Midterm Flashcards by Hillary Blahitka

What do the superficial epithelial cells do in the stomach?

They produce mucus and bicarbonate for acid protection

…die and produce more

How well did you know this?

Not at all

Perfectly

What protects the stomach lining from acid?

The mucus layer

How well did you know this?

Not at all

Perfectly

What do the stomach’s parietal cells do?

produce HCl

How well did you know this?

Not at all

Perfectly

What do the stomach’s chief cells do?

They produce digestive enzymes that break down food for their nutrients

How well did you know this?

Not at all

Perfectly

Where is gastrin produced?

What does it do?

G-cells

- they stimulate the parietal cells to make more HCl

How well did you know this?

Not at all

Perfectly

Where is histamine produced in the stomach?

What does it do?

The ECL (enterochromaffin-like) cells

When histamine is produced, it stimulates the parietal cells to make more HCl

How well did you know this?

Not at all

Perfectly

Name 3 gastric acid producers…

Gastrin
Acetylcholine
Histamine

How well did you know this?

Not at all

Perfectly

Name 2 gastric acid reducers

Prostaglandins

2. Somatostatin

How well did you know this?

Not at all

Perfectly

Where is the bicarbonate layer located in the stomach?

In between the mucus layer and the superficial epithelial layer

How well did you know this?

Not at all

Perfectly

What’s the difference between erosion and an ulcer?

Erosion is just a superficial injury resulting in decreased mucosal defence

An ulcer is complete erosion through the GI mucus that results in a GI bleed

How well did you know this?

Not at all

Perfectly

What 3 things can can peptic ulcer disease (PUD)?

H. pylori
NSAIDS…they inhibit prostaglandin production
stress

How well did you know this?

Not at all

Perfectly

What’s the difference between a gastric ulcer and a duodenal ulcer?
Which one is more common?

gastric = stomach

not helped by food
pain over wide area under breastbone

duodenal = in the duodenum…more common

helped by eating
pain under breastbone and umbilicus

How well did you know this?

Not at all

Perfectly

What are the virulence factors of H.pylori?

they colonize the stomach
they penetrate the mucus layer (to evade low pH)
they cause inflammation and cell death

How well did you know this?

Not at all

Perfectly

How does urease help H.pylori?

Urease produces ammonia which neutralizes stomach acid and allow the bacteria to travel to the mucus layer

How well did you know this?

Not at all

Perfectly

What lifestyle choices can cause ulcers?

How?

Alcohol - irritates the stomach lining
Smoking - cause larger ulcers, harder to treat
Cocaine/amphetamine - reduces blood flow to mucus, therefore less bicarbonate

How well did you know this?

Not at all

Perfectly

What is the difference between diabetes type l and ll in terms of insulin?

type l - complete lack on insulin

type ll - small amounts or insulin resistance

How well did you know this?

Not at all

Perfectly

An HbA1C level of ________%, is an indicator of diabetes

> 6.5

How well did you know this?

Not at all

Perfectly

Are the C-peptide levels high or low in type I diabetes?

Type II?

type I - low

type II - normal or high

How well did you know this?

Not at all

Perfectly

Which type of diabetes is diabetic ketoacidosis (DKA) more prevalent in?
What are the symptoms?

Type I

ketones in blood and urine (from fat breakdown)
acidosis
hyperglycemia
frequent urination and thirst
abdominal pain
hunger
deep, rapid breathing
fruity breath
can be alert, stuperous, comatose

How well did you know this?

Not at all

Perfectly

What are the 2 sources of blood supply to the liver?

Hepatic artery - O2 blood from general circulation

Hepatic portal vein - dO2 blood from small intestines (contains nutrients)

How well did you know this?

Not at all

Perfectly

What vessel drains blood from the liver?

The hepatic vein

The liver is not vascularized with capillaries. Instead it has blood filled ____________.

sinusoids

What does albumin do?

regulates fluid balance

This pigment is released when RBC’s die and becomes water-soluble
Also causes itching in liver disease patients

Bilirubin

What does the liver clean/detoxify?

- bacteria - alcohol - ammonia - OTC and Rx drugs - other toxins

What does the liver store?

Glycogen | Iron and other vitamins

What are the 5 liver functions?

1. energy metabolism & substrate interconversion 2. protein synthesis 3. solubilization, transport and storage 4. detox and clearance 5. bile production

What is hepatocellular liver disease?

- injury to hepatocytes - leads to decrease in synthetic/metabolic functions - AST/ALT levels will be high

What is cholestatsis liver disease?

- impaired bile formation (hepatocytes) | - impaired bile flow (bile duct)

What are the parameters for acute hepatitis?

It is acute if it lasts less than 6 months | It is chronic if it lasts longer

What are the 7 types of hepatitis?

1. viral (A-E) 2. alcohol 3. drug-induced 4. autoimmune 5. NAFLD-->NASH 6. ischemic 7. giant cell

What is the difference between NAFLD and NASH?

When NAFLD is severe enough, it leads to inflammation, fibrosis and cirrosis. This is referred to as non-alcoholic steatohepatitis

What are the symptoms of liver failure?

- abdominal pain - breast development in males - dark urine/clay colored stools - fatigue - low grade fever - general itching - jaundice - loss of appetite - nausea and vomiting - weight loss

______________ is caused by a small RNA virus and results in immunity when the patient recovers.

Hepatitis A

What virus is - asymptomatic/mild symptoms - transferred by sex/bodily fluids - characterized by hepatocyte death due to the immune response

Hepatitis B

What are the 2 characteristics of cirrhosis?

Liver tissue is replaced by: 1. Fibrous scar tissue - blocks blood flow 2. Regenerative nodules - lumps that form from the regenerative process

_________________ become activated when the liver is injured. What do they do?

- Stellate cells | - they produce fibers which cause the liver to become rigid

Injury of the liver leads to...

1. activation of stellate cells 2. accumulation of scar tissue 3. loss of hepatocyte microvilli 4. sinusoidal epithelial fenestrae ....all of these eventually lead to complete loss of hepatic function

What is the Child-Turcotte-Pugh (CTP) score used for?

- used to determine 1-2 year survival | - rated on a 1-15 point system

What is the Model for End-state Liver Disease (MELD) score used for?

- used to determine 3-month survival | - judgement scale for liver transplants

What is ascites? | What is it caused by?

- excess fluid in the peritoneal cavity Caused by: - portal hypertension - increased pressure in portal vein system - fluid that has been forced out of blood vessels - the liver's decreased ability to filter blood

What is jaundice? | What is it caused by?

- yellow discoloration of the skin Caused by: - increased levels of bilirubin in the blood and skin - damaged liver cells interferes with excretion/uptake of bilirubin

What does VacA do?

1. Inflammation/apoptosis 2. formation of acidic vacuoles in cells 3. forms pores in epithelial cells

What does LPS do?

- recruits immune cells - inflammation - death of cells

How do NSAIDS cause PUD?

``` They inhibit prostaglandin synthesis prostaglandins - stimulate bicarbonate release - produce mucus - stimulate mucosal growth - decrease acid production ```

What is Zollinger-Ellison syndrom?

A gastrin secreting tumor that can cause ulcers

What causes DKA?

- body can't use glucose for energy - breakdown fats instead...this creates ketones which accumulate in blood and urine - acidosis - hyperglycemia

What is the TIMI score used for?

- used for determining risk severity for UA/NSTEMI ``` 0-2 = low risk 3-4 = moderate risk 5-7 = high risk ```

What is the math of MAP?

MAP = 2/3 diastolic pressure + 1/3 systolic pressure

What is the math of BP?

BP = TPR x CO CO = HR x SV