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ACVIM General Boards 2024 > Renal and GI physio > Flashcards

Renal and GI physio Flashcards

1
Q

Pepsinogen
Source, Stimulus, Action

A

Source: Chief cells
Stimulus:
- Stretch, Ach from vagus nerve
- HCl
Action: precursor for pepsin (10-20% of protein digestion)

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2
Q

Somatostatin
Source, Stimulus, Action

A

Source: D cells
Stimulus: Low gastric pH (food has moved on from stomach so no longer providing buffer so pH in stomach drops).
Action:
- paracrine: Inhibit gastrin secretion
- endocrine: inhibit pariatal cell acid secretion
- neurocrine: Decrease gastric motility

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3
Q

Phases of Gastric Secretion

A
  1. Cephalic - 30%
    - sight/smell of food
    - ach from vagus nerve
    - gastrin from G cells
    - histamine from ECL cells
  2. Gastric - 60%
    - Gastric digestion and release of peptides
    - stretch - vasovagal and local enteric reflexes
    - gastrin from G cells
  3. Intestinal - 10% - shuts down gastric secretion
    - gastric emptying
    - decreases intestinal and gastric antral pH
    - somatostatin from D cells
    - Secretin from S cells
    - CCK from I cells
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4
Q

What is the purpose of the oxyntic glands and where are they located?
What cells are found here?

A

Exocrine - Acid secretion
Located in body/fundus of stomach
Parietal cells, chief cells, mucus neck cells

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5
Q

What is the purpose of the pyloric glands and where are they located?
What cells are found here?

A

Endocrine - Secrete gastrin
Located in the atrum of the stomach
G cells

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6
Q

Gastrin
Source, Stimulus, Action

A

Source: G cell
Stimulus:
- stretch and vagal stimulation
- peptides and amino acids (spec. phenylalanine and tryptophan)
Action:
- acts on enterochromaffin-like cells in an endocrine like fashion to tell them to secrete histamine which acts on parietal cells
- acts on parietal cells to secrete stomach acid

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7
Q

What is the most potent stimulator of parietal cells?

A

Histamine

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8
Q

What are the three receptors on parietal cells? What binds to them and how do they activate the parietal cells?

A

M3 (ach), H2 (histamine), CCK (gastrin)
M3 and CCK increase intracellular calcium and histamine increases cyclic AMP to result in activation of parietal cells by a shape change to secrete HCl.

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9
Q

What is an example of a somatostatin anologue and what does it do?

A

Ocrtreotide
- inhibit acid secretion and gastrin release

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10
Q

Ghrelin
Source, Stimulus, Action

A

Source: Stomach (intestine, pancreas, hypothalamus)
Activation: GOAT
Action:
- Pituitary GH secretion
- Stimulate appetite, growth, fat deposition
- Anti-inflammatory

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11
Q

MOA of entyce

A

Ghrelin analog
Transient increases in growth hormone and IGF-1

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12
Q

Leptin
Source, Stimulus, Action

A

Source: Adipocytes
Stimulus: Increased fat tissue
Action:
- decrease production of appetite stimulators in hypothalamus (neuropeptide Y, Agouti related protein)
- Activation of POMC neurons ( alpha melanocyte stimulating hormone, activation of melanocortin receptors
- increase sympathetic activity - increase activity and metabolic rate
- decrease insulin secretion
- Pro-inflammatory

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13
Q

Secretin
Source, Stimulus, Action

A

Source: S cells in duodenum
Stimulus: low duodenal pH (acid), lipids
Action:
- Inhibit acid secretion from parietal cells
- Slow gastric emptying
- Secretion of bicarb rich pancreatic fluid

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14
Q

Cholecystokinin (CCK)
Source, Stimulus, Action:

A

Source: I cells of duodenum and jejunum
Stimulus: Amino acids (also FA’s, acid)
Actions:
1. Pancreas
- potentiates secretin
- pancreatic enzyme secretion
2. Gallbladder
- gallbladder contraction
- Relaxation of sphincter of Oddi
3. Inhibition of gastric liquid emptying

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15
Q

What are the exocrine cells of the pancreas? Endocrine?

A

Acinar (digestive enzymes) and ductal cells (bicarb rich fluid)
Alpha (glucagon) and beta cells (insulin)

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16
Q

What stimulates the acinar cells to secrete zymogens?

A

CCK, Ach

17
Q

What stimulates the ductal cells?

A

Secretin

18
Q

What is an incretin? Give 2 examples.

A

Hormones from intestine secreted in response to nutrients that potentiate insulin secretion
- GIP
- GLP1

19
Q

How much conjugated bile acid is reabsorbed in terminal ilium?

A

95%

20
Q

Gastric Inhibitory Peptide
Source, Stimulus, Action

A

Source: K cells of intestine
Stimulus: intraduodenal FA and AA&raquo_space; carbohydrates
Action:
- Inhibit gastric acid secretion
- Stimulate insuline secretion during hyperglycemia

21
Q

What is the incretin effect?

A

Oral glucose will cause a much larger spike in insulin than IV glucose

22
Q

Glucagon like peptide 1 (GLP1)
Source, Action, Stimulus

A

Source: L cells of ileum and colon (widespread in cats)
Stimulus: intraluminal glucose and lipids
Action:
- inhibit gastric acid secretion
- stimulate insulin secretion
- inhibit gastric emptying (ileal break)

23
Q

Peptide YY
Other name, Source, Action, Stimulus

A

AKA GLP-2
Source: Distal ileum and Colon
Stimulus: FAs, less so carbs
Actions:
- Ileal break (slows gastric emptying)
- inhibit CCK and secretin secretion
- proliferation of gut mucosa

24
Q

What is the gastrocolic reflex?

A

Distension of the stomach results in activation of colon leading to defecation

25
Q

List the hormones/secretagogs with their cell of origin of or acting on the GI tract in order from oral to aboral (with location)

A

Stomach
1. Gastrin - G cell of the pyloric gland (antrum)
2. HCl - Parietal cell of the oxyntic gland
3. Histamine - Enterochromaffin like cell of the oxyntic gland
4. Pepsinogen - Chief cell of the oxyntic gland
5. Somatostatin - D cell of the stomach (oxyntic and pyloric)
6. Ghrelin
7. Leptin - adipocytes

Duodenum, Pancreas, Biliary
1. Secretin - S cells of duodenum
2. Cholesystokinin - L cells of the duodenum
3. Zymogens - Acinar cells of pancreas
4. H20/HCO3 - ductal cells of pancreas
Incretins:
5. GIP - K cells of duodenum
6. GLP 1- L cells of duodenum

Distal ileum and Colon
1. Peptype YY

Everywhere
1. Motilin - M cells
2. Serotonin - enterochromaffin cells, enteric neurons

26
Q

Motilin
Source, Action, Stimulus

A

Source: M cells throughout GIT
Stimulus: Most importantly fasting state but also acid and lipid in fed state.
Action: Initiates phase 3 of migrating motility complex.

27
Q

Seratonin
AKA, Source, Action, Stimulus

A

AKA 5-hydroxytryptamine
Source: enterochromaffin cells and enteric neurons throughout GIT
Action:
- Stimulate GI smooth muscle contraction
- Secrete intestinal electrolytes

28
Q

5-HT4 receptor agonsists (2)

A

Cisipride and metoclopramide (meto also D2 antagonist)

29
Q
A

ACVIM General Boards 2024 (5 decks)

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