Questions for midterm 3

Question 1

4 things present in the gastric secretion and where they come from

Answer 1

Mucus (goblet cells)
HCl (parietal cells - same as intrinsic factor)
Pepsin (chief cells)
Gastric lipase (chief cells)

Question 2

3 ways the gastric epithelium protects itself from stomach acid

Answer 2

Mucus and bicarbonate layer
Tight junctions to prevent the penetration of HCl
Luminal membrane is impermeable to H+ ions

Question 3

4 mucosal protective mechanisms

Answer 3

Mucus
Bicarbonate
Prostaglandins (mucosal blood flow)
Rapid turnover of mucosa

Question 4

3 things H pylori secretes that can damage the epithelium

Answer 4

Urease (it neutralizes stomach acid and produces ammonia as a damaging byproduct)
Enzymes
Exotoxins

Question 5

3 effects of H pylori on the epithelium

Answer 5

Mucosal damage
Inflammation
Mucosal cell death

Question 6

3 ways H pylori is transmitted

Answer 6

Person to person
Exposure to gastric secretions
Water borne

Question 7

6 ways to test for H pylori

Answer 7

Endoscopy and a biopsy
Culture
Breath test
Urease test
ELISA
Rapid test for H pylori

Question 8

2 ways to treat H pylori

Answer 8

Antibiotics

Proton pump inhibitors

Question 9

What are 2 helpful actions of prostaglandins

Answer 9

Support platelets (helps the blood clotting function)
Protect the stomach (protects lining from effects of acid)
From COX 1

Question 10

3 harmful effects of prostaglandins

Answer 10

Inflammation
Pain
Fever

Question 11

Which COX pathway do you want to inhibit?

Answer 11

COX 2

Question 12

3 functions of aspirin

Answer 12

Inhibits blood clotting
Prevents stroke
Prevents CV attack

Question 13

Celecoxib

Answer 13

Selective COX 2 inhibitor

Good because it causes less bleeding and fewer ulcers

Question 14

4 harmful effects of ASA and non-selective NSAIDS

Answer 14

Disrupt the mucosal barrier
Reduce bicarbonate production
Directly damage the gastric mucosal epithelium
Reduce the production of prostaglandins

Question 15

Insulin

Answer 15

Released from pancreatic beta cells when there are high levels of glucose in the blood
Acts on the liver, adipose, and muscle to increase glucose uptake and storage, reduce gluconeogenesis, glycogenolysis, and glucose release

Question 16

Glucagon

Answer 16

Release from pancreatic alpha cells when blood glucose levels are low
Acts on the liver to increase gluconeogenesis, glycogenolysis, and reduce glucose storage

Question 17

5 hormones from pancreatic islets and the cells they are released from

Answer 17

Insulin (beta)
Glucagon (alpha)
Somatostatin (delta)
Pancreatic polypeptide (PP cells)
Ghrelin (epsilon cells)

Question 18

Why do diabetic patients have increased appetite?

Answer 18

Her body is in starvation mode
No signals from ghrelin and no negative feedback from leptin
But not helping because she cannot use the glucose

Question 19

Incretins

Answer 19

Hormones from the gut that prepare the beta cell to secrete insulin

Question 20

Incretin effect in T2D

Answer 20

Lost

Question 21

GLP-1

Answer 21

From proglucagon, cleaved in intestinal L cells to GLP-1
Secreted from small intestine
Causes proliferation of beta cell and the release of insulin in response to glucose
Suppresses glucagon secretion
Inhibits gastric emptying/secretion/pancreatic secretion
Decreases food intake and body weight
Deficient in T2D

Question 22

GIP

Answer 22

Secreted from K cells in the first part of the small intestine
Enhances the release of insulin in response to infusions of glucose
No effect on satiety or body weight
Does not inhibit glucagon
Normal levels but decreased responsiveness in T2D

Question 23

GLP-2 function

Answer 23

Increases the size of the villi

Question 24

3 functions of GLP-1 in the beta cells

Answer 24

Increases insulin gene transcription
Leads to beta cell proliferation
Decreased beta cell apoptosis

Question 25

Why was GLP-1 approved to manage diabetes?

Answer 25

Glucose dependent insulin release (no risk for hypoglycemia)
Lowers blood glucose levels in normal people and those with T2D
Can help product enough insulin to overcome the resistance (to a point)

Question 26

Why is high glucose toxic for the beta cells?

Answer 26

Glucotoxicity

Lipotoxicity

Question 27

Is GLUT2 or GLUT4 insulin dependent?

Answer 27

GLUT4

Found in the muscle and adipose (need insulin to take glucose into cells)