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Su: Phys 2 > Hepatobiliary/GI > Flashcards

Hepatobiliary/GI Flashcards

1
Q

obstructive jaundice bili type

A

conjugated bili (DIRECT) that cannot get into circulation

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2
Q

does obstructive jaundice have plasma bili

A

yes

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3
Q

does obstructive jaundice have urine bili

A

yes

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4
Q

hemolytic jaundice bili type

A

unconjugated (INDIRECT) because its tightly bound to albumin

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5
Q

does hemolytic jaundice have plasma bili

A

yes

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6
Q

does hemolytic jaundice have urine bili

A

no

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7
Q

markers of liver injury

A

AST
ALT
AP

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8
Q

markers of liver function

A

albumin
total bili

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9
Q

albumin levels in cirrhosis

A

low albumin

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10
Q

total bili levels in liver failure

A

incr unconjugated
decr conjugated

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11
Q

hepatocellular abnormality levels to check

A

ALT/AST

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12
Q

cholestatic abnormality check levels of

A

AP +- TB

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13
Q

NALD liver enzymes

A

ALT>AST

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14
Q

ALD liver enzymes

A

AST>ALT

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15
Q

cirrhoiss

A

decr albumin
incr sinusoid resistance
incr portal pressure
ascites

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16
Q

treat ascites

A

suck out fluids
give albumin

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17
Q

gastrin cells

A

G cells in stomach/duodenum

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18
Q

gastrin stimuli

A

AAs
food
vagal stim

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19
Q

gastrin effects

A

incr H+
incr mucosa
incr motility

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20
Q

CCK cells

A

I cells in duodenum/jejunum

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21
Q

CCK stimuli

A

AAs
FFAs

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22
Q

CCK effect

A

GB contraction
sphincter of oddi relax
incr pancreas enzyme
incr bicarb
decr emptying
incr pancreas/GB trophic effects

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23
Q

secretin cells

A

S cells in duodenum/jejunum

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24
Q

secretin stimuli

A

incr H+ (pH < 4.5)
FFA

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25
Q

secretin effect

A

incr pancreatic/biliary bicarb
decr H+
decr mucosa
incr pancreatic trophic effects

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26
Q

GIP/GLP cells

A

K/L cells in duodenum/jejunum

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27
Q

GIP/GLP stimuli

A

oral glucose
AAs
FFAs

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28
Q

GIP/GLP effects

A

incr pancreatic insulin
decr H+

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29
Q

somatostatin cells

A

D cells in pancreatic islets and GI mucosa

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30
Q

somatostatin stimuli

A

incr H+

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31
Q

somatostatin effects

A

decr GI hormones
decr H+
decr pancreatic enzyme/bicarb
decr GB contraction

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32
Q

motilin cells

A

M cells in duodenum/jejunum

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33
Q

motilin stimuli

A

decr vagal signaling

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34
Q

motilin effect

A

incr motor complex to clear debris and prevent SIBO

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35
Q

sympa GI

A

decr motility
decr secretions
sphincter constriction
vasoconstriction

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35
Q

Para/Enteric GI

A

incr motility
incr secretions
sphincter relaxation
vasodilation

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36
Q

enteric: VIP

A

incr sm muscle relaxation

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37
Q

enteric: GRP

A

incr gastrin secretion

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38
Q

how are ICC coupled to SMC

A

through L type Ca2+ channel

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39
Q

what determines the max rate of contraction

A

slow wave/basal electrical rhythm

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40
Q

when do contractions occur

A

when threshold spike frequency is met

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41
Q

incr spike frequency

A

incr contraction strength

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42
Q

what inhibits slow wave/BER

A

decr ACH
incr epi

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43
Q

what cranial nerves contribute to salivation

A

CN VII - facial
CN IX - glossopharyngeal

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44
Q

what is the primary regulator of salivation

A

parasympathetics

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45
Q

what is different about sympathetic stimulated saliva

A

high protein content

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46
Q

what does stress do to saliva

A

vasoconstricts
decreasing saliva

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47
Q

what increases salivary flow rate

A

Ach

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48
Q

high flow rate saliva content

A

high Na+
high bicarb
high Cl-

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49
Q

low flow rate saliva content

A

low Na+
low bicarb
low Cl-

50
Q

which flow rate saliva is more plasma liek

A

high flow rate

51
Q

NET salivary reabsorption

A

Na+
Cl-

are less than that of plasma

52
Q

NET salivary secretion

A

K+
bicarb

are greater than that of plasma

53
Q

saliva tonicity

A

hypotonic

54
Q

3 mechanisms to regular stomach acid

A

Vagal
G cells
ECL cells

55
Q

rank strength of stomach acid regulation mechanisms

A

hist>Ach>gastrin

56
Q

increased H+ secreation causes

A

incr somatostatin

57
Q

somatostatin inhbitis

A

G cells
ECL cells
parietal cells

to decrease HCl

58
Q

primary stimulat for pancreatic enzyme secreation

A

CCK

59
Q

what potentiates CCK

A

Ach

60
Q

secretin role in pancreas

A

secretes bicard to ensure neutral pH for enzymes function

61
Q

what potentiates secretin

A

CCK and Ach

62
Q

what increases bicarb secretion

A

increased secretin triggers bicarb release in pancreas

63
Q

pancreatic juice pH

A

8.6 (alkaline)

64
Q

pancreatic juice breakdown

A

high Na+
high bicarb
low Cl-
low K+

65
Q

plasma breakdown

A

high Na+
low bicarb
high Cl-
low K+

66
Q

difference between plasma and pancreatic juice

A

pancreatic juice is higher in bicarb and lower in Cl-

67
Q

what enzyme digests starch

A

amylase

68
Q

what proenzymes digrest proteins

A

trypsinogen
chymotrypsinogen
procarboxypeptidase
peolastase

69
Q

what activates trypsinogen

A

enteropetidase activates trypsinogen to trypsin

70
Q

what activates poelastase

A

trypsin

71
Q

why are some enzymes in the pancrease inactive?

A

inactive stoerage prevents pancreas autodigestion

72
Q

which enzyme does fat digestion

A

lipase

73
Q

which enzymes digest nucleic acids

A

deoxyribonuclease
ribonuclease

74
Q

what makes primary bile

A

liver

75
Q

what are the components of primary bile

A

bile salts + cholesterol + lecithin

76
Q

what concentrates bile

A

the gallbladder

77
Q

what must you have to get bile out of the gall bladder

A

CCK

78
Q

what allows the sphincter of oddi to relax during bile secretion

A

increased NO
increased VIP

79
Q

what are the 2 functions of the ileum

A

B12 absorptions
ABST - bile salt reabsoprtion

80
Q

what % of bile salts are reabsorbed

A

95%

81
Q

liquid bile ratio

A

10:3:1
high bile salt
high lecithin
low cholesterol

82
Q

cholelithiasis

A

gall stones

83
Q

what factors favor gall stone formation

A

low bile salt
low lecithin
high cholesterol

84
Q

saliva bicarb and K+

A

high bicarb
high K+

85
Q

what inhibits saliva

A

sleep
dehydration
atropine

86
Q

enzymes in salivaryformation

A

alpha amylase
lingual lipase

87
Q

HCl formation stimulated by

A

gastrin
histamine
parasympathetics

88
Q

HCl inhibited by

A

decr stomach pH
chype
somatostatin

89
Q

gastric pepsinogen is stimulated by

A

parasympathetics

90
Q

pancreatic secretions are _____ in bicarb

A

high bicarb

91
Q

pancreatic secretions are stimulated by

A

secretin
CCk
parasympathetics

92
Q

pancreatic enzymes

A

pancreatic lipase
amylase
protease

93
Q

what stimulates pancreatic enzymes

A

CCk
parasympathetics

94
Q

bile is stimulated by

A

CCK
and parasympathetics

95
Q

bile is inhibited by

A

illeal resection

96
Q

gi contraction types

A

segmentation
tonic contraction
peristalsis

97
Q

segmentation occurs in

A

stomach
intestines

98
Q

tonic contraction occurs in

A

sphincters

99
Q

peristalsis occurs in

A

esophagus
stomach
intestines

100
Q

Gi contractions are driven by

A

smooth muscle cells via the BER from ICCs

101
Q

what nerves contribute to swallowing

A

glossopharyngeal
vagal

102
Q

where is the swallowing center

A

medulla

103
Q

resting position of UES

A

contracted due to somatic Ach stimulus

104
Q

how do you relax the UES

A

stop sending Ach

105
Q

resting position of LES

A

contracted due to autonomic Ach stimulating enteric neuron to release vNE stimulus

106
Q

what relaxes LES

A

Ach stimulating enteric neuron to release NO/VIP

107
Q

UES is what type of muscle

A

skeletal

108
Q

LES is what type of msucle

A

smooth

109
Q

esophagus is what type of muscle

A

upper 1/3 = skeletal
lower 2/3 = smooth

110
Q

is swallowing voluntary or involuntary

A

voluntary

111
Q

what about peristalsis?

A

reflexive

112
Q

4 things that can trigger vomiting

A

pain/anticipation
anesthetics
pharynx/stomach stimuli
motion sickness

113
Q

pain works on

A

cortical centers
then vomiting center

114
Q

anesthetics impact the

A

CTZ

115
Q

pharynx/stomach stimuli triggers

A

visceral afferents in the CTZ and NTS

116
Q

motion sickness impacts

A

NTS

117
Q

CTZ nTs

A

dopa
ach
serotonin
histamine
opiods
neurokinin-1

118
Q

NTS Nts

A

dopa
ach
serotonin
histamine
neurokinin-1

119
Q

vomiting center nts

A

dopa
ach
serotonin
histamine

120
Q

what is open during vomiting

A

UES
LES

121
Q

what closes during vomiting

A

nares
diaphragm contracts

122
Q

what forces vomit out

A

delta P
when diaphragm contracts
abs increase stomach pressure

Su: Phys 2 (12 decks)

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