteria
- the brown colour is due to melanin
the solid portion contains 30% bacteria
- 200mL is produced daily on average.
- it is chiefly formed from water, bacteria, and inorganic material
- solids form 25% of its composition (Water 75%)
- the brown colour is due to bile salts or bacteria (unsure which)
The majority of the water ingested or secreted into the bowel is usually absorbed in the
- Stomach/duodenum
- Jejunum
- Ileum
- Ascending and transverse colon
- Descending and sigmoid colon
Jejunum