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GI II > HECK CCP > Flashcards

HECK CCP Flashcards

1
Q

Why does gas collect in gut because of pneumatosis intestinalis

A

bacteria byproduct

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2
Q

What is the major cause of SBS

A

necrotizing enterocolitis

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3
Q

What is the clinical presentation of NEC

A

bloody stools, distended abdomen, radiographic presentation pneumatosis intestinalis

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4
Q

Why does NEC not occur before birth

A

because before birth the intestine is sterile, no bacteria colonization

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5
Q

What are risk factors for necrotizing enterocolitis

A

prematurity
intestinal ischemia
bacterial colonization
enteral feeding (milk and formula)

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6
Q

What parts of the intestine are involved in NEC

A

terminal ileum, cecum and right colon

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7
Q

Microscopically what does NEC look like

A

mucosal or transmural necrosis, ulceration and or submucosal gas bubbles

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8
Q

Ischemia can lead to what in cells

A

decreases oxidative phosphorylation in mitchondria which leads to dec Na pump so influx and swelling/bursting also dec ATP so increase anaerobic glycolysis so lactic acidosis and decreaed protein synthesis

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9
Q

What are the results of mitchondrial dysfunction

A

necrosis and apoptosis

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10
Q

What cells are responsible for innate immune defense in intestines

A

paneth cells in the crypts

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11
Q

What type of control is there for proinflammatory and proapoptotic signaling pathways

A

neg feedback

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12
Q

Describe intrinsic and extrinsic paths for apoptosis

A

extrinsic through MAMPs and caspase 8

intrinsic through cytochrome C and caspase 9

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13
Q

What is secreted in SI and what is absorbed

A

secreted: Pancreatic secretions, bile, HCO3
absorbed: water, Na, K, Cl

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13
Q

What is secreted in SI and what is absorbed

A

secreted: Pancreatic secretions, bile, HCO3
absorbed: water, Na, K, Cl

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14
Q

What transport occurs in duodenum and proximal jejunum

A 
Nutrient coupled Na
Na/H exchanger (without Cl-HCO3)
Passive Cl absorption
Cl secretion through CFTR
Carbs, prteins, lipids, Ca Fe, Folate
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14
Q

What transport occurs in duodenum and proximal jejunum

A 
Nutrient coupled Na
Na/H exchanger (without Cl-HCO3)
Passive Cl absorption
Cl secretion through CFTR
Carbs, prteins, lipids, Ca Fe, Folate
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15
Q

Where is folate exclusively absorbed

A

duodenum

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15
Q

Where is folate exclusively absorbed

A

duodenum

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16
Q

What pancreatic secretions are very important to micelles

A

pancreatic lipase and phospholipase A2

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16
Q

What pancreatic secretions are very important to micelles

A

pancreatic lipase and phospholipase A2

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17
Q

What biliary secretions are important to micelles

A

bile salts

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17
Q

What biliary secretions are important to micelles

A

bile salts

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18
Q

Where are majority of GI hormones released

A

duodenum and proximal jejunum

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18
Q

Where are majority of GI hormones released

A

duodenum and proximal jejunum

19
Q

What hormone is secreted still in ileum

A

CCK

19
Q

What hormone is secreted still in ileum

A

CCK

20
Q

What hormone is secreted in stomach

A

gastrin

20
Q

What hormone is secreted in stomach

A

gastrin

21
Q

What most patients who lost duodenum and jejunum be monitored for

A

Na, H2O, Fat soluble Vitamins, Ca, Mg, PO4 and Fe3+

21
Q

What most patients who lost duodenum and jejunum be monitored for

A

Na, H2O, Fat soluble Vitamins, Ca, Mg, PO4 and Fe3+

22
Q

What absorption secretion happens in the ileum

A

Na absorption through NaH and Cl-HCO3 exchangers
Cl absorption Cl-HCO3 exchanger, parallel exchangers (electroneutrality)
K absoprtion, passive

22
Q

What absorption secretion happens in the ileum

A

Na absorption through NaH and Cl-HCO3 exchangers
Cl absorption Cl-HCO3 exchanger, parallel exchangers (electroneutrality)
K absoprtion, passive

23
Q

What foods and nutrients occur in the ileum

A

carbs, proteins, lipids, Ca, iron and folate, bile acids and cobalamin

23
Q

What foods and nutrients occur in the ileum

A

carbs, proteins, lipids, Ca, iron and folate, bile acids and cobalamin

24
Q

what are major problems with consequences of loss of ileum

A

Vit B12 déficience
steatorrhea(no bile salts)
diarrhea (increased bile salts in colon

24
Q

what are major problems with consequences of loss of ileum

A

Vit B12 déficience
steatorrhea(no bile salts)
diarrhea (increased bile salts in colon

25
Q

What will the diarrhea contents be in cases of loss of ileum

A

increase H2O, Na, and Cl

25
Q

What will the diarrhea contents be in cases of loss of ileum

A

increase H2O, Na, and Cl

26
Q

What ions are secreted/absorbed in colon

A

secreted: K
absorbed: water, Na, Cl

26
Q

What ions are secreted/absorbed in colon

A

secreted: K
absorbed: water, Na, Cl

27
Q

What mechanisms are in the colon

A 
parallel NaH and ClHCO3 exchangers
epithelial Na channel
passive Cl absorption
ClHCO3 exchanger and parallel ones
passive/active K secretion
active K absorption
27
Q

What mechanisms are in the colon

A 
parallel NaH and ClHCO3 exchangers
epithelial Na channel
passive Cl absorption
ClHCO3 exchanger and parallel ones
passive/active K secretion
active K absorption
28
Q

What type of fatty acid does the colon absorb

A

short chain fatty acid
product of bacterial metabolism
exchanged for bicarb

28
Q

What type of fatty acid does the colon absorb

A

short chain fatty acid
product of bacterial metabolism
exchanged for bicarb

29
Q

What are the consequences with loss of colon

A

inability to salvage lost water and Na

decreased intestinal transit time

29
Q

What are the consequences with loss of colon

A

inability to salvage lost water and Na

decreased intestinal transit time

30
Q

consequences of losing ileocecal valve

A

bacterial overgrowth syndrome
colonic bacteria in small intestine
results in D lactic acidosis

30
Q

consequences of losing ileocecal valve

A

bacterial overgrowth syndrome
colonic bacteria in small intestine
results in D lactic acidosis

31
Q

when absorption adapts after resection what occurs to that area

A

hypertrophy and hyperplasia

31
Q

when absorption adapts after resection what occurs to that area

A

hypertrophy and hyperplasia

32
Q

over time how does the bowel change after fast adaptation

A

bowel will lengthen and dilate

32
Q

over time how does the bowel change after fast adaptation

A

bowel will lengthen and dilate

33
Q

What transporters specifically increase in adaptive changes after SBS resection

A

SGLT1 PepT1 and NHE-3(NaH)(with ClHCO3)

33
Q

What transporters specifically increase in adaptive changes after SBS resection

A

SGLT1 PepT1 and NHE-3(NaH)(with ClHCO3)

34
Q

How can a baby be fed with SI removed

A

parental(IV)

34
Q

How can a baby be fed with SI removed

A

parental(IV)

35
Q

What is the determining factor for survival of SI after resection

A

length of small bowel and presence of the ileocecal valve

35
Q

What is the determining factor for survival of SI after resection

A

length of small bowel and presence of the ileocecal valve

GI II (12 decks)

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