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PHYSIOLOGY > Prelims - NUTRIENT DIGESTION AND ABSORPTION (Dr. Lim) > Flashcards

Prelims - NUTRIENT DIGESTION AND ABSORPTION (Dr. Lim) Flashcards

1
Q

It is the enzymatic conversion of complex dietary substances to form that can be absorbed as initiated by sight, smell and taste of food.

A

Digestive Process

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2
Q

Some digestion begins in __________ —> __________ —> __________

A

Mouth

Lumen of Stomach

Small Intestine

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3
Q

Digestion within the SI can occur in both the

A

Lumen

SI Brush Border Membrane

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4
Q

Digestion in SI LUMEN is mediated by

A

Pancreatic Enzymes

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5
Q

Digestion in SI BRUSH BORDER MEMBRANE is by

A

Brush Border Enzymes

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6
Q

TRUE or FALSE

Glucose may not require digestion

A

TRUE

*INTESTINAL CELLS may absorb the nutrient as ingested

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7
Q

POLYMER (Protein) may be digested in lumen to its CONSTITUENT MONOMERS (AA) by __________ before absorption

A

Pancreatic Enzymes

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8
Q

OLIGOMER (Sucrose) is digested into its CONSTITUENT MONOMERS (Monosaccharides) by __________ before absorption

A

Brush Border Enzymes

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9
Q

TRUE or FALSE

OLIGOMER (Oligopeptide) may be directly absorbed by cell & then broken down into MONOMERS (AA) inside cell

A

TRUE

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10
Q

TRUE or FALSE

TRIACYLGLYCEROL broken down into constituent components before absorption; cell may RESYNTHESIZE original molecule

A

TRUE

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11
Q

__________ absorbs Carbohydrates, Proteins & Lipids

A

Entire SI

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12
Q

Absorption is greatest in the ___________, less in ___________, much less in the __________.

A

Duodenum

Jejunum

Ileum

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13
Q

CALCIUM, IRON AND FOLATE

Some substances are actively absorbed only in the

A

Duodenum

  • CALCIUM: LOW ABSORPTION in Jejunum and Ileum
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14
Q

There is LOW ABSORPTION of Calcium

A

Jejunum & Ileum

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15
Q

BILE ACIDS are absorbed along the ENTIRE SI, but active absorption occurs only in the __________

A

Ileum

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16
Q

COBALAMIN is absorbed only in the __________

A

Ileum

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17
Q

What are the diseases in the ESOPHAGUS

A

(1) GERD
(2) Achalasia
(3) Cardia
(4) Barrett’s Esophagus
(5) Esophageal Cancer

“GA C BE”

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18
Q

Diseases of the STOMACH

A

(1) Dyspepsia
(2) Gastritis
(3) Gastric Ulcer
(4) Gastric Cancer

“D GGG”

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19
Q

Diseases of the DUODENUM, JEJUNUM & ILEUM

A

(1) Duodenal Ulcer
(2) Celiac Disease
(3) Crohn’s Disease (CD)
(4) Intestinal Tuberculosis (ITb)

“DC CI”

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20
Q

Diseases of the COLON

A

(1) Diarrhea
(2) Constipation
(3) Inflammatory Bowel Syndrome (IBS)
(4) Inflammatory Bowel Disease (IBD)
(5) Colorectal Cancer (CRC)

“DCI IC”

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21
Q

Organ site for CELIAC SPRUE

A

Duodenum

Jejunum

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22
Q

Organ Site for CHRONIC PANCREATITIS

A

Exocrine Pancreas

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23
Q

Organ site for SURGICAL RESECTION OF ILEUM; CHRON DISEASE OF ILEUM

A

Ileum

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24
Q

Organ site for PRIMARY LACTASE DEFICIENCY

A

Small Intestine

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25
Q

Defective process in CELIAC SPRUE

A

Fat Absorption

Lactose Hydrolysis

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26
Q

Defective process in CHRONIC PANCREATITIS

A

Fat Digestion

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27
Q

Defective process in SURGICAL RESECTION OF ILEUM; CHRON DISEASE OF ILEUM

A

Cobalamin and Bile Acid absorption

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28
Q

Defective process in PRIMARY LACTASE DEFICIENCY

A

Lactose Hydrolysis

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29
Q

CARBOHYDRATE DIGESTION provides % of total energy

A

45% of the total energy needs of Western diets

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30
Q

CARBOHYDRATES require __________ before absorption

A

Hydrolysis to Monosaccharides

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31
Q

What are the dietary carbohydrates?

A

MONOSACCHARIDES - monomers
OLIGOSACCHARIDES - short polymers
POLYSACCHARIDES - long polymers

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32
Q

TRUE or FALSE

Small intestine cannot directly absorb monomers

A

FALSE

  • Small Intestine can directly absorb monomers but NOT polymers
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33
Q

TRUE or FALSE

Small Intestine can directly absorb MONOMERS by NOT POLYMERS

A

TRUE

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34
Q

TRUE or FALSE

Some polymers are DIGESTIBLE

A

TRUE

  • Some POLYMERS are DIGESTIBLE: body can digest them from MONOMERS that SI can absorb
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35
Q

TRUE or FALSE

Other polymers are NONDIGESTIBLE

A

TRUE

  • Other polymers are nondigestible: “FIBER”
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36
Q

Polymer that is nondigestible

A

Fiber

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37
Q

45-60% of dietary carbohydrates come from

A

Starch (Polysaccharide)

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38
Q

Storage form of carbohydrates in plants

A

Starch (Amylose & Amylopectin)

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39
Q

Storage form of carbohydrates in animal

A

Glycogen

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40
Q

Straight chain glucose polymer multiple glucose residues

A

Amylose

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41
Q

Massive branched glucose polymer contain 1M glucose residues

A

Amylopectin

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42
Q

TRUE or FALSE

Amylose > Amylopectin

A

FALSE

  • AMYLOPECTIN > Amylose
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43
Q

Most dietary oligosaccharides are

A

Disaccharides

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44
Q

SUCROSE & LACTOSE make up __________ of dietary carbohydrates

A

30-40%

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45
Q

Table sugar from SUGAR CANE & SUGAR BEETS

A

Sucrose

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46
Q

Sugar found in MILK

A

Lactose

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47
Q

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)

A

Salivary Amylase

Pancreatic Amylase

Brush Border Enzymes

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48
Q

Monossacharides account for __________ of total carbohydrate intake

A

5-10%

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49
Q

CARBOHYDRATE DIGESTION

SI can absorb _________

A

ONLY Monosaccharides

  • all dietary carbohydrates must be digested to monosaccharides before absorption
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50
Q

CARBOHYDRATE DIGESTION

COLON __________

A

CANNOT absorb monosaccharides

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51
Q

Two Steps of Digestive Process of dietary CARBOHYDRATES

A

(1) Intraluminal Hydrolysis

(2) Membrane Digestion

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52
Q

__________ of starch to Oligosaccharides by __________

A

Intraluminal Hydrolysis

Salivary & Pancreatic Amylases

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53
Q

__________ of Oligosaccharides to Monosaccharides by _________

A

Membrane Digestion

Brush Border Disaccharides

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54
Q

LUMINAL DIGESTION begins with action of __________ & finishes with __________

A

Salivary Amylase

Pancreatic Amylase

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55
Q

Initiates starch digestion; inactivated by gastric acid

A

Salivary Amylase

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56
Q

Completes starch digestion in lumen of small intestine; endoenzyme that hydrolyzes internal alpha 1,4 linkages

A

Pancreatic a-Amylase

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57
Q

Salivary & Pancreatice alpha Amylase are

A

Endoenzymes

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58
Q

Salivary & Pancreatic alpha Amylase CAN DIGEST __________, but CANNOT BREAK __________

A

LINEAR INTERNAL ALPHA 1,4 LINKAGES between glucose residues

TERMINAL ALPHA 1,6 LINKAGES (between the last two sugars in the chain)

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59
Q

Salivary & pancreatic alpha amylase CANNOT SPLIT __________ at branch points of Amylopectin or ___________

A

a-1,6 linkages

adjacent a-1,4 linkages

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60
Q

Products of a amyase action are

A

(1) Linear glucose oligomers
(2) Maltotriose
(3) Maltose
(4) a-limit dextrins

“LMMA”

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61
Q

__________ splits LACTOSE, then both monomers are transported via __________

A

Lactase

SLGT1

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62
Q

___________ removes glucose monomers for transport

A

Glucoamylase (MALTASE)

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63
Q

___________ are 2 enzymes

___________ splits Sucrose, Maltose & Maltotriose

A

Sucrase-isomaltase

Sucrase moiety

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64
Q

__________ are intrinsic membrane proteins with catalytic domains facing lumen

A

Brush Border Oligosaccharides

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65
Q

__________ splits a-limit dextrins, maltose & maltotriose

A

Isomaltase moiety

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66
Q

Na-COUPLED TRANSPORTER mediates uptake of GLUCOSE or GALACTOSE

A

SGLT1

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67
Q

Mediates FACILITATED DIFFUSION of FRUCTOSE

A

GLUT5

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68
Q

Mediates EFFLUX across BASOLATERAL membrane

A

GLUT2

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69
Q

GLUT5 transport is thru?

A

Passive Diffusion

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70
Q

SGLT1 is a?

A

Na-coupled transporter

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71
Q

TRUE or FALSE

SUCRASE activity is greatly reduced much more by fasting than LACTASE ACTIVITY

A

TRUE

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72
Q

__________ is more susceptible to enterocyte injury, it is also SLOWER TO RECOVER from damage than other oligosaccharide activity

A

Lactase Activity

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73
Q

REDUCED LACTASE ACTIVITY is a consequence of __________ & ___________

A

Genetic Regulation

Environmental Effects

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74
Q

Symptoms of Lactose Intolerance

A 
✅ Bloating
✅ Pain or cramps in lower belly ✅ Gurgling sounds
✅ Gas
✅ Loose stools
✅ Diarrhea
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75
Q

___________ RISES after glucose or lactose ingestion

and

H2 in the breath is _________

A

Plasma glucose

Low

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76
Q

___________ can split lactose into glucose and galactose and can absorb the two monosaccharides

A

SI

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77
Q

Product of lactose metabolism by colonic bacteria which metabolize lactose that enters colon

A

H2

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78
Q

What metabolizes lactose that enters colon

A

Colonic Bacteria

  • large amounts of H2 is excreted in the breath
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79
Q

3 Monosaccharide products of Carbohydrate Digestion

A

Glucose
Galactose
Fructose

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80
Q

Monosaccharides are absorbed in the SI in two-step process

A

(1) UPTAKE across the APICAL MEMBRANE into epithelial cell

(2) Coordinated EXIT across the BASOLATERAL MEMBRANE

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81
Q

PROTEIN DIGESTION

Digestion-absorption involve ___________

A

4 Major Pathways

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82
Q

In protein digestion, __________ enzymes come from __________

A

Luminal Enzymes

Stomach & Pancreas

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83
Q

4 Major Pathways of Protein Digestion

A

(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

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84
Q

Proteins come from

A

Dietary & Endogenous sources

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85
Q

Protein is encoded by __________ & it consist of __________ AA

A

mRNA

20

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86
Q

How many AA’s are not synthesized in adequate amounts by the body

A

9 AA’s

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87
Q

TRUE or FALSE

Protein derived from plant sources are digested more completely than animal protein

A

FALSE

  • Protein derived from animal sources digested more completely than plant protein
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88
Q

These are secreted as proenzymes and require conversion to their active form for protein hydrolysis to occur

A

Gastric & Pancreatic Proteases

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89
Q

Pancreatic enzymes are secreted as __________

A

Inactive Proenzymes

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90
Q

What are the 5 pancreatic enzymes participate in PROTEIN DIGESTION

A

(1) Trypsinogen
(2) Chymotrypsinogen
(3) Proelastase
(4) Procarboxypeptidase A
(5) Procarboxypeptidase B

“TC PPP”

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91
Q

_________ & _________ hydrolyze proteins to single AA or to oligopeptides

A

Pepsin from Stomach

5 - Pancreatic Proteases

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92
Q

_________ in cytoplasm hydrolyze oligopeptides into their consistuent AA

A

Peptidases

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93
Q

Peptides exit across BASOLATERAL MEMBRANE through one of three __________

A

Na-INDEPENDENT AA transporters

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94
Q

Oligopeptide uptake occurs via

A

H/oligopeptide cotransporter (PepT1)

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95
Q

If _________ present in lumen as free AA, enterocyte absorbs it through apical AA transporters

A

Glycine

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96
Q

Glycine is absorbed through

A

Apical AA Transporters

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97
Q

If same amount of GLYCINE is present in lumen in form of dipeptide GLYCYLGLYCINE, rate kf appearance in blood is _______

A

twice as high

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98
Q

__________ which moves several AA monomers for each turnover of transporter, is an effective mechanism for absorbing “AA”

A

PepT1

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99
Q

AA enter enterocytes through 1 or more group-specific _________

A

Apical Membrane Transporters

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100
Q

Predominant apical AA transport system is _________ results in _________

A

SYSTEM Bo

Na-dependent uptake of neutral AA

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101
Q

SYSTEM Bo results in

A

Na-dependent uptake of neutral AA

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102
Q

SYSTEM Bo gene in humans?

A

SLC6A19

  • solute carrier family 6 member 19
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103
Q

Mediates epithelial resorption of neutral AA across apical membrane in kidneys & intestines

A

SLC6A19 gene in humans

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104
Q

Mutation in SLC6A19 gene

A

Hartnup disease

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105
Q

Defects in APICAL amino acid transport

A

(1) Hartnup Disease

(2) Cystinuria

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106
Q

Defects in BASOLATERAL amino acid transport

A

(1) Lysinuric Protein Intolerance

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107
Q

HARTNUP DISEASE is a

A

Autosomal Recessive Disorder

108
Q

CYSTINURIA is an

A

Autosomal Recessive Disorder

109
Q

LYSINURIC PROTEIN INTOLERANCE is a

A

Rare Autosomal Recessive Disorder

110
Q

This disease is associated with SI abnormalities in absorption of neutral amino acids (L-phenylalanine)

A

Hartnup Disease

111
Q

What is defective in Hartnup Disease

A

Apical System Bo (SLCA19)

112
Q

Manifestations of Hartnup Disease

A

Pellagra
Cerebellar Ataxia
Psychiatric Abnormalities

113
Q

This disease is associated with renal tubule abnormalities of cationic amino acids (L-arginine) & L-cystine

A

Cystinuria

114
Q

What is defective in Cystinuria

A

Apical Ststem Bo+ (SLC7A9/SLC3A1 dimer)

115
Q

Manifestation of Cystinuria

A

Formation of Kidney Stones

116
Q

What is defect in Lysinuric Protein Intolerance

A

System y+L

  • which is solely located on BASOLATERAL MEMBRANE
117
Q

This disease is when urinary excretion of cationic AA is increased & poorly absorbed from intestine

A

Lysinuric Protein Intolerance

118
Q

Lysinuric Protein Intolerance is characterized by

A

LYSINE DEFICIENCY - skeletal & immunological abnormalities

119
Q

Lysinuric Protein Intolerance is present in

A

SI, Hepatocytes, Kidney Cells

120
Q

Organic compounds of biological origin sparingly soluble in water

A

Natural Lipids

121
Q

Lipids as NONPOLAR compounds

A

Completely INSOLUBLE in water (cholesterol esters, carotene)

122
Q

Lipids as POLAR compounds

A

Amphiphilic, having both polar & nonpolar groups

123
Q

Body’s only source of essential fatty acids

A

Dietary fat

124
Q

Acts as vehicle for absorption of fat-soluble vitamins

A

Dietary fat

125
Q

Major nutrient responsible for postprandial satiety

A

Dietary fat

126
Q

TRUE or FALSE

Ratio of SATURATED to UNSATURATED fatty acids in TAGs: LOW in animal fats & HIGH in plant fats

A

FALSE

  • HIGH in animal fats & LOW in plant fats
127
Q

_________ of dietary lipids from cell membranes & are _________

A

5%

Phospholipids

128
Q

Most phospholipids are

A

Glycerophospholipids

129
Q

Glycerophospholipids have

A

GLYCEROL backbone

130
Q

It is a predominant phospholipid

A

Phosphatidylcholine (Lecithin)

131
Q

Has SERINE rather than a glycerol backbone

A

Sphingolipid

132
Q

DIETARY LIPIDS are disrupted mechanically in _________

A

mouth & stomach

133
Q

Resulting lipid particles from dietary lipids are stabilized as

134
Q

Central process in digestion of lipids is

A

HYDROLYSIS in aqueous milieu of the intestinal lumen

135
Q

Central process in digestion of lipids is catalyzes by

A

LIPASES

  • secreted by glands & cells of upper GI tract
136
Q

KEY STEP PRELIMINARY to lipid digestion is

A

Transformation of ingested solid fat & oil masses into an EMULSION of fine oil droplets in water

137
Q

Emulsification of dietary fats begin with?

A

Chewing & gastric churning caused by antral peristalsis against a closed pylorus

138
Q

Chewing & gastric churning is caused by

A

Antral peristalsis against a closed pylorus

139
Q

LIPID DIGESTION

Mechanical processes will:

A

(1) REDUCE SIZE of lipid droplets
(2) INCREASE RATIO of surface area to volume
(3) INCREASE AREA of oil-water interface

140
Q

__________ initiate lipid digestion

A

Lingual & Gastric (Acid) Lipase

141
Q

In some species small amount of lipid digestion begins in _________, mediated by __________

A

Mouth

Lingual Lipase

142
Q

In STOMACH, both _________ secreted by gastric CHIEF CELL digest substantial amounts of lipid

A

Lingual Lipase & Gastric Lipase

143
Q

Process of fat digestion begins in

144
Q

Fat digestion is completed in _________, by enzymes synthesized & secreted by __________

A

Proximal SI

Pancreatic Acinar Cells

145
Q

Fat digestion is carried into DUODENUM by

A

Pancreatic Juice

146
Q

TRUE or FALSE

As LIPASES hydrolyze TAGs at surface, TAGs from core replace them, causing droplet to grow

A

FALSE

  • As LIPASES hydrolyze TAGs at surface, TAGs from core replace them, causing droplet to shrink
147
Q

CORE LIPIDS include

A

(1) Triacylglycerols
(2) Diacylglycerols
(3) Cholesterol Esters

148
Q

SURFACE LIPIDS include

A

(1) Fatty Acid Soaps
(2) Monoacylglycerols
(3) Lysolecithins
(4) Cholesterol
(5) Bile Salts

149
Q

Products of lipolysis enter bulk water phase of intestinal lumen as vesicles, mixed _________ & __________

A

Micelles

Monomers

150
Q

Process of how Lipids cross enterocyte brush border

A

(1) Lipids as mixed MICELLES & MONOMERS
(2) Diffuse across unstirred water layer on surface of JEJUNAL MUCOSA
(3) Cross enterocyte brush border

151
Q

To reach interior of enterocyte, lipolytic products must cross these barriers

A

(1) MUCOUS GEL LAYER - lines intestinal epithelial surface
(2) UNSTIRRED WATER LAYER (Disequilibrium Zone) - contiguous with enterocyte’s apical membrane
(3) APICAL MEMBRANE

“MUA”

152
Q

This barrier lines intestinal epithelial surface

A

Mucous gel layer

153
Q

This barrier is contiguous with enterocyte’s apical membrane

A

Unstirred Water Layer (Disequilibrium Zone)

154
Q

_________ carry lipids through the acidic unstirred layer to surface of enterocyte

A

Mixed micelles

155
Q

__________ leave mixed micelle & enter an acidic microenvironment created by APICAL Na-H EXCHANGER

A

2-MAG
FA
Lysophospholipids
Cholesterol

156
Q

2-MAG, FA, LYSOPHOSPHOLIPIDS & CHOLESTEROL leave mixed micelle & enter an acidic microenvironment created by _________

A

Apical Na-H Exchanger

157
Q

Enterocyte re-esterifies lipid components & assembles them into

A

Chylomicrons

158
Q

Largest of lipoprotein particles

A

Chylomicrons

159
Q

Consist primarily of TAGs with smaller amounts of phospholipids, cholesteryl esters, cholesterol & apolipoproteins

A

Chylomicrons

160
Q

_________ re-esterifies lipid components & assembles them into CHYLOMICRONS

A

Enterocyte

161
Q

Enterocyte secretes ________ into lymphatic circulation during FEEDING

A

Chylomicrons

162
Q

Enterocyte secretes ________ during FASTING

163
Q

Enterocyte secretes VLDL during

164
Q

Enterocytes secretes chylomicrons into lymphatic circulation during

165
Q

TRUE or FALSE

Chylomicrons are too large to pass through fenestrate of blood capillaries

166
Q

Chylomicrons enter lymph through

A

Larger interendothelial channels of lymphatic capillaries

167
Q

In fed & fasted states, intestine secretes ________ which are smaller than chylomicrons

168
Q

Intestinal absorption of FAT-SOLUBLE VITAMINS follows pathways of __________

A

Lipid Absorption & Transport

169
Q

In contract to water-soluble counterparts, FAT-SOLUBLE VITAMINS

A

(1) do not form classical coenzyme structures or prosthetic groups with soluble apoproteins
(2) can also be stored in fat depots in body

170
Q

Vitamin A is also called as

171
Q

Vitamin D is also called as

A

1,25 cholecalciferol

172
Q

Vitamin E is also called as

A

a-Tocopherol

173
Q

Vitamin K is also known as

A

K1=phylioquinone

K2=various menaquinones

174
Q

Role of Vitamin A

A

Retinal pigment

175
Q

Role of Vitamin D

A

Ca+ absorption

176
Q

Role of Vitamin E

A

Antioxidant: thought to prevent oxidation of unsaturated fatty acids

177
Q

Role of Vitamin K

A

Clotting: necessary for synthesis by liver of prothrombin and favtors VII, IX and X

178
Q

RDA of Vitamin A

A

Male: 1000 ug
Female: 800 ug

179
Q

RDA of Vitamin D

180
Q

RDA of Vitamin E

A

Male: 10 mg
Female: 8 mg

181
Q

RDA of Vitamin K

A

Male: 70-80 ug
Female: 60-65 ug

182
Q

Effect of deficiency of Vitamin A

A

Follicular hyperkeratosis

Night blindness

183
Q

Effect of deficiency of Vitamin D

184
Q

Effect of deficiency of Vitamin E

A

Peripheral Neuropathy

185
Q

Effect of deficiency of Vitamin K

A

Hemorrhagic Disease

186
Q

Fat-Soluble vitamin deficiency occurs in various fat malabsorption states:

A

(1) Induced by malabsorptive BARIATRIC SURGERY
(2) Drugs (ORLISTAT) that impair TAG hydrolysis
(3) Drugs (CHOLESTYRAMINE) that bind bile acids
(4) Reduction of bile acids by IMPAIRED HEPATOBILIARY FUNCTION
(5) UNABSORBABLE dietary fat substitutes

187
Q

Drug that IMPAIR TAG HYDROLYSIS

188
Q

Drug that BIND BILE ACIDS

A

Cholestyramine

189
Q

Dietary Folate (PteGlu7) other names

A

Folate or Folic Acid or Pteroylmonoglutamate (PteGlu1)

190
Q

Dietary Folate

191
Q

Dietary Folate (PteGlu7) must be deconjugated by _________ before absorption by an anion exchanger at APICAL MEMBRANE

A

Brush Border Enzyme

192
Q

A cofactor in biochemical reactions involving transfer of 1-carbon fragment

A

Tetrahydrofolate (THF)

193
Q

Reduced form of Folate

A

Tetrahydrofolate (THF)

194
Q

Tetrahydrofolate is essential for synthesis of ________ & ________

A

THYMINE & PURINES

  • which are components of DNA
195
Q

Essentia for synthesis of Thymine & Purines

A

Tetrahydrofolate

196
Q

This reduces the risk of neural tube defects

A

Folic acid supplementation in Pregnancy

197
Q

Folate Deficiency is most clinically noticeable in

A

Bone Marrow

198
Q

RNA & protein synthesis are not impaired in Folic Acid Deficiency, instead

A

Large RBCs (Megaloblasts) are produced

199
Q

Tetrahydrofolate has three parts:

A

(1) Active pteridine moiety
(2) p-aminobenzoate
(3) Glutamate

“APG”

200
Q

Oxidized form of folate

A

PteGlu1

  • biologically INACTIVE
  • MEDICINAL FORM of folate
  • Monoglutamate
201
Q

In PROXIMAL SI, ___________ removes glutamate residues from dietary folate

A

Brush Border Peptidase

202
Q

Enterocyte absorbs PteGlu1 using _________

A

folate-OH exchanger

203
Q

_________: reduce some of PteGlu1 to DHF -> THF (active form of folate)

A

Enterocyte

  • may methylate some of THF to form N5-methyl-THF
204
Q

PteGlu1 exits across

A

Basolateral Membrane (Unknown Transporter)

205
Q

form of folate needed for DNA synthesis

A

5,10 - Methylene THF

206
Q

Cell converts THF to

A

5,10 - Methylene THF

  • which is the form of folate needed for DNA Synthesis
207
Q

Cell transform 5,10 - methylene THF to

A

N5 - methyl THF

208
Q

Acts as methyl donor in synthesis of METHIONINE

A

N5 - methyl THF

209
Q

TRUE or FALSE

Cobalamin (Vitamin B12) is synthesized only by microorganisms not by mammalian cells

210
Q

Primary source of COBALAMIN in humans:

A

Ingestion of Animal Products

  • not present in vegetables or fruit
211
Q

Strict vegetarians have

A

Cobalamin deficiency

212
Q

Cobalamin primary function

A

COENZYME for Homocysteine: Methionine Methyltransferase

213
Q

Steps 1-8 show:

Steps 4-8 show:

A

Fate of Dietary Cobalamim (CBL)

Role of IF

214
Q

Carries Cobalamin into the duodenum

215
Q

Absorption of Cobalamin

A

(1) Cobalamin is bound to proteins in food
(2) Acid pH & Pepsin release cobalamin from dietary protein
(3) Gastric glands secrete HAPTOCORIN, which binds to cobalamin
(4) Gastric parietal cells secrete IF
(5) Pancreas secretes proteases & HCO3-
(6) CBL is released after proteolytic degradation of haptocorrin
(7) IF-CBL complex forms
(8) Ileal enterocyte absorbs IF-CBL complex

216
Q

IF/cobalamin compolex is through

A

Endocytosis

217
Q

Cobalamin binds to _________: required for cobalamins exit from entercoyte

A

Transcobalamin II (TCII)

218
Q

Comprises dietary sources & digestive secretions

A

Ca2+ load presented to SI

219
Q

Ca2+ absorption is regulated primarily by

220
Q

Ca2+ occurs by _________ in DUODENUM

A

Active Transport

221
Q

Ca2+ absorption is by ________ throughout SMALL INTESINE

222
Q

SI absorbs calcium by 2 mechanisms

A

(1) PASSIVE (Paracellular Absorption) of calcium

(2) ACTIVE (Transcellular Absorption) of calcium

223
Q

Pathway predominates but not under control of Vitamin D

A

Passive (Paracellular) Absorption of Calcium

224
Q

Absorption of Calcium that occurs throughout the SI

A

Passive (Paracellular) Absorption of calcium

225
Q

Absorption of Calcium that occurs only in the duodenum

A

Active (Transcellular) Absorption of calcium

226
Q

TRANSCELLULAR Calcium Absorption involves 3 Steps:

A

(1) Calcium enters cell across APICAL MEMBRANE through channel
(2) Inside cell -> Calcium buffered by binding proteins - CALBINDIN -> Taken up into endoplasmic reticulum
(3) Enterocyte extrudes calcium across BASOLATERAL MEMBRANE through CALCIUM PUMP & Na-Ca EXCHANGER -> Calcium Absorption

227
Q

Calcium buffered by binding proteins called

228
Q

Enterocyte extrudes calcium across BASOLATERAL MEMBRANE through

A

Calcium pump & Na-Ca exchanger

229
Q

MAGNESIUM

Load to __________

A

SI; dietary sources & digestive secretions (green vegetables, cereals, meats)

230
Q

Important for proper secretion of PTH hormone

231
Q

Depletion of this vitamin is associated with Hypocalcemia

232
Q

Depletion of Magnesium is associated with

A

Hypocalcemia

233
Q

Systems affected by Mg deficiency

A
  • GI
  • Cardiovascular
  • Neuromuscular
234
Q

Magnesium absorption occurs by

A

ACTIVE PROCESS in ILEUM

235
Q

An important intracellular ion required as ENZYME COFACTOR

236
Q

Many enzymes using ATP require that ATP be complexed with _________

237
Q

This does not consistently increase Mg absorption

A

1,25 - dihydroxyvitamin D

238
Q

The rest of SI absorbs Mg _________

239
Q

TRUE or FALSE

Patients with decreased intestinal Calcium absorption have normal Mg absorption

A

FALSE

  • Patients with INCREASED intestinal Calcium absorption have normal Mg absorption
240
Q

Heme & nonheme iron is absorbed by

A

DUODENUM by Distinct Cellular Mechanisms

241
Q

Iron overload

A

Hemochromatosis

242
Q

Most anemia complication of iron depletion

243
Q

Iron plays important roles in:

A

(1) HEME GROUPS of cytochromes

(2) Key component of OXYGEN-CARRYING HEME MOIETIES OF HGB & MYOGLOBIN

244
Q

Heme Iron is derived from

A

Myoglobin & Hemoglobin

245
Q

Heme Iron is absorbed by

A

Duodenal Epithelial Cells

246
Q

Two types of Nonheme Iron

A
  • Ferric Iron (Fe3+)

- Ferrous Iron (Fe2+)

247
Q

Nonheme iron that form salt complexes with anions easily

A

Ferric Iron (Fe3+)

248
Q

Nonheme Iron that is not readily absorbed

A

Ferric Iron (Fe3+)

249
Q

Ferric Iron (Fe3+) is not soluble in what pH

A

pH values > 3

250
Q

Nonheme Iron that does not complex easily

A

Ferrous Iron (Fe2+)

251
Q

Ferrous Iron (Fe2+) is soluble in which pH

A

Soluble at pH as high as 8

252
Q

________ reduces non-heme Fe3+ to Fe2+ iron

253
Q

The absorption of nonheme iron occurs almost exclusively as ________

254
Q

How is Nonheme Fe2+ Absorption

A

DMT cotransports Fe2+ iron with H+

255
Q

TRUE or FALSE

No absolute daily requirement for carbohydrate or fat intake exists

256
Q

TRUE OR FALSE

Nutritionists recommend: daily intake of carbohydrate vs fat should differ with age, gender or activity level

A

Nutritionists recommend: daily intake of carbohydrate vs fat should not differ with age, gender or activity level

257
Q

Requirement for total caloric intake vary & depend

A

Person’s ability to use & store energy

Daily activity level

258
Q

What is the daily protein requirmeent for adult humans

A

0.8 g/kg body weight

259
Q

TRUE or FALSE

Daily protein requirement is higher in pregnant women, postsurgical patients & athletes

260
Q

Diet must contain the 9 essential AA because

A

the body cannot synthesize tyem

261
Q

Amino acids

A

(1) Arginine
(2) Glutamate
(3) Glycine
(4) Glutamine

262
Q

Amino Acid that is PRECURSOR TO NITRIC OXIDE

263
Q

Amino Acid that is a MAJOR EXCITATORY NEUROTRANSMITTER IN THE BRAIN

264
Q

Amino Acid that is a MAJOR INHIBITORY NEUROTRANSMITTER

265
Q

Amino Acid that is the MAJOR SOURCE OF NH3 PRODUCTION IN THE KIDNEY & REGULATES PROTEIN TURNOVER IN THE MUSCLE

266
Q

TRUE or FALSE

Minerals & Vitamins are energy sources

A

FALSE

  • not energy sources
267
Q

Minerals & Vitamins are essential for

A

(1) Enzymatic reactions
(2) Protein complexes
(3) Pecursors for biomolecules
(4) Metabolism
(5) Immune competence
(6) Muscle force production
(7) Blood clotting

PHYSIOLOGY (6 decks)

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