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USMLE Step 1: GI > GI Physiology > Flashcards

GI Physiology Flashcards

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USMLE® Step 1 flashcards
1
Q

Name the cell source for the following GI hormones: Gastrin, cholecystokinin, secretin, somatostatin, glucose-dependent insulinotropic peptide.

A

G cells (antrum of stomach), I cells (duodenum, jejunum), S cells (duodenum), D cells (pancreatic islets, GI mucosa), K cells (duodenum, jejunum)

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2
Q

State whether GASTRIN inc/dec the following: gastric H+ secretion, growth of gastric mucosa, gastric motility.

A

Inc; inc; inc

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3
Q

Stomach distention/alkalinization, amino acids, peptides, vagal stimulation inc/dec gastrin; stomach pH <1.5 inc/dec gastrin

A

Inc; dec

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4
Q

Gastrin is increased in which syndrome?

A

Zollinger-Ellison syndrome

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5
Q

Which 2 amino acids are potent stimulators of gastrin?

A

Phenylalanine and tryptophan

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6
Q

State whether CCK inc/dec the following: pancreatic secretion, gallbladder contraction, gastric emptying, Sphincter of Oddi relaxation.

A

Inc; inc; dec; inc

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7
Q

Fatty acids and amino acids inc/dec CCK.

A

Inc

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8
Q

State whether SECRETIN inc/dec the following: pancreatic HCO3- secretion, gastric acid secretion, bile secretion.

A

Inc; dec; inc

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9
Q

Acid, fatty acids in lumen of duodenum inc/dec secretin.

A

Inc

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10
Q

State whether SOMATOSTATIN inc/dec the following: gastric acid and pepsinogen secretion, pancreatic and small intestine fluid secretion, gallbladder contraction, insulin and glucagon release.

A

Dec; dec; dec; dec

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11
Q

Vagal stimulation inc/dec somatostatin; acid inc/dec somatostatin.

A

Dec; inc

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12
Q

State whether GIP inc/dec the following: gastric H+ secretion (exocrine), insulin release (endocrine).

A

Dec, inc

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13
Q

Fatty acids, amino acids, and oral glucose inc/dec GIP.

A

Inc

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14
Q

State whether VIP inc/dec the following: intestinal water and electrolyte secretion, relaxation of intestinal smooth muscle and sphincters.

A

Inc; inc; dec; inc

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15
Q

Adrenergic input inc/dec VIP; distention and vagal stimulation inc/dec VIP

A

Dec; inc

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16
Q

T/F: A VIPoma is a non-alpha, non-beta islet cell pancreatic tumor.

A

TRUE

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17
Q

VIPoma presents with watery diarrhea, achlorhydria, and hyper/hypokalemia.

A

Hypokalemia

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18
Q

Nitric oxide inc/dec smooth muscle relaxation, including lower esophageal sphincter.

A

Inc

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19
Q

Motilin is inc/dec in fasting state.

A

Inc

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20
Q

T/F: Erythromycin is a motilin receptor agonist used to stimulate intestinal paralysis.

A

TRUE

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21
Q

_____ cells produce intrinsic factor and gastric acid.

A

Parietal

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22
Q

Intrinsic factor is a vitamin _____ binding protein required for uptake in the _____.

A

B12; terminal ileum

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23
Q

What 2 conditions are associated with autoimmune destruction of parietal cells?

A

Chronic gastritis and pernicious anemia

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24
Q

Gastric acid inc/dec stomach pH; inc/dec by histamine, ACh, gastrin; inc/dec by somatostatin, GIP, prostaglandin, secretin.

A

Dec; inc; dec

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25
Q

What tumor causes continuous high levels of acid secretion and ulcers?

A

Gastrinoma

26
Q

Pepsin is produced by _____ cells and aids in carbohydrate/protein secretion.

A

Chief; protein

27
Q

Vagal stimulation and local acid inc/dec pepsin.

A

Inc

28
Q

_____ converts inactive pepsinogen to pepsin.

A

H+

29
Q

HCO3- is produced by _____ cells and _____ glands.

A

Mucosal (stomach, duodenum, salivary glands, pancreas); Brunner’s (duodenum)

30
Q

Pancreatic and biliary secretion with secretin inc/dec HCO3-.

A

Inc

31
Q

Saliva is a secretion from which 3 glands?

A

Parotid, submandibular, and sublingual glands

32
Q

Saliva is stimulated by sympathetic activity only.

A

FALSE: sympathetic AND parasympathetic

33
Q

In saliva, _____ digests starch; _____ neutralizes acid; _____ lubricate food.

A

Amylase; HCO3-; mucins

34
Q

Saliva is normally hypo/hypertonic d/t absorption but more hypo/isotonic with higher flow rates.

A

Hypotonic; isotonic

35
Q

_____ blocks vagal stimulation of parietal cells.

A

Atropine

36
Q

Gastrin increases acid secretion through it’s effect on _____ cells, leading to _____ release.

A

ECL; histamine

37
Q

Brunner’s glands secret acidic/alkaline mucus.

A

Alkaline

38
Q

Hypertrophy of Brunner’s glands is seen in which disease?

A

Peptic ulcer disease

39
Q

In pancreatic secretions, the fluid is hypo/isotonic; low flow leads to high _____ while high flow leads to high _____.

A

Isotonic; Cl-; HCO3-

40
Q

Alpha-amylase digests _____.

A

Starch

41
Q

Lipase, phospholipase A, colipase digest _____.

A

Fat

42
Q

Proteases digest _____.

A

Protein

43
Q

Proteases are secreted as proenzymes, also called _____.

A

Zymogens

44
Q

Trypsinogen is converted to active enzyme trypsin by _____; involved in a positive/negative feedback loop.

A

Enterokinase/enteropeptidase (from duodenal mucosa); positive

45
Q

Salivary amylase starts digestion, hydrolyzes alpha-1,4 linkages to yield _____.

A

Disaccharides (maltose and alpha-limit dextrins)

46
Q

Pancreatic amylase hydrolyzes starch to _____ and _____.

A

Oligosaccharides and disaccharides.

47
Q

Where is the highest concentration of pancreatic amylase found?

A

Duodenal lumen

48
Q

What is the rate-limiting step in carbohydrate digestion?

A

Oligosaccharide hydrolases

49
Q

T/F: Only monosaccharides (glucose, galactose, fructose) are absorbed by enterocytes.

A

TRUE

50
Q

Glucose and galactose are taken up by _____; fructose is taken up by _____; all are transported to blood by _____.

A

SGLT1; GLUT-5; GLUT-2

51
Q

What does the D-xylose absorption test tell you?

A

Distinguishes GI mucosal damage from other causes of malabsorption.

52
Q

Where is iron absorbed?

A

Absorbed as Fe2+ in duodenum

53
Q

Where is folate absorbed?

A

Jejunum

54
Q

Where is B12 absorbed?

A

Terminal ileum (along with bile acids, requires intrinsic factor)

55
Q

Where are Peyer’s patches found?

A

Lamina propria and submucosa of ileum

56
Q

B cells stimulated in germinal centers of Peyer’s patches differentiate into _____-secreting plasma cells.

A

IgA (*Remember Intra-gut Antibody mnemonic!)

57
Q

Bile is composed of which 6 substances?

A

Bile salts, phospholipids, cholesterol, bilirubin, water, ions

58
Q

Name 3 functions of bile.

A

Digestion and absorption of lipids and fat-soluble vitamins; cholesterol excretion; antimicrobial activity

59
Q

Bilirubin is removed from blood by _____; conjugated with _____; and excreted in _____.

A

Liver; glucuronate; bile

60
Q

Is direct bilirubin conjugated/unconjugated; water soluble/insoluble?

A

Conjugated (with glucuronic acid); water soluble

61
Q

Is indirect bilirubin conjugated/unconjugated; water soluble/insoluble?

A

Unconjugated; water insoluble

62
Q

Bile is excreted in feces as _____; excreted in urine as _____.

A

Stercobilin; urobilin

USMLE Step 1: GI (5 decks)

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