Prelims - NUTRIENT DIGESTION AND ABSORPTION (Dr. Lim) Flashcards
It is the enzymatic conversion of complex dietary substances to form that can be absorbed as initiated by sight, smell and taste of food.
Digestive Process
Some digestion begins in __________ —> __________ —> __________
Mouth
Lumen of Stomach
Small Intestine
Digestion within the SI can occur in both the
Lumen
SI Brush Border Membrane
Digestion in SI LUMEN is mediated by
Pancreatic Enzymes
Digestion in SI BRUSH BORDER MEMBRANE is by
Brush Border Enzymes
TRUE or FALSE
Glucose may not require digestion
TRUE
*INTESTINAL CELLS may absorb the nutrient as ingested
POLYMER (Protein) may be digested in lumen to its CONSTITUENT MONOMERS (AA) by __________ before absorption
Pancreatic Enzymes
OLIGOMER (Sucrose) is digested into its CONSTITUENT MONOMERS (Monosaccharides) by __________ before absorption
Brush Border Enzymes
TRUE or FALSE
OLIGOMER (Oligopeptide) may be directly absorbed by cell & then broken down into MONOMERS (AA) inside cell
TRUE
TRUE or FALSE
TRIACYLGLYCEROL broken down into constituent components before absorption; cell may RESYNTHESIZE original molecule
TRUE
__________ absorbs Carbohydrates, Proteins & Lipids
Entire SI
Absorption is greatest in the ___________, less in ___________, much less in the __________.
Duodenum
Jejunum
Ileum
CALCIUM, IRON AND FOLATE
Some substances are actively absorbed only in the
Duodenum
- CALCIUM: LOW ABSORPTION in Jejunum and Ileum
There is LOW ABSORPTION of Calcium
Jejunum & Ileum
BILE ACIDS are absorbed along the ENTIRE SI, but active absorption occurs only in the __________
Ileum
COBALAMIN is absorbed only in the __________
Ileum
What are the diseases in the ESOPHAGUS
(1) GERD
(2) Achalasia
(3) Cardia
(4) Barrett’s Esophagus
(5) Esophageal Cancer
“GA C BE”
Diseases of the STOMACH
(1) Dyspepsia
(2) Gastritis
(3) Gastric Ulcer
(4) Gastric Cancer
“D GGG”
Diseases of the DUODENUM, JEJUNUM & ILEUM
(1) Duodenal Ulcer
(2) Celiac Disease
(3) Crohn’s Disease (CD)
(4) Intestinal Tuberculosis (ITb)
“DC CI”
Diseases of the COLON
(1) Diarrhea
(2) Constipation
(3) Inflammatory Bowel Syndrome (IBS)
(4) Inflammatory Bowel Disease (IBD)
(5) Colorectal Cancer (CRC)
“DCI IC”
Organ site for CELIAC SPRUE
Duodenum
Jejunum
Organ Site for CHRONIC PANCREATITIS
Exocrine Pancreas
Organ site for SURGICAL RESECTION OF ILEUM; CHRON DISEASE OF ILEUM
Ileum
Organ site for PRIMARY LACTASE DEFICIENCY
Small Intestine
Defective process in CELIAC SPRUE
Fat Absorption
Lactose Hydrolysis
Defective process in CHRONIC PANCREATITIS
Fat Digestion
Defective process in SURGICAL RESECTION OF ILEUM; CHRON DISEASE OF ILEUM
Cobalamin and Bile Acid absorption
Defective process in PRIMARY LACTASE DEFICIENCY
Lactose Hydrolysis
CARBOHYDRATE DIGESTION provides % of total energy
45% of the total energy needs of Western diets
CARBOHYDRATES require __________ before absorption
Hydrolysis to Monosaccharides
What are the dietary carbohydrates?
MONOSACCHARIDES - monomers
OLIGOSACCHARIDES - short polymers
POLYSACCHARIDES - long polymers
TRUE or FALSE
Small intestine cannot directly absorb monomers
FALSE
- Small Intestine can directly absorb monomers but NOT polymers
TRUE or FALSE
Small Intestine can directly absorb MONOMERS by NOT POLYMERS
TRUE
TRUE or FALSE
Some polymers are DIGESTIBLE
TRUE
- Some POLYMERS are DIGESTIBLE: body can digest them from MONOMERS that SI can absorb
TRUE or FALSE
Other polymers are NONDIGESTIBLE
TRUE
- Other polymers are nondigestible: “FIBER”
Polymer that is nondigestible
Fiber
45-60% of dietary carbohydrates come from
Starch (Polysaccharide)
Storage form of carbohydrates in plants
Starch (Amylose & Amylopectin)
Storage form of carbohydrates in animal
Glycogen
Straight chain glucose polymer multiple glucose residues
Amylose
Massive branched glucose polymer contain 1M glucose residues
Amylopectin
TRUE or FALSE
Amylose > Amylopectin
FALSE
- AMYLOPECTIN > Amylose
Most dietary oligosaccharides are
Disaccharides
SUCROSE & LACTOSE make up __________ of dietary carbohydrates
30-40%
Table sugar from SUGAR CANE & SUGAR BEETS
Sucrose
Sugar found in MILK
Lactose
Carbohydrate digestion begins by the action of __________, OLIGOSACCHARIDES are then broken down by __________ to DISACCHARIDES (Maltose, Sucrose, Lactose), then the __________ breaks it down to MONOSACCHARIDES (Galactose, Glucose, Fructose)
Salivary Amylase
Pancreatic Amylase
Brush Border Enzymes
Monossacharides account for __________ of total carbohydrate intake
5-10%
CARBOHYDRATE DIGESTION
SI can absorb _________
ONLY Monosaccharides
- all dietary carbohydrates must be digested to monosaccharides before absorption
CARBOHYDRATE DIGESTION
COLON __________
CANNOT absorb monosaccharides
Two Steps of Digestive Process of dietary CARBOHYDRATES
(1) Intraluminal Hydrolysis
(2) Membrane Digestion
__________ of starch to Oligosaccharides by __________
Intraluminal Hydrolysis
Salivary & Pancreatic Amylases
__________ of Oligosaccharides to Monosaccharides by _________
Membrane Digestion
Brush Border Disaccharides
LUMINAL DIGESTION begins with action of __________ & finishes with __________
Salivary Amylase
Pancreatic Amylase
Initiates starch digestion; inactivated by gastric acid
Salivary Amylase
Completes starch digestion in lumen of small intestine; endoenzyme that hydrolyzes internal alpha 1,4 linkages
Pancreatic a-Amylase
Salivary & Pancreatice alpha Amylase are
Endoenzymes
Salivary & Pancreatic alpha Amylase CAN DIGEST __________, but CANNOT BREAK __________
LINEAR INTERNAL ALPHA 1,4 LINKAGES between glucose residues
TERMINAL ALPHA 1,6 LINKAGES (between the last two sugars in the chain)
Salivary & pancreatic alpha amylase CANNOT SPLIT __________ at branch points of Amylopectin or ___________
a-1,6 linkages
adjacent a-1,4 linkages
Products of a amyase action are
(1) Linear glucose oligomers
(2) Maltotriose
(3) Maltose
(4) a-limit dextrins
“LMMA”
__________ splits LACTOSE, then both monomers are transported via __________
Lactase
SLGT1
___________ removes glucose monomers for transport
Glucoamylase (MALTASE)
___________ are 2 enzymes
___________ splits Sucrose, Maltose & Maltotriose
Sucrase-isomaltase
Sucrase moiety
__________ are intrinsic membrane proteins with catalytic domains facing lumen
Brush Border Oligosaccharides
__________ splits a-limit dextrins, maltose & maltotriose
Isomaltase moiety
Na-COUPLED TRANSPORTER mediates uptake of GLUCOSE or GALACTOSE
SGLT1
Mediates FACILITATED DIFFUSION of FRUCTOSE
GLUT5
Mediates EFFLUX across BASOLATERAL membrane
GLUT2
GLUT5 transport is thru?
Passive Diffusion
SGLT1 is a?
Na-coupled transporter
TRUE or FALSE
SUCRASE activity is greatly reduced much more by fasting than LACTASE ACTIVITY
TRUE
__________ is more susceptible to enterocyte injury, it is also SLOWER TO RECOVER from damage than other oligosaccharide activity
Lactase Activity
REDUCED LACTASE ACTIVITY is a consequence of __________ & ___________
Genetic Regulation
Environmental Effects
Symptoms of Lactose Intolerance
✅ Bloating ✅ Pain or cramps in lower belly ✅ Gurgling sounds ✅ Gas ✅ Loose stools ✅ Diarrhea
___________ RISES after glucose or lactose ingestion
and
H2 in the breath is _________
Plasma glucose
Low
___________ can split lactose into glucose and galactose and can absorb the two monosaccharides
SI
Product of lactose metabolism by colonic bacteria which metabolize lactose that enters colon
H2
What metabolizes lactose that enters colon
Colonic Bacteria
- large amounts of H2 is excreted in the breath
3 Monosaccharide products of Carbohydrate Digestion
Glucose
Galactose
Fructose
Monosaccharides are absorbed in the SI in two-step process
(1) UPTAKE across the APICAL MEMBRANE into epithelial cell
(2) Coordinated EXIT across the BASOLATERAL MEMBRANE
PROTEIN DIGESTION
Digestion-absorption involve ___________
4 Major Pathways
In protein digestion, __________ enzymes come from __________
Luminal Enzymes
Stomach & Pancreas
4 Major Pathways of Protein Digestion
(1) HYDROLYZE proteins -> peptides -> AA -> absorbed
(2) DIGEST proteins -> peptides, but enzymes present at BRUSH BORDER digest peptides -> AA -> absorbed
(3) DIGEST proteins -> peptides then taken up as OLIGOPEPTIDES by ENTEROCYTES -> further digestion of oligopeptides -> AA -> moved into BLOOD
(4) DIGEST dietary proteins -> OLIGOPEPTIDES taken up by ENTEROCYTES -> moved DIRECTLY INTO BLOOD
Proteins come from
Dietary & Endogenous sources
Protein is encoded by __________ & it consist of __________ AA
mRNA
20
How many AA’s are not synthesized in adequate amounts by the body
9 AA’s
TRUE or FALSE
Protein derived from plant sources are digested more completely than animal protein
FALSE
- Protein derived from animal sources digested more completely than plant protein
These are secreted as proenzymes and require conversion to their active form for protein hydrolysis to occur
Gastric & Pancreatic Proteases
Pancreatic enzymes are secreted as __________
Inactive Proenzymes
What are the 5 pancreatic enzymes participate in PROTEIN DIGESTION
(1) Trypsinogen
(2) Chymotrypsinogen
(3) Proelastase
(4) Procarboxypeptidase A
(5) Procarboxypeptidase B
“TC PPP”
_________ & _________ hydrolyze proteins to single AA or to oligopeptides
Pepsin from Stomach
5 - Pancreatic Proteases
_________ in cytoplasm hydrolyze oligopeptides into their consistuent AA
Peptidases
Peptides exit across BASOLATERAL MEMBRANE through one of three __________
Na-INDEPENDENT AA transporters
Oligopeptide uptake occurs via
H/oligopeptide cotransporter (PepT1)
If _________ present in lumen as free AA, enterocyte absorbs it through apical AA transporters
Glycine
Glycine is absorbed through
Apical AA Transporters
If same amount of GLYCINE is present in lumen in form of dipeptide GLYCYLGLYCINE, rate kf appearance in blood is _______
twice as high
__________ which moves several AA monomers for each turnover of transporter, is an effective mechanism for absorbing “AA”
PepT1
AA enter enterocytes through 1 or more group-specific _________
Apical Membrane Transporters
Predominant apical AA transport system is _________ results in _________
SYSTEM Bo
Na-dependent uptake of neutral AA
SYSTEM Bo results in
Na-dependent uptake of neutral AA
SYSTEM Bo gene in humans?
SLC6A19
- solute carrier family 6 member 19
Mediates epithelial resorption of neutral AA across apical membrane in kidneys & intestines
SLC6A19 gene in humans
Mutation in SLC6A19 gene
Hartnup disease
Defects in APICAL amino acid transport
(1) Hartnup Disease
(2) Cystinuria
Defects in BASOLATERAL amino acid transport
(1) Lysinuric Protein Intolerance