S6) Completing digestion/absorption Flashcards

1
Q

What is absorption?

A

Absorption is the movement of electrolytes, water and nutrients from the gut lumen into the blood

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2
Q

Identify 3 carbohydrate monosaccharides

A
  • Fructose
  • Galactose
  • Glucose
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3
Q

The goal of carbohydrate digestion is to get monosaccharides.

Why is this?

A
  • End products of carbohydrate metabolism
  • They can move out of the lumen
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4
Q

Where does carbohydrate digestion conclude?

A

Final enzyme digestion takes place in the brush border by ‘brush border hydrolases’

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5
Q

Identify 3 common dietary carbohydrates

A
  • Starch (polysaccharide)
  • Lactose (disaccharide)
  • Sucrose (disaccharide)
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6
Q

Describe the structure of amylose

A

Amylose is a polysaccharide made of α-D-glucose units, bonded to each other through α(1→4) glycosidic bonds

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7
Q

Describe the structure of amylopectin

A

Amylopectin is a water soluble polysaccharide and highly branched polymer of glucose found in plants containing both α(1→4) and α(1→6) glycosidic bonds

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8
Q

Describe the structure of maltose

A

Maltose is a disaccharide formed from two units of glucose joined with an α(1→4) bond

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9
Q

Describe the structure of isomaltose

A

Isomaltose is an isomer of maltose, formed from two units of glucose joined with an α(1→6) bond

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10
Q

Describe the structure of alpha dextrins

A

Alpha limit dextrin is a short chained branched amylopectin remnant, produced by hydrolysis of amylopectin with alpha amylase

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11
Q

Describe the completion of starch digestion by brush border enzymes

A
  • Maltose (maltase) = glucose + glucose
  • Alpha dextrins (isomaltase) = glucose
  • Lactose (lactase) = glucose + galactose
  • Sucrose (sucrase) = glucose + fructose
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12
Q

Describe how glucose is absorbed into the intestinal epithelium

A
  • Na+/K+ ATPase on basolateral membrane maintains low intracellular Na+
  • SGLT-1 binds Na+ which allows glucose binding
  • Na+ & glucose moves into cell
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13
Q

Describe how fructose is absorbed into the intestinal lumen

A

Fructose is transported by facilitated diffusion using the GLUT5 transporter to enter enterocyte

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14
Q

How is glucose transported into the blood?

A

GLUT2 transports glucose out of enterocyte which then diffuses down gradient into capillary blood

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15
Q

Explain the principle of oral rehydration in terms of sodium and glucose absorption

A
  • Uptake of Na+ generates osmotic gradient (water follows)
  • Glucose uptake stimulates Na+ uptake
  • Hence, mixture of glucose and salt will stimulate maximum water uptake
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16
Q

What kind of proteins are digested?

A
  • Amino acids
  • Dipeptides
  • Tripeptides
17
Q

Describe protein digestion in the stomach

A
  • Pepsinogen released from chief cell is converted to pepsin by HCl
  • Pepsin acts on protein to form oligopeptides/amino acids which move into the small intestine
18
Q

Describe the role of the pancreas in protein digestion

A
  • Pancreas releases proteases as zymogens
  • Trypsinogen is converted to trypsin by enteropeptidase
  • Trypsin then activates other proteases
19
Q

What do exopeptidases do?

A

Exopeptidases break bonds at the end of the polypeptide to produce dipeptides or amino acids e.g. carboxypeptidases (A&B)

20
Q

What do endopeptidases do?

A

Endopeptidases break bonds in the middle of the polypeptide to produce smaller polypeptide chains e.g. trypsin, chymotrypsin, elastase

21
Q

How are amino acids absorbed?

A

Amino acids are transported into cell using a Na+-amino acid co-transporter

22
Q

Most protein products are ingested as dipeptides/tripeptides.

Describe how this occurs

A
  • Dipeptides/tripeptides are transported by H+ co-transporter – peptide transporter 1
  • Inside cell these are converted to amino acids by cytosolic peptidases
23
Q

Describe the transport of sodium in the small and large intestines

A
  • Both intestines have Na+-K+ ATPase on basolateral membrane
  • On the apical membrane:

I. Small intestine – Na+ is co-transported

II. Large intestine – Na+ channels

24
Q

Describe calcium absorption in the intestines when calcium intake is low

A
  • Active transcellular absorption
  • Ca2+ enters cell via facilitated diffusion
  • This process requires Vitamin D (Calbindin), stimulated by PTH
25
Describe calcium absorption in the intestines when calcium intake is normal/high
Passive paracellular absorption
26
Describe iron absorption in the intestines
- Iron is absorbed across apical membrane (co-transport with H+) - Gastric acid is important in the process
27
Compare and contrast iron uptake when iron levels are high/low
- **When Iron levels are low** – iron binds to transferrin (transported to stores) - **When Iron levels are high** – iron contained in ferritin complexes (trapped in cell) and lost when enterocyte is replaced
28
Describe iron storage
- Approx. half of iron is in **haemoglobin** - Other half stored in ferritin complexes in **bone marrow, liver** and **spleen**
29
How are water soluble vitamins absorbed?
Water soluble vitamins mainly absorbed by **Na+ cotransport**
30
Describe how Vitamin B12 is absorbed
- **Vitamin B12** absorbed in terminal ileum bound to **intrinsic factor** - Intrinsic factor is secreted by **gastric parietal cells,** hence, B12 deficiency caused by gastritis/terminal ileal removal
31
Identify 4 signs/symptoms of coeliac disease
- Diarrhoea - Flatulence - Weight loss - Sensory loss in her hands
32
What is Coeliac disease?
**Coeliac disease** is the intolerance of the gliadin fraction of gluten which is found in wheat, rye and barley and results in immune response
33
The resulting immune response in coeliac disease damages the intestinal mucosa. How does this manifest?
- Absence of intestinal villi - Lengthening of intestinal crypts - Lymphocytes infiltrate epithelium ⇒ Impaired digestion/malabsorption
34
Identify 2 investigations for Coeliac disease
- Upper GI endoscopy - Duodenal biopsies
35
Identify 3 blood tests which can be used to diagnose Coeliac Disease
- Serology - Electrolyte imbalances - Anaemia
36
What is the treatment for Coeliac disease?
Diet