GI/Pancreas/Hepatic Flashcards by Theresa Blakey

What do parietal cells do

make and secrete H+ ions

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What regulates gastric acid secretion

ACh and histamine

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What catalyzes conversion of CO2 to carbonic acid

carbonic anhydrase

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What are the two plexuses in the GI tract

myenteric and submucosal –> parasympathetic to the GIT

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What is intrinsic factor

needed for cobalamin absorption in the ileum

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Where is conjugated bile acid absorbed in the GIT

actively absorbed in the ileum

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What stimulated gastrin secretion

stretch, vagal stimulation, peptides in the stomach

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What is final product of carbohydrate metabolism

glucose

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What transport protein binds free iron in the small intestine

Apotransferrin

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What is the function of secretin

stimulated HCO3 production

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Where is HCO3 exchanges with Cl for

in the small intestines

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What stimulated pancreatic secretions

Ach, CCK, and secretin

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what is the primary constituent of chylomicrons

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What prevents fat from reassembling in the small intestines

micelles

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What causes fatty acid release

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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What is erythromycin

motilin agonist

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What causes lipemia after a fast

VLDL

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which routes of administration undergo first pass metabolism

oral and rectal

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What does elevated bile acids differentiate from

PLE vs. liver disease

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what is the treatment for hyperlipidemia

gemfibrozil

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what causes proteinuria in min. sch. with high TG

glomerular fat lesions

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What is the treatment for pancreatitis

supportive care IV

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what is seen on labwork with EPI

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

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what does the gastrocolic reflex cause

motility

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What vitamin is synthesized in the body

vitamin D

Which organ converts lactic acid to glucose

liver via lactate dehydrogenase

How and where does secretin work?

secreted by the duodenum and jejunum Secretes HCO3

How does Cholecystokinin work

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

Gastrin

G-cells - antrum H+ secretion from parietal cells & growth of gastric mucosa

CCK

I-cells duodenum/jejunum GB contraction, secretion of pancreatic enzymes, secretion of HCO3, growth of exocrine pancreas/GB, inhibits gastric emptying

Secretin

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

Gastric Inhibitory Peptide (GIP)

K-cells duodenum/jejunum Secretes insulin (beta cells) and inhibits H+ secretion in stomach/emptying

Motilin

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

Ghrelin

Gastric cells Appetite stimulus (entyce ghrelin antagonist)

Leptin

Fat cells Decrease appetite

Somatostatin

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

Histamine

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

mucous neck cells

secrete mucousa, HCO3, and pepsinogen

Parietal cells

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

Chief cells

pepsinogen

pyloric glands

G-cells - gastrin into circulation

What does H+ production allow for

conversion of pepsinogen to pepsin to allow for protein digestion

Where do slow waves of gastric motility originate from

interstitial cells of cajal

Stimulants of pancreatic secretions

Ach, CCK, and secretin

Stimulants of H+ secretion

Histamine, Ach, gastrin

Inhibition of H+ secretion

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

MOA cisapride

5HT4 agonist (promotility) efferent to GI

MOA Erythromycin

motilin agonist (promotility) efferent to GI

MOA Diphenhydramine and meclizine

H1 antagonist (antinausea) CRTZ, vestibular

MOA Maropitant

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

MOA omeprazole

PP inhibitor

MOA famotidine

H2 blocker

MOA ondasetron

5HT3 antagonist (antinausea) afferent, CRTZ, emeti

MOA butorphanol

ENK antagonist; CRTZ and higher centers

MOA metoclopramide

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

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

bile salts (micelles)

What AA are essential for cats

arginine and taurine

What is an essential fatty acid for dogs and cats

Linoleic acid arachidonic acid - only cats

Which LDL is in gross lipemia after 24 hours of fasting

VLDL (mostly TG)

Where does conversion of lactic acid to glucose occur

liver

What is the second step of drug conjugation in the liver

glucouronidation

What is the treatment for copper storage disease

D-penicillamine or trientine

What carries copper

ceruloplasmin

what is the shunt fraction in microvascular displasia

usually high

CS of feline hepatic encephalopathy

aggression, hypersalivation, and seizures

Anorexic cat with elevated ALP > GGT

hepatic lipidosis

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

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

Which disease will have elevated post-prandial BA Hypoalbuminemia from PLE or liver failure

Liver failure

Which disease will have elevated post-prandial BA Cholestasis due to hepatic or post hepatic

cholestasis due to hepatic

What are BW changes in PSS

low urea, BG, Chol, Alb high ammonia, high BA, target cells, microcytosis, anemia

What is a rapid treatment of severe hepatic encephalopathy

lactulose enema and correct lyte abnormality

What is unique about ALP in cats

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

What is the half life of ALP ing dogs

66 hours

Half life of ALT in dogs and cats

dogs - 60 hours cat - 3.5 hours

Half life of AST in dogs and cats

dog - 12 hours cat - 1.5 hours

What are signs of PSS in cat

ptyalism, seizures, and neuro signs - copper eyes

What are responsible for elevation in ALP with cholestasis

bile acids

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

due to short half life

What is the most sensitive test for chronic pancreatitis - cat

AUS

What inhibits glucagon

insulin somatostatin

What macroglobulin can be seen with pancreatitis

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

kallikrein (precursor to bradykinin)

What are GI panel findings on EPI

low B12 and increased folate -- also low TLI

MOA misoprostal

PGE1 analog

Ursodiol MOA

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

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

neostigmine

MOA of chemo-related vomiting at CRTZ

serotonin (5HT3)

promotility drug that binds to cholinesterase

neostigmine