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General Boards > GI/Pancreas/Hepatic > Flashcards

GI/Pancreas/Hepatic Flashcards

1
Q

What do parietal cells do

A

make and secrete H+ ions

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2
Q

What regulates gastric acid secretion

A

ACh and histamine

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3
Q

What catalyzes conversion of CO2 to carbonic acid

A

carbonic anhydrase

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4
Q

What are the two plexuses in the GI tract

A

myenteric and submucosal –> parasympathetic to the GIT

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5
Q

What is intrinsic factor

A

needed for cobalamin absorption in the ileum

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6
Q

Where is conjugated bile acid absorbed in the GIT

A

actively absorbed in the ileum

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7
Q

What stimulated gastrin secretion

A

stretch, vagal stimulation, peptides in the stomach

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8
Q

What is final product of carbohydrate metabolism

A

glucose

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9
Q

What transport protein binds free iron in the small intestine

A

Apotransferrin

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10
Q

What is the function of secretin

A

stimulated HCO3 production

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11
Q

Where is HCO3 exchanges with Cl for

A

in the small intestines

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12
Q

What stimulated pancreatic secretions

A

Ach, CCK, and secretin

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13
Q

what is the primary constituent of chylomicrons

A

TG

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14
Q

What prevents fat from reassembling in the small intestines

A

micelles

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15
Q

What causes fatty acid release

A

hormone sensitive lipase

glucagon activate adipose tissue –> increased FA
Also inhibits TG storage in the liver –> preventing liver from removing FA from the blood

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16
Q

What is erythromycin

A

motilin agonist

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17
Q

What causes lipemia after a fast

A

VLDL

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18
Q

which routes of administration undergo first pass metabolism

A

oral and rectal

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19
Q

What does elevated bile acids differentiate from

A

PLE vs. liver disease

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20
Q

what is the treatment for hyperlipidemia

A

gemfibrozil

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21
Q

what causes proteinuria in min. sch. with high TG

A

glomerular fat lesions

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22
Q

What is the treatment for pancreatitis

A

supportive care IV

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23
Q

what is seen on labwork with EPI

A

B12 - normal or low (worse prognosis if low)
folate - normal to elevated
TLI - low
PLI - normal to low

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24
Q

what does the gastrocolic reflex cause

A

motility

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25
Q

What vitamin is synthesized in the body

A

vitamin D

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26
Q

Which organ converts lactic acid to glucose

A

liver via lactate dehydrogenase

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27
Q

How and where does secretin work?

A

secreted by the duodenum and jejunum

Secretes HCO3

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28
Q

How does Cholecystokinin work

A

released from duodenum and jejunum (I cells) secondary to food/fat –> release pancreatic enzymes and bile

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29
Q

Gastrin

A

G-cells - antrum

H+ secretion from parietal cells & growth of gastric mucosa

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30
Q

CCK

A

I-cells duodenum/jejunum

GB contraction, secretion of pancreatic enzymes, secretion of HCO3, growth of exocrine pancreas/GB, inhibits gastric emptying

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31
Q

Secretin

A

S-cells duodenum

Secretes HCO3 in response to H+ and FA in the lumen. Inhibits gastrin, gastric acid production, and motility

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32
Q

Gastric Inhibitory Peptide (GIP)

A

K-cells duodenum/jejunum

Secretes insulin (beta cells) and inhibits H+ secretion in stomach/emptying

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33
Q

Motilin

A

M-cells proximal duodenum

Between meals - initiates and coordinates migrating motility complexes (MMC) to increase GI motility and helps to clear stomach

After meal - coordinates gastric, pancreatic, and biliary secretions

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34
Q

Ghrelin

A

Gastric cells

Appetite stimulus (entyce ghrelin antagonist)

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35
Q

Leptin

A

Fat cells

Decrease appetite

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36
Q

Somatostatin

A

Acts locally due to low pH

D-cells of GI mucosa

negative feedback - STOPS everything, inhibits gastric H+ secretion, pepsinogen/insulin, GB contraction, and motility

37
Q

Histamine

A

Endocrine like cells of the GI mucosa (H+ secreting areas)

H+ secretion from parietal cells

38
Q

mucous neck cells

A

secrete mucousa, HCO3, and pepsinogen

39
Q

Parietal cells

A

HCl
<10% intrinsic factor dog

Apical cells prduce HCl all the time via H+/K/ATPase pump (omprazole acts here) –> Cl follows the H+ into the lumen

Basolateral membrane absorbed HCO3 via Cl/HCO3 exchanger

40
Q

Chief cells

A

pepsinogen

41
Q

pyloric glands

A

G-cells - gastrin into circulation

42
Q

What does H+ production allow for

A

conversion of pepsinogen to pepsin to allow for protein digestion

43
Q

Where do slow waves of gastric motility originate from

A

interstitial cells of cajal

44
Q

Stimulants of pancreatic secretions

A

Ach, CCK, and secretin

45
Q

Stimulants of H+ secretion

A

Histamine, Ach, gastrin

46
Q

Inhibition of H+ secretion

A

low stomach pH, somatostatin, PGE (protective to gastric mucosa)

47
Q

MOA cisapride

A

5HT4 agonist (promotility) efferent to GI

48
Q

MOA Erythromycin

A

motilin agonist (promotility) efferent to GI

49
Q

MOA Diphenhydramine and meclizine

A

H1 antagonist (antinausea) CRTZ, vestibular

50
Q

MOA Maropitant

A

NK1 antagonist (antinausea) afferent to NTS and emetic, CRTZ

51
Q

MOA omeprazole

A

PP inhibitor

52
Q

MOA famotidine

A

H2 blocker

53
Q

MOA ondasetron

A

5HT3 antagonist (antinausea) afferent, CRTZ, emeti

54
Q

MOA butorphanol

A

ENK antagonist; CRTZ and higher centers

55
Q

MOA metoclopramide

A

dopamine antagonist (antinausea) CRTZ, emetic
5HT4 agonist (promotility) efferent
5HT3 antagonist (antinausea) CRTZ, emetic, afferent

56
Q

What prevents fatty acid and monoglyceride turning back to TG in the intestines

A

bile salts (micelles)

57
Q

What AA are essential for cats

A

arginine and taurine

58
Q

What is an essential fatty acid for dogs and cats

A

Linoleic acid

arachidonic acid - only cats

59
Q

Which LDL is in gross lipemia after 24 hours of fasting

A

VLDL (mostly TG)

60
Q

Where does conversion of lactic acid to glucose occur

A

liver

61
Q

What is the second step of drug conjugation in the liver

A

glucouronidation

62
Q

What is the treatment for copper storage disease

A

D-penicillamine or trientine

63
Q

What carries copper

A

ceruloplasmin

64
Q

what is the shunt fraction in microvascular displasia

A

usually high

65
Q

CS of feline hepatic encephalopathy

A

aggression, hypersalivation, and seizures

66
Q

Anorexic cat with elevated ALP > GGT

A

hepatic lipidosis

67
Q

Prehepatic portal hypertension can be caused by portal vein atresia - name diseases

A

Cirrhosis - intrahepatic
Congenital PSS
Primary hypoplasia of portal vein - intrahepatic

68
Q

Which disease will have elevated post-prandial BA

Hypoalbuminemia from PLE or liver failure

A

Liver failure

69
Q

Which disease will have elevated post-prandial BA

Cholestasis due to hepatic or post hepatic

A

cholestasis due to hepatic

70
Q

What are BW changes in PSS

A

low urea, BG, Chol, Alb

high ammonia, high BA, target cells, microcytosis, anemia

71
Q

What is a rapid treatment of severe hepatic encephalopathy

A

lactulose enema and correct lyte abnormality

72
Q

What is unique about ALP in cats

A

shorter half life (6 hours) - less sensitive, but more specific to liver

73
Q

What is the half life of ALP ing dogs

A

66 hours

74
Q

Half life of ALT in dogs and cats

A

dogs - 60 hours
cat - 3.5 hours

75
Q

Half life of AST in dogs and cats

A

dog - 12 hours
cat - 1.5 hours

76
Q

What are signs of PSS in cat

A

ptyalism, seizures, and neuro signs - copper eyes

77
Q

What are responsible for elevation in ALP with cholestasis

A

bile acids

78
Q

Why is an elevation in ALP more concerning in cat vs. dogs

A

due to short half life

79
Q

What is the most sensitive test for chronic pancreatitis - cat

A

AUS

80
Q

What inhibits glucagon

A

insulin
somatostatin

81
Q

What macroglobulin can be seen with pancreatitis

A

A2

82
Q

what is elevated in pancreatitis that leads to vasodilation, nociception, and increased vascular permeability

A

kallikrein (precursor to bradykinin)

83
Q

What are GI panel findings on EPI

A

low B12 and increased folate – also low TLI

84
Q

MOA misoprostal

A

PGE1 analog

85
Q

Ursodiol MOA

A

increases solubility and hydrophilicity of bile acids, increases choleresis, immunomodulation, and inhibits apoptosis by stabilizing mitochondria

86
Q

What drug can be used as a prokinetic due to AchE inhibitor activity

A

neostigmine

87
Q

MOA of chemo-related vomiting at CRTZ

A

serotonin (5HT3)

88
Q

promotility drug that binds to cholinesterase

A

neostigmine

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