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Step 1 Gastrointestinal-First Aid 2017 > Physiology > Flashcards

Physiology Flashcards

1
Q

Where are G cells located

A

Antrum of stomach, duodenum

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2
Q

Which cells secrete gastrin

A

G cells

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3
Q

Function of G cells

A

Increase:

  1. gastric H+ secretion
  2. growth of gastric mucosa
  3. increase gastric motility
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4
Q

Increased vagal activity releasing gastrin-releasing peptide (GRP) stimulates which cells in the stomach

A

G cells to secrete gastrin

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5
Q

What decreases gastrin release by G cells?

A

Decreased pH

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6
Q

Increase in stomach distention or alkalinization will cause release of what regulatory substance

A

Gastrin from G cells

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7
Q

Peptic ulcers with extremely high levels of gastrin even after administration of secretin indicates that you have what condition?

A

Zollinger-Ellison syndrome

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8
Q

Conditions that increase gastrin levels

A

Chronic PPI use - alkalinizes stomach
Chronic atrophic gastritis - H. pylori infection
Zollinger-Ellison syndrome - gastrinoma

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9
Q

Location of D cells in GI tract

A

Pancreatic islet and GI mucosa

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10
Q

What do D cells secrete?

A

Somatostatin

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11
Q

What is the function of somatostatin?

A

Decreases pretty much all types of secretions in stomach

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12
Q

Somatostatin analog used to treat acromegaly, carcinoid syndrome and variceal bleeding

A

Ocreotide

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13
Q

Stimulates D cells to secrete somatostatin

A

Acid

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14
Q

Stops D cells from secreting somatostatin

A

Decreased vagal stimulation

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15
Q

Secrete cholecystokinin

A

I cells

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16
Q

Secrete somatostatin

A

D cells

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17
Q

Secrete gastrin

A

G cells

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18
Q

Location of I cells

A

Duodenum, jejunum

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19
Q

Stimulates I cells to secrete cholecystokinin

A

Fatty acids and amino acids

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20
Q

Causes pancreatic secretions, gallbladder contraction, decreases gastric emptying and increases relaxation of sphincter of Oddi

A

Cholecystokinin

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21
Q

I cells secrete cholecystokinin and produce the following effects

A

Increased pancreatic secretions, gallbladder contraction, and relaxation of the sphincter of Oddi
Decrease gastric emptying

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22
Q

Acts on neuronal muscarinic pathways to cause pancreatic secretions

A

Cholecystokinin

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23
Q

Secrete secretin

A

S cells

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24
Q

Location of S cells

A

Duodenum

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25
Q

Causes secretion of pancreatic HCO3- and bile and decreases gastric acid secretion

A

Secretin

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26
Q

S cells secret secretin and produce the following actions

A

Increase pancreatic bicarb and bile secretion

Decrease gastric acid secretion

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27
Q

Allows pancreatic enzymes to function in the duodenum by neutralizing stomach acids

A

Bicarb secreted from pancreas

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28
Q

Type of cells found in the duodenum

A

S, I, K, G, M cells

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29
Q

What do K cells secrete?

A

Glucose-dependent insulinotropic peptide

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30
Q

Endocrine function of Glucose-dependent insulinotropic peptide

A

Increase insulin release

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31
Q

Exocrine function of Glucose-dependent insulinotropic peptide

A

Decrease gastric acid secretion

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32
Q

What increases Endocrine function of Glucose-dependent insulinotropic peptide secretion

A

Fatty acids, Amino acids, and Glucose (FAG)

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33
Q

Secrete Endocrine function of Glucose-dependent insulinotropic peptide

A

K cells

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34
Q

Where are K cells located

A

Duodenum, jejunum

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35
Q

Endocrine function of Glucose-dependent insulinotropic peptide is also known as what?

A

Gastric inhibitory peptide (GIP)

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36
Q

Produces migrating motor complexes

A

Motilin

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37
Q

Secretes motilin

A

Small intestine

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38
Q

Macrolide that is a motilin receptor agonist, used for stimulation of intestinal peristalsis

A

Erythromycin

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39
Q

What increases release of motilin

A

Fasting state

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40
Q

Secretes vasoactive intestinal polypeptide (VIP)

A

Parasympathetic ganglia in sphincters, gallbladder, small intestine

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41
Q

Causes increased intestinal water and electrolyte secretion and relaxation of intestinal smooth muscle and sphincters

A

VIP

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42
Q

Secretion of this peptide is increased by distention and vagal stimulation and decreased by adrenergic input

A

VIP

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43
Q

Patient presenting with watery diarrhea, hypokalemia and achlorhydria most likely has what?

A

VIPoma

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44
Q

Location of VIPoma

A

Non-alpha and non-beta islet cell tumor of the pancreas

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45
Q

What is typically the cause of achalasia

A

Increased LES tone from loss of NO

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46
Q

Function of NO in the GI tract

A

Increases smooth muscle relaxation including lower esophageal sphincter (LES)

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47
Q

What cells are located in the stomach?

A

Parietal cells, Chief cells, Mucosal cells, G cells

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48
Q

Hormone that acts on the stomach by increasing appetite

A

Ghrelin

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49
Q

What decreases secretion ghrelin?

A

Food

50
Q

What increases secretion of ghrelin?

A

Fasting state

51
Q

What heritable disease increases ghrelin

A

Prader-Willi syndrome

52
Q

What elective procedure decreases ghrelin

A

Gastric bypass surgery

53
Q

Required for B12 uptake in terminal ilium

A

Intrinsic factor

54
Q

What cells secrete intrinsic factor?

A

Parietal cells

55
Q

Where are parietal cells located?

A

Stomach

56
Q

Consequence of autoimmune destruction of parietal cells

A

Chronic gastritis and pernicious anemia

57
Q

Cells that secrete gastric acid in the stomach

A

Parietal cells

58
Q

Function of gastric acid

A

Decrease pH and convert pepsinogen to pepsin

59
Q

What increases gastric acid secretion by parietal cells?

A

Histamine, ACh, and gastrin

60
Q

What decreases gastric acid secretion by parietal cells?

A

Somatostatin, GIP, prostaglandin, secretin

61
Q

What drugs inhibit prostaglandin synthesis, increasing gastric acid secretion?

A

NSAIDs

62
Q

Where are parietal cells located?

A

In the body of the stomach

63
Q

Which cells secrete pepsin?

A

Chief cells

64
Q

Where are Chief cells located?

A

In the body of the stomach

65
Q

What is the function of pepsin

A

Protein digestion

66
Q

What causes Chief cells to secrete pepsin?

A

Vagal stimulation and local acid

67
Q

Secrete pepsin

A

Chief cells

68
Q

Digests protein in stomach

A

Pepsin

69
Q

Neutralizes acid

A

Bicarbonate

70
Q

Secretes bicarbonate

A

Mucosal cells and Brunner glands

71
Q

Where are mucosal cells found?

A

Stomach, duodenum, salivary glands, pancreas

72
Q

Where are Brunner glands located?

A

Duodenum

73
Q

What causes increased secretion of bicarbonate?

A

Secretin

74
Q

Where is bicarbonate trapped in?

A

Mucus secreted by gastric epithelium

75
Q

What is the function of mucus secreted by gastric epithelium?

A

Trap bicarbonate

76
Q

What is the strongest regulator of gastric acid secretion

A

Histamine released by ECL cells via gastrin stimulation

77
Q

In what section of the stomach are the majority of mucus cells found?

A

Antrum of the stomach

78
Q

Responsible for starch digestion

A

Alpha amylase

79
Q

Responsible for fat digestion

A

Lipases

80
Q

Responsible for protein digestion

A

Proteases

81
Q

Enzyme secreted in its active form

A

Alpha amylase

82
Q

Brush border enzyme found on duodenal and jejunal mucosa that converts trypsinogen to its active form

A

Enterokinase/enteropeptidase

83
Q

Function of Enterokinase/enteropeptidase

A

Convert trypsinogen to trypsin

84
Q

Function of trypsin

A

Convert other zymogens to their active form

85
Q

Proteases that digest protein

A

Trypsin, chymotrypsin, elastase, carboxypeptidases

86
Q

Trypsin, chymotrypsin, elastase, carboxypeptidases are secreted as zymogens, inactive proenzymes and are converted to their active enzyme form by which enzyme

A

Trypsin

87
Q

Trypsin converting trypsinogen to more trypsin is a type of what regulation

A

Positive feedback loop

88
Q

What saccharides are absorbed by enterocytes?

A

Monosaccharides: glucose, galactose, fructose

89
Q

Which sodium-glucose transport protein-1 (SGLT1) takes up which to monosaccharides?

A

Glucose and Galactose

90
Q

Which transporter is responsible for the uptake of Fructose?

A

GLUT5

91
Q

Which transporter is responsible for the uptake of all monosaccharides?

A

GLUT2

92
Q

Which sodium-glucose transport protein has Na-dependent transport?

A

SGLT1

93
Q

Which glucose transporter works via facilitated diffusion?

A

GLUT5

94
Q

What form of iron is absorbed in the duodenum?

A

Fe2+ (oxidized)

95
Q

What part of the small intestine absorbs iron?

A

Duodenum

96
Q

What part of the GI tract absorbs folate?

A

Small bowel

97
Q

Vitamin that requires intrinsic factor for absorption

A

B12

98
Q

What part of the small intestine absorbs vitamin B12?

A

Terminal ileum

99
Q

Part of the small intestine where bile and salts are absorbed

A

Terminal ileum

100
Q

Patient with small bowel disease may be deficient in what nutrients?

A

Iron, B9 and B12

101
Q

Unencapsulated lymphoid tissue found in lamina propria and submucosa of ileum

A

Peyer patches

102
Q

Function of Peyer patches

A

Contain M cells that sample and present antigens to immune cells

103
Q

Cells in Peyer patches that sample and present antigens to immune cells

A

M cells

104
Q

Major type of immunoglobulin found in gut epithelium

A

IgA

105
Q

B-cells in Peyer patches are stimulated and differentiate to secrete which type of immunoglobulin

A

IgA

106
Q

Enzyme that is the rate-limiting step in bile acid synthesis

A

7alpha-hydroxylase

107
Q

Responsible for digestion and absorption of lipids and fat-soluble vitamins

A

Bile

108
Q

Responsible for cholesterol secretion and is the body’s primary way of eliminating cholesterol

A

Bile

109
Q

Provides antimicrobial activity in the GI tract via membrane disruption of pathogens

A

Bile

110
Q

Functions of bile

A
  1. Digestion and absorption of lipids and fat-soluble vitamins
  2. Cholesterol excretion
  3. Antimicrobial activity
111
Q

What is bile composed of?

A

Bile salts, phospholipids, cholesterol, bilirubin, water, and ions

112
Q

Enzyme that heme to biliverdin

A

Heme oxygenase

113
Q

Protein that carries bilirubin to liver

A

Albumin

114
Q

Bilirubin that is water insoluble

A

Indirect bilirubin

115
Q

Function of UDP-glucuronosyl-transferase

A

Conjugate bilirubin to direct bilirubin

116
Q

Bilirubin that is water soluble

A

Direct bilirubin

117
Q

Form of bilirubin that is excreted in feces and gives stool its brown color

A

Stercobilin

118
Q

What happens to the majority of bilirubin

A

Excreted in feces

119
Q

Organ where bilirubin is conjugated

A

Liver

120
Q

Form of bilirubin that is excreted in urine and gives it its yellow color

A

Urobilin

Step 1 Gastrointestinal-First Aid 2017 (5 decks)

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