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FHB GI Material - Richie > L5/6 > Flashcards

L5/6 Flashcards

1
Q

Hypersecretion is usually the cause of gastric or duodenal ulcers?

A

duodenal ulcers

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2
Q

Parietal cell secrete

A

HCL

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3
Q

Intrinsic factor is req for

A

VitB12 absorption

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4
Q

Intrinsic factor (IF) is ONLY secreted where?

A

Stomach

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5
Q

Dominant regulation of stomach function?

A

Neural

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6
Q

Histamine promotes

A

H+ secretion in stomach

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7
Q

What stimulates gastric acid secretion?

A

Gastrin

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8
Q

What is the negative regulator of gastric secretion?

A

somatostatin

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9
Q

What is secreted in all regions of stomach

A

Mucus and bicarbonate

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10
Q

Where are G-cells in stomach?

A

Antrum of stomach

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11
Q

Grinding function of stomach is localized where?

A

Antrum and pyloric area

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12
Q

What cells secrete intrinsic factor?

A

Parietal cells (also secrete HCL)

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13
Q

Chief cells secrete

A

Pepsinogens

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14
Q

Enterochromaffin-like (ECL) cells secrete

A

Histamine (powerful stimulator of HCL)

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15
Q

D-cells secrete

A

Somatostatin

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16
Q

G-cells secrete

A

gastrin (stimulate HCL secretion)

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17
Q

Why do patients with gastric surgery need vitamin B12?

A

Loss IF

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18
Q

Name the 6 types of secretory cells in the fundus and antrum of the stomach

A
  1. G cells - gastrin
  2. Chief cells - pepsinogen
  3. ECL - histamine
  4. D cells - somatostatin
  5. Parietal cells - HCL and Intrinsic factor
  6. Mucous neck cells - mucus
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19
Q

Name the only ESSENTIAL factor of gastric juice

A

Intrinsic factor!

20
Q

How many states can the parietal cell take on?

A

Resting and activated states.

21
Q

What transporter is blocked by omeprazole?

A

The H/K ATPase antiporter on the luminal side of parietal cell. Prevents the secretion of H+ into lumen.

22
Q

What transporter in the parietal cell accounts for the “alkaline tide”?

A

HCO3-/Cl- antiporter on basolateral membrane. Net secretion of HCL is paired with net absorption of HCO3- into blood.

23
Q

What is the strongest extrinsic stimulator of gastric secretions?

A

CN X

24
Q

Name 3 stimulators of H+ secretion by parietal cells

A
  1. ACh - neurocrine
  2. Gastrin - endocrine
  3. Histamine - paracrine
25
Q

What substance competitively inhibits ACh binding to muscarinic (M3) receptors on parietal cells?

A

Atropine

26
Q

What substance competes with histamine for the parietal H2 receptor?

A

Cimetidine

27
Q

What substance binds the cholecystokinin B (CCKB) receptor on parietal cells?

A

gastrin

28
Q

What binds to CCKB receptors on parietal cells?

A

Gastrin

29
Q 
Histamine can potentiate the effects of \_\_\_\_ on parietal H+ secretion?
A. Gastrin
B. ACh
C. Somatostatin
D. Gastrin and ACh
A

D.

Interpathway gossip. Things that stimulate IP3/Ca2+ help each other.

30
Q

Is gastrin paracrine?

A

Dude, it’s endocrine.

31
Q

Vagovagal reflex

A

Distention of stomach in response to food stimulates CNX to promote gastrin release

32
Q

Somatostatin-mediated negative feedback of H+ secretion. What’s the direct and indirect effect of somatostatin?

A

INDIRECT: parietal cells - decreases cAMP

DIRECT: SS acts on G-cells to decrease gastrin secretion

33
Q

Controversy about long-term effect of PPI…

A

be aware of it

34
Q

NSAIDS inhibit synthesis of…

A

prostaglandin. Thus, we promote GI bleeding since lose prostaglandin, which negatively regulates H+ secretion by decreasing parietal intra cell cAMP

35
Q

Which is thin walled? Orad or caudad region of the stomach?

A

Orad is thin walled. Caudad is thick walled.

36
Q

Vagovagal reflex

A

AFFERENT: Stretch receptors in stomach promote:

EFFERENT: Acid secretion, active relaxation of gastric wall muscle, and gastric motility.

CN X Excitatory: ACh and substance P mediated contraction of lower stomach (increase motility)

CN X inhibitory: VIP mediated relaxation of fundus

37
Q

In which of the following scenarios would you find simple columnar epithelia, with goblet cells?

A. intestinal mucosa
B. Gastric ulcer (with intestinal metaplasia)
C. Barrett’s esophagus
D. All of the above

A

D. All of the above

38
Q

Name 3 factors that promote pyloric sphincter constriction, and slow gastric emptying

A

ACh via CNX excitatory fibers
CCK via duodenal I-cells
NE via sympathetics

39
Q

Name 2 factors that promote pyloric sphincter relaxation

A

VIP and NO, via CNX inhibitory fibers

40
Q

Damage to mucosal barrier, is consistent with

A. Gastric ulcer
B. Duodenal ulcer

A

A. Gastric ulcer

41
Q

Which of the following could promote duodenal ulcers?
A. Insufficient HCO3- secretion by pancreas
B. Gastrinoma (Zillinger-Ellison syndrome)
C. Insufficient constriction of pyloric sphincter
D. All of the above

A

D. All of the above

42
Q

Patient X has a high parietal cell mass, and high parietal cell H+ secretion, fatty stool (steatorrhea) and duodenal ulcers. Symptoms subside with omeprazole and cimetidine. These signs are consistent with…

A

Zillinger-Ellison syndrome (gastrinoma)

43
Q 
Which ulcer type is associated with loss of mucosal barrier?
A. Peptic
B. Gastric
C. Duodenal
D. Peptic and Gastric
A

D. Peptic and Gastric

44
Q

Which ulcer type is associated with H. pylori?
B. Gastric
C. Duodenal
D. Peptic and Gastric

A

B. Gastric ulcer

45
Q 
Patients with which ulcer type, surprisingly, can exhibit lower than normal H+ secretion?
A. Peptic
B. Gastric
C. Duodenal
D. Peptic and Gastric
A

B. Gastric

Lacking negative feedback to gastrin release

46
Q 
Which of the following is a protective mucosal factor?
A. NSAID
B. H. pylori
C. H+ and pepsin
D. Prostaglandin
A

D. prostaglandin

47
Q 
Which of the following is a damaging factor to mucosal barriers?
A. Prostaglandin
B. HCO3- 
C. Growth factors
D. Alcohol
A

D. Alcohol

FHB GI Material - Richie (8 decks)

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