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M104 T1 > M104 T1 L8 * T7 is in folder T2 > Flashcards

M104 T1 L8 * T7 is in folder T2 Flashcards

1
Q

What types of persitalsis are there?

A

segmentation - at the brush border

haustra churning - in the LI

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2
Q

What proportion of the NHS Eat Well Plate consists of carbohydrates?

A

a third of total dietary intake

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3
Q

What are the three monosaccharides?

A

glucose
fructose
galactose

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4
Q

What are the three disaccharides? MSL

A

sucrose
lactose
maltose

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5
Q

What are the three brush border enzymes that digest disaccharides?

A

sucrase
lactase
maltase

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6
Q

What are the two oligosaccharides?

A

raffinose

stachyose

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7
Q

What is a special feature of oligosaccharides regarding their digestibility?

A

they are resistant to digestion and often pass unchanged into the colon
AAR they contribute to the faecal matter and also help support the microbiome

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8
Q

What are Lactulose-derived oligosaccharides used for?

A

to treat constipation

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9
Q

What happens to Lactulose once it enters the digestive system?

A

is not digested by the SI - it travels unchanged into the colon
through osmosis, more water enters the colon, softening the stools to facilitate defaecation

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10
Q

What are the three polysaccharides?

A

starch
glycogen
cellulose

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11
Q

What are the four groups of carbohydrates?

A

monosaccharides
disaccharides
oligosaccharides
polysaccharides - the main polysaccharide in diet

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12
Q

What is each starch mlc made up of?

A

two glucose mlcs

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13
Q

What are the two types of non storage polysaccharides?

A

cellulose - insoluble

pectin - soluble

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14
Q

What two processes convert carbs into E in the body?

A

glycolysis

the Citric Acid Cycle

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15
Q

What are normal serum blood glucose levels?

A

4 - 7 M/L

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16
Q

What is a special feature of oligosaccharides regarding their digestibility?

A

they aren’t digested in the GI tract

they are important to provide faecal bulk which allows the excretion of dead cells and the increase of transit time

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17
Q

What are the polyunsaturated FAs otherwise known as?

A

the essential FAs

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18
Q

What does 95% of dietary fat intake consist of?

A

Triacylglycerol

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19
Q

What happens to essential FAs once consumed?

A

they are elongated, desaturated and used in synthesis

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20
Q

What product is formed from linoleic acid?

A

arachidonic acid

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21
Q

What products are formed from a-linoleic acid?

A

eicosapentaenoic acid

docosahexaenoic acid

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22
Q

What are two dietary sources of linoleic acid?

A

vegetable and safflower oils

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23
Q

What are four dietary sources of a-linoleic acid?

A

green leafy vegetables
canola
wheat and soybean oils

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24
Q

What are the omega-3 FAs?

A

ALA, EPA and DHA

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25
Q

What are three dietary sources of arachidonic acid?

A

meat, poultry and eggs

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26
Q

What are the dietary sources of EPA and DHA?

A

oily fish

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27
Q

What is the role of lipoprotein lipase?

A

mediates the storage of adipose tissues in the outermost tissue

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28
Q

How is the action of lipoprotein lipase affected by the presence of insulin?

A

insulin - upregulated

FA release during fasting - downregulation

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29
Q

What is the effect of fat on food?

A

it enhances flavour and increases palatability

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30
Q

Which vitamins are contained in fats?

A

the essential fat soluble vitamins A D E K

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31
Q

What is vitamin A important for?

A

black and white vision

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32
Q

What is vitamin D important for?

A

the absorption of calcium - maintains good bone health

has the potential to protect against the negative impacts of COVID

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33
Q

What term is associated with vitamin E?

A

antioxidant

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34
Q

What is vitamin K important for?

A

its role in the clotting cascade

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35
Q

What is white brain matter predominately composed of?

A

fat

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36
Q

What are fats the precursors of?

A

steroids, hormones and some vitamins

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37
Q

What are the three macronutrients?

A

fat
protein
carbohydrates

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38
Q

What is added to low fat yoghurt to make it less runny than it is?

A

carbohydrates and gums

gives it a similar consistency to high fat yoghurts

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39
Q

Are there any stores of protein or fat in the body?

A

protein - none at all

fat - glycogen

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40
Q

What is a waste product of deanimation?

A

alpha ketoacid residues

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41
Q

What are alpha ketoacid residues from deanimation used for?

A

as E for metabolic pathways of glucose or FAs

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42
Q

What happens to excess alpha ketoacid residues?

A

they are excreted as urea and ammonium via urine

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43
Q

What can be made from the amac pool inside the body?

A

amac derivatives (e.g. NTs)

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44
Q

What are the protein requirements for normal and older adults in g/kg/day?

A

normal - 0.8g/kg/day

elderly - 1.2g/kg/day

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45
Q

How are the protein requirements for patients with acute illness affected / deviated from normal level?

A

will exceed normal levels bc the immune response requires more to allow full recovery and repair so tissue proteins are broken down and amacs are used for other functions instead
in an acute illness, there is often a negative nitrogen balance due to inflammation induced catabolism (COVID19)

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46
Q

How many amacs are needed in the body?

A

20 amacs

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47
Q

What are the three types of amacs needed in the body?

A

essential (9)
non-essential (4)
conditionally non-essential (7)

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48
Q

What essential precursor does tyrosine amac require?

A

phenylalanine

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49
Q

In what conditions will glutamine be depleted?

A

burns, COVID or sepsis

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50
Q

How are conditionally non-essential amacs sourced?

A

mostly from the normal everyday breakdown of cells within the body - non essential
but in hypercatabolic states, will be required from diet to meet the shortfall fall inside the body

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51
Q

What happens to conditionally non-essential amacs in hypercatabolic states?

A

there is a condition that is using them all up

so their use is exceeded, causing a deficiency

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52
Q

What is dumping syndrome usually caused by?

A

gastric surgery or damage to the pyloric sphincter

53
Q

What are the effects of dumping syndrome?

A

hypotension
tachycardia
a feeling of faintness

54
Q

What is the role of the internal, external and anal sphincters?

A

allows the body to feel the presence of faecal matter and to control defaecation

55
Q

What is the role of the cognitive and emotional brain?

A

it acknowledges environmental and habitual cues from the environment to enact hunger / thirst mechanisms)

56
Q

How does the barker hypothesis come to play in terms of if a pregant mother is in a state of starvation?

A

when the infant is born, as they grow up, they have a greater risk of obesity and high bp

57
Q

What is the role of the metabolic brain?

A

it monitors whether the metabolic demands of the body are being met

58
Q

What is the role of lingual lipase?

A

to lipolyse dietary fats during oral processing

59
Q

What is different about fundic mucosal gastric lipase compared to SI gastric lipases?

A

it’s an acid enzyme

60
Q

Where is gastric lipase secreted from?

A

gastric cells in the fundic mucosa

61
Q

What is special about gastric acid enzymes?

A

they don’t require any stabilisation

doesn’t require bile acid from the liver or colipase from the pancreas for optimal functioning

62
Q

What percentage of lipid hydrolysis in neonates and in adults is conducted by gastric lipase in the fundic mucosa?

A

neonates - up to 50% of lipid hydrolysis

adults - up to 30% of lipid hydrolysis

63
Q

What is the role of chief cells?

A

they produce pepsinogen, which is converted to pepsin in presence of HCL

64
Q

Why is lipid hydrolysis essential in neonates?

A

bc breast milk contains a moderate amount of fat so it’s important that lipid hydrolysis is occuring

65
Q

What are the two bile acids?

A

cholic and chenodeoxycholic acid

66
Q

What is a special feature of bile acids?

A

each molecule is amphipathic

67
Q

What are the effects of bile acids being amphipathic?

A

allows it to act as a detergent (polarity-wise) to solubilize lipids to form mixed micelles

68
Q

What is pancreatic lipase secreted along-side?

A

pro-colipase

69
Q

Where is pro-colipase activated, and by what substance?

A

in the intestinal lumen by trypsin

70
Q

What is the role of colipase?

A

to stabilise pancreatic lipase - stops it breaking down, which increases its efficiency

71
Q

What is the effect of pancreatic lipase?

A

it hydrolyses tryglycerols to form monocyglycerol, FAs and glycerol

72
Q

What are the two important primary pancreatic proteases?

A

trypsin and chymotrypsin

73
Q

What are the two inactive proenzyme forms of the primary pancreatic proteases?

A

trypsinogen and chymotrypsinogen

74
Q

What happens to trypsinogen and chymotrypsinogen?

A

they are synthesized and packaged within secretory vesicles

they are then activated by an enteropeptidase - enterokinase secreted by the mucosal membrane of duodenum

75
Q

What substances are contained in the secretory vesicles containing the two inactive proenzyme forms of the primary pancreatic proteases?

A

trypsinogen and chymotrypsinogen

a trypsin inhibitor

76
Q

What is the purpose of the trypsin inhibitor in the secretory vesicles?

A

it serves as a safeguard against trypsinogen converting to trypsin within the pancreas or pancreatic ducts

77
Q

How does chenodeoxycholic acid work as a bile acid?

A

it dissolves the cholesterol that makes gallstones
it inhibits cholesterol synthesis in the liver and its absorption in the intestines, which helps to decrease the formation of gallstones

78
Q

What enzymes are exocrine pancreas secretions that empty into the SI?

A

trypsin, chymotrypsin

elastase, carboxypeptidase

79
Q

What are the precursosrs of elastase and carboxypeptidases?

A

PROelastase

PROcarboxypeptidase

80
Q

Which amacs does trypsin break down the bonds between?

A

arginine and lysine

81
Q

Which amacs does chymotrypsin break down the bonds between?

A

tryptophane
phenylalanine
tryosine
leucine

82
Q

Which amacs does elastase break down the bonds between?

A

alanine
glycine
serine

83
Q

Which amacs does carboxypeptidase break down the bonds between?

A 
hydrophobic amacs
basic amacs (arginine, lysine...)
84
Q

What reactions does trypsin catalyse?

A

the conversion of chymotrypsinogen, proelastase and procarboxypeptidase into their activated enzyme forms

85
Q

What are the components of starch and their proportions?

A

amylopectin - 70%

amylose - 30%

86
Q

Why doesn’t salivary amylase have much of a digestory impact?

A

bc food doesn’t stay long enough in the mouth for the starch to be fully digested

87
Q

Where is amylase released from?

A

the salivary glands

the pancreas

88
Q

What proportion of fluid entering the GI tract will be absorbed at the SI?

A

8 / 9 L

89
Q

What area of the SI is particularly provided for by the SI’s large vascular supply?

A

the messentry

90
Q

What are the differences between all the nervous systems?

A 
somatic - conscious
autonomic - unconscious
sympathetic - excitation
parasympathetic - (longer word) relaxes and digests
enteric - digestive tract relax
91
Q

What is an effect of hyperkalemia?

A

blood flow to the SI is compromised

so patients are less able to absorb nutrients form the SI due ot reduced blood flow

92
Q

Why is peristalsis changed to a form of segmentation in the SI?

A

so that food is pushed against the wall of the brush border so that the enzymes can come in contact with the food

93
Q

What is the role of the brush-border enzyme maltase-glucoamylase?

A

to break down maltose / maltotriose / oligosaccharides into glucose

94
Q

What are the intraluminal-saccharides in the SI?

A

sucrose, lactose
maltose, maltotriose, oligosaccharides
a-limit dextrins

95
Q

What is the role of the brush-border enzyme sucrase-isomaltase?

A

to break down a-limit dextrins into glucose

to break down SUCROSE into glucose and fructose

96
Q

Which carbohydrates are absorbed into the body?

A

the monosaccharides only - glucose, galactose and fructose

97
Q

What is the role of GLUT-5?

A

to absorb fructose

98
Q

What are the importers of monosaccharides in the SI?

A

Na+/glucose symporters

GLUT-5

99
Q

What is the role of GLUT-2?

A

to transport absorbed monosaccharides from intestinal cells into the bloodstream

100
Q

What happens when emulsified fat droplets are mixed with bile?

A

forms mixed micelles that float in the still water of the SI

101
Q

How are chylomicrons generated?

A

the ER puts together fats in clusters and encases them with proteins covers

102
Q

How are FAs contained in micelles transported to the left thoracic duct?

A

when in the still water, they come into contact with lipases in the brush border, where they are absorbed into the intestinal cells
the ER builds chylomicrons which enter the lacteal
the lacteal transports the fats to the left thoracic duct

103
Q

Do intestinal cells absorb free FAs?

A

yes, but it’s limited

104
Q

How are proteins absorbed in the SI?

A

via a range of transporters that use Na+ for amac absorption

via the HPT1 transporter for the absorption of di & tripeptides

105
Q

What are the two processes by which proteins are absorbed in the SI?

A

Na+ transporters

HPT1 transporter

106
Q

What do HPT1 transporters require to work?

A

hydrogen ions

107
Q

What happens to proteins once inside intestinal cells?

A

there’s further break down of the di & tripeptides to form amacs
then they move into the bloodstream via facilitated diffusion

108
Q

What are the Na+ exchangers in intestinal cells?

A 
NHE3 (between the SI lumen and the cell)
NaK ATPase (between the cell and the bloodstream)
109
Q

How does the NHE3 exchanger work?

A

it exchanges H+ for Na+
H+ leaves the cell
Na+ enters from the lumen

110
Q

How does NaK ATPase work?

A

it exchanges K+ for Na+
3 Na+s leave the cell
2 K+s enter from the bloodstream

111
Q

What happens to NSPs after ingestion?

A

they usually aren’t digested in the SI

they pass onto the colon unchanged

112
Q

What are examples of NSPs?

A

most oligosaccharides

resistant starch

113
Q

How are soluble fibres digested?

A

they are fermented by bacteria in the colon

114
Q

What are examples of soluble fibres?

A

lentils, baked beans

115
Q

What happens to insoluble fibres after ingestion?

A

they make up the cellulose ‘roughage’ in the diet

116
Q

What substances are contained in soluble fibres?

A

pectin / gum

117
Q

What happens to NSPs in the LI?

A

they are fermented by microbes in the colon

118
Q

What are the products of NSP fermentation?

A

gas and short chain FAs acids

119
Q

What is the structural formula of the gas byproduct of NSP fermentation?

A

CO2-H2-CH4

120
Q

What are the short chain FAs acids produced from NSP fermentation?

A

acetate
propionate
butyrate

121
Q

How does the GI tract chance over time?

A

at birth - sterile
during the birth process and feeding - gradually becomes colonised with microbes
7 / 8 years old - the adult population of microbes is achieved
older adults - microbe population is compromised, more vomiting / diarrhoea

122
Q

What happens to propionate once it has been produced from NSP fermentation?

A

it is taken up by the liver

123
Q

What happens to butyrate once it has been produced from NSP fermentation?

A

it is used by colonic cells

124
Q

On average, how many different species are present in the microbiome?

A

over 500 different species

125
Q

What are features of the classic Western diet?

A

high in animal protein
high in fat and refined sugar
low in fibre

126
Q

On average, how many microbes are present per m3 of fluid in the colon?

A

a maximum of 10^12 microbes / m3 of fluid in the colon

127
Q

How does the classic Western diet affect the microbiome?

A

reduction in bacterial diversity, so lower levels of good bacteria and FAs

128
Q

What are features of the agrarian diet?

A

has lots of fibre, nuts, legumes and vegetables

is low in animal fat and in animal protein

129
Q

How does the agrarian diet affect the microbiome?

A

has a better bacterial diversity

lots of short chain FA synthesis

M104 T1 (15 decks)

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