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eMRCS questions > Physiology GI Book > Flashcards

Physiology GI Book Flashcards

1
Q

Components of gallstones

A

Mixed most common- cholesterol, bile pigments and calcium

Cholesterol stones- pure

Pigments- calcium bilirubinate

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2
Q

How much bile is produced in 1 day

A

1L

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3
Q

Drugs that induce CYP450

A

Anticonvulsants: phenytoin, carbamazepine, phenobarbitone. Steroids: dexamethasone, prednisolone, glucocorticoids. Antibiotics: rifampicin

Omeprazole and amiodarone

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4
Q

Different cells within the stomach and their function

A

Chief- pepsinogen in fundus
Parietal- gastric acid and intrinsic factor
Endocrine G cell- gastrin
Goblet cells - mucous
D cells- somatostatin

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5
Q

Which cells in stomach contain HK ATPase transporter

A

Parietal cells

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6
Q

Where are G cells located

A

Stomach
Duodenum
Pancreas

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7
Q

How are G cells stimulated, inhibited and function

A

Stimulated by stomach distention, vagus nerve and partially digested proteins in duodenum

Inhibited by acid in duodenum

Function- to stimulate gastric acid

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8
Q

What inhibits gastric acid secretion

A

Secretin, cholecystokinin and somatostatin

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9
Q

How much gastric acid is produced in 1 day

A

1-1.5L

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10
Q

Classification of severe pancreatitis

A

P- PaO2 <8
A- age >55
N- neutrophils >15
C- Corrected Ca <2
R- renal urea >16
E- enzymes AST/ALT >200
A- albumin <32
S- sugar >10

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11
Q

How much salvia is produced in 1 day

A

800-1500ml

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12
Q

pH of saliva

A

6-7- for enzyme ptyalin (type of amylase)

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13
Q

Composition of oxyntic gland

A

Mucosal cells
Chief cells
Parietal - have cannaliculi

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14
Q

Pyloric stenosis biochemistry

A

Hypokolaemic hypocholaemia alkalosis

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15
Q

What is unconjugated bilirubin bound by in the blood and what does it bond with to become conjugated

A

Albumin

Glucuronic acid

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16
Q

Why does cholestatic jaundice present with certain symptoms

A

Conjugated bilirubin leaks into blood- causing dark urine

Pale stools- no conjugated bilirubin secreted into GI tract

Bile salts leak into blood- causing pruritus

17
Q

What is absorbed, secreted and synthesised in colon

A

Net absorption water and Na
Net secretion of K and HCO3
Indirect role of synthesis of vit K and B by bacteria

18
Q

Effects of pancreatic tumour resection

A

Loss of protyletic and lipolytic enzymes- leading to poor digestion of protein and fat
Weight loss and poor absoption of ADEK
Loss of alkaline secretion- failure to neutralise gastric chyme- malabsorption of Ca, Fe and PO4- causing anaemia and osteoporosis

19
Q

Movements in small intestine

A

Segmentation- main- 9-12 per min
Back and forth
Frequency decreases further down
Paced by depolarisation- slow waves- para increasing activity
(large bowel 3-4 per min)

Peristalsis
Much weaker here than oesophagus or stomach
Stimulated by stretch reflex and serotonin

20
Q

Phases of swallowing

A

Oral- voluntary
Pharyngeal- shortest, involuntary
Oesophageal - involuntary- lower sphincter pressure 15mmHg§

21
Q

Function and location of cholecystokinin secretion

A

SI
Increase intestinal motility, contraction o gallbladder, stimulation of pancreatic enzyme release
Inhibits gastric motility and secretion

22
Q

Function and location of secretin secretion

A

SI
Stimulates water and bicarb secretion in panc
Enhances cholecystokinin
Inhibits gastric motility and secretion

23
Q

Function and location of GLP1 secretion

A

Ileum and colon
Inhibits gastric motility and secretion
Stimulates secretion of insulin

24
Q

Function and location of guanylin secretion

A

Ileum and colon
Stimulates intestinal secretion of CL

25
Q

Exocrine cells of pancreas

A

Acinar- respond to cholecystokinin and Act and release enzymes and CL
Duct- respond to secretin and release HCO3 rich fluid

Ratio of enzymes depends of diet

26
Q

How much bile is produced and secreted in 1 day

A

250-1500ml

27
Q

pH pepsin works best at

A

2-3

28
Q

Myenteric plexus function

A

Also known as Auerbach
Stimulation increases tonic contractions and rapid movements due to peristaltic wave

29
Q

Cranial nerves involved in swallowing

A

Oral
Trigeminal- mastication and sensation to ant 2/3 tongue
Hypoglossal- tongue movements
Facial- post 1/3 tongue, motor lips, cheek and stylohyoid

Pharyngeal
Glossopharyngeal- sensory to soft palate, post tongue and upper pharynx, motor to stylopharyngess and superior constrictor, salivary
Trigeminal, glosso, vagus (motor to palatoglossus, cricophayngeus, intrinsic muscles of larynx)- autonomic motor

Oesophageal
Sensation- X
Motor- V, IX, X

30
Q

Rate of peristalsis in oesophagus

A

5cm/sec

31
Q

Metabolic complications of parenteral nutrition

A

Hyperglycaemia/hypo
Hyperlipidaemia
Essential FA def
Hypercholaemic metabolic acidosis
Hyperammonaemia

32
Q

Vit K is used to make which clotting factors

A

Factors- 2, 7,9, 10, C

33
Q

What stimulates gastric acid production

A

Vagus nerve
Histamine - inhibited by nausea

34
Q
A

eMRCS questions (45 decks)

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