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GI/Nutrition > Test 1 (Week 1) > Flashcards

Test 1 (Week 1) Flashcards

1
Q

What stimulates release of GIP?

A

fatty acids, amino acids, oral glucose

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2
Q

What stimulates release of GLP-1?

A

glucose, amino acids, small peptides, fatty acids

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3
Q

What are the 4 basic layers of GI tract ‘tube’.

A

-Mucosa -Submucosa -Muscular -Adventitia

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4
Q

What stimulates release of Gastrin?

A

stomach distention and protein digestion products (small peptides, amino acids)

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5
Q

H pylori infection is associated with a ____ risk of GERD.

A

decreased

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6
Q

What cell type lines the beginning of the stomach to the pectinate line in the rectum?

A

simple columnar epithelium

after pectinate line, it changes to stratified squamous epithelium

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7
Q

What’s the function of the myenteric plexus?

A

controls gut motility (can have both stimulatory and inhibitory influences)

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8
Q

What do mucous salivary secretions contain?

A

contains mucins (glycoproteins that are important for lubrication and protection of mucosal surfaces)

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9
Q

What supplies parasympathetic innervation of the GI tract?

A

vagus and pelvic splanchnic

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10
Q

What are the 2 components of the enteric nervous system?

A

-Meissner’s (submucosal) plexus -Auerbach’s (myenteric) plexus

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11
Q

Describe the Gastroileal reflex.

A

gastric distention relaxes ileocecal sphincter and increases ileal motility

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12
Q

What’s the treatment for bacterial pharyngitis?

A

often strep pyogenes as culprit; self resolves but treat to prevent complications (rheumatic fever) with penicillin, cephalosporins, or amoxicillin

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13
Q

What is the #1 risk factor for leuko/erythro plakias and what can the develop in to?

A

tobacco use; squamous cell carcinoma

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14
Q

What’s the mainstay therapy for GERD?

A

proton pump inhibitors

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15
Q

What are the basic taste sensations?

A

sweet, sour, salty, bitter

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16
Q

What are the 3 main branches of the celiac trunk?

A

left gastric, splenic, common hepatic

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17
Q

Where is ghrelin released and what does it do?

A

produced by stomach; stimulates appetite, food intake, and fat deposition. Potent stimulator of growth hormone secretion

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18
Q

What structures are contained within the hepatoduodenal ligament?

A

portal triad: proper hepatic artery, portal vein, common bile duct

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19
Q

Indirect inguinal hernias exit ___ to the inferior epigastric vessels.

A

lateral

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20
Q

What is the largest salivary gland?

A

parotid

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21
Q

where do hepatic sinusoids drain to?

A

central vein

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22
Q

Through which inguinal ring will indirect hernias pass through?

A

deep inguinal ring

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23
Q

Which Parasympathetic ganglia stimulate the secretion from the parotid gland?

A

otic ganglion

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24
Q

NSAID overuse is a common cause of gastric ulcers. What’s the mechanism by which this happens?

A

NSAIDs inhibit the production of prostaglandins in the gastric mucosa. Prostaglandins normally function to protect the gastric mucosa [via mucus production, bicarb secretion, and local vasodilation]

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25
Q

From what cells do gastrointestinal stromal tumors (GIST) arise from?

A

interstitial cells of Cajal (pacemaker cells) GIST are most common mesenchymal tumors of the abdomen

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26
Q

What are the 3 common translocations seen in gastric lymphomas?

A

t(11;18) t(1;14) t(14;18)

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27
Q

At what vertebral level does the esophagus enter the abdomen?

A

T10

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28
Q

Most common salivary gland tumor

A

pleomorphic adenoma it’s benign

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29
Q

which exocrine glands are called compound glands?

A

glands with branched ducts

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30
Q

What’s the mechanism of action phenothiazines (all end with -azine) and benzamides (end in -amide)?

A

block D2 (dopamine) receptors; most also have anticholinergic effects

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31
Q

What is the muscle type found in the lower third of the esophagus?

A

smooth muscle

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32
Q

What are some common risk factors for peptic ulcer disease?

A

-H. pylori infection -NSAIDs -Age -Smoking

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33
Q

What’s the classic antihistaminergic used to treat motion sickness?

A

dimenhydrinate (dramamine)

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34
Q

What inhibits release of somatostatin?

A

vagal stimulation

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35
Q

What’s the treatment for candidiasis infection?

A

-oral nystatin (swish and spit/swallow) -fluconazole -IV amphotericin B (extreme cases)

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36
Q

What is the endocrine portion of the pancreas?

A

islets of langerhans

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37
Q

What are the inhibitory neurotransmitters of the enteric nervous system?

A

VIP (vasoactive intestinal polypeptide) and NO

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38
Q

What stimulates release of somatostatin?

A

acid

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39
Q

What causes Budd-Chiari syndrome?

A

occlusion of IVC or hepatic vein that leads to back up of blood to central vein with centrilobar congestion

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40
Q

What causes annular pancreas?

A

the ventral bud of the pancreas splits and reforms around the duodenum (constricting it)

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41
Q

how many slow waves will the colon produce per minute?

A

3-12

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42
Q

Describe the enterogastric reflex.

A

duodenal stretch and chemoreceptors signal the stomach to optimize digestion and absorption

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43
Q

At what part of the esophagus do Zenker’s diverticulum usually occur?

A

Killian triangle

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44
Q

What’s the metastatic potential of Type III carcinoid tumors?

A

>50%

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45
Q

GI smooth muscle functions as a ______.

A

syncytium; large areas of smooth muscle contract as a single unit

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46
Q

Approximately 95% of the bile salts secreted are reabsorbed in the _____.

A

terminal ileum

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47
Q

Which liver zone is closest to the portal triads?

A

zone 1

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48
Q

What’s the mechanism by which viral gastroenteritis causes nausea and vomiting?

A

Viral infection and inflammation of gastric mucosa stimulate afferent nerve fibers in the stomach which are transmitted primarily via the vagus nerve, to the NTS resulting in nausea and vomiting Serotonin released by NTS neurons triggers dopamine release in the emetic center (via D2 receptors)

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49
Q

What med is given to treat carcinoid syndrome?

A

octreotide (a somatostatin analog)

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50
Q

slow undulating changes in resting membrane potential

A

slow waves

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51
Q

What cell type lines oral cavity to end of esophagus?

A

stratified squamous epithelium

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52
Q

What’s the role of intrinsic factor secreted by parietal cells of the stomach?

A

helps in vitamin B12 absorption which is important for maturation of RBCs (deficiency of intrinsic factor= pernicious anemia)

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53
Q

What inhibits activation of the emesis center?

A

endocannabinoids

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54
Q

What is the lining epithelium of the esophagus?

A

stratified squamous

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55
Q

Describe the intrinsic defecation reflex.

A

It is mediated entirely by the ENS. Rectal distention initiates afferent signals that spread through the myenteric plexus to descending and sigmoid colon and rectum. This causes contractions that force feces towards the anus.

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56
Q

Acute onset vomiting (within first 24 hours after beginning chemotherapy) is mostly mediated by what neurotransmitter?

A

serotonin (acts to increase release of dopamine)

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57
Q

What causes eosinophilic esophagitis?

A

thought to represent an allergic process, triggered by antigens in foods

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58
Q

H. pylori is strongly associated with peptic ulcer disease. How does the organism survive in the deeper layers of gastric mucus?

A

produces urease which cleaves urea to ammonia–> alkalinize their immediate environment

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59
Q

What is gastroschisis?

A

failure of body wall closure followed by gut herniation

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60
Q

What’s the purpose of migrating motor complexes (MMC)?

A

Sweep HCl and undigested residues toward colon and maintains low bacterial counts in upper small intestine (minimizes bacterial overgrowth)

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61
Q

Which lingual papillae does not have taste buds?

A

filiform papillae

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62
Q

Where is somatostatin released from and what does it do?

A

D cells in pancreatic islets and GI mucosa; inhibits release of ALL gut hormones

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63
Q

Describe the gastrocolic reflex.

A

presence of food in the stomach initiates peristalsis and movement of feces into the rectum

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64
Q

What are the major salivary glands?

A

parotid, submandibular, and sublingual

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65
Q

Describe receptive relaxation.

A

relaxation of tonically contracted smooth muscle of orad stomach (fundus, upper part of body of stomach) carried out by NO and vasoactive intestinal polypeptide (VIP)

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66
Q

What are pyogenic granulomas composed of?

A

blood vessels and inflammation=granulation tissue

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67
Q

What causes Achalasia and what is it associated with?

A

failure of relaxation of lower esophageal sphincter (LES) due to loss of myenteric plexus; associated with increased risk of esophageal squamous cell carcinoma

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68
Q

What characterizes the defecation process in patients with spinal cord injuries?

A

Characterized by: prolonged colonic transit time and absence of high amplitude propagating contractions

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69
Q

When can you not use PT or PTT?

A

when the patient is on anticoagulants

or when patient has DIC or vitamin K deficiency

warfarin specifically extends PT

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70
Q

What are the excitatory neurotransmitters of the enteric nervous system?

A

ACh and substance P

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71
Q

What kind of ulcers are seen on endoscopy of patients with CMV esophagitis?

A

serpiginous ulcers

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72
Q

What meds are given to prevent chemo nausea/vomiting that work by substance P blockade?

A

Aprepitant

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73
Q

What enzyme breaks down triglycerides into 2-monoglyceride and free fatty acids?

A

pancreatic lipase

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74
Q

Which neurotransmitter activates the emesis center?

A

dopamine

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75
Q

blood supply of hindgut

A

IMA (comes off abdominal aorta at L3)

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76
Q

how many slow waves will the duodenum produce per minute?

A

12

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77
Q

blood supply of midgut

A

SMA (comes off abdominal aorta at L1)

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78
Q

What do acinar cells have that centroacinar cells don’t?

A

secretory vesicles

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79
Q

The spleen is derived from ____.

A

mesenchymal tissue

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80
Q

What stimulates release of CCK?

A

fatty acids or monoglycerides, small peptides and amino acids

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81
Q

Where is GIP (glucose dependent insulinotropic peptide) released from and what does it do?

A

released from K cells in duodenum and jejunum; stimulates insulin release and inhibits gastric acid secretion

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82
Q

Delayed onset vomiting (begins more than 24 hours after starting chemotherapy) is mostly mediated by what neurotransmitter?

A

substance P

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83
Q

What causes Hirschsprungs Disease?

A

failure of neural crest cell migration; a section of the colon will lack ganglionic cells and will therefore be unable to relax. Normal colon proximal to the aganglionic segment will be dilated since feces can’t pass this point

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84
Q

What meds are given to prevent chemo nausea/vomiting that work by serotonin blockade?

A

ondansetron and granisetron

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85
Q

In which part of the esophagus do squamous cell carcinomas most often arise? Adenocarcinomas?

A

squamous=middle third adenocarcinoma= lower third

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86
Q

What do serous salivary secretions contain?

A

watery secretion containing an alpha-amylase (ptyalin) that hydrolyzes starch

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87
Q

pain with swallowing

A

odynophagia

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88
Q

characterized by serpiginous ulcers especially in the distal esophagus

A

CMV esophagitis

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89
Q

What are the common causes of peptic ulcer disease?

A

-hypersecretion of HCl -helicobacter pylori infection -abuse of NSAIDs

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90
Q

What supplies sympathetic innervation of the GI tract?

A

thoracic and lumbar splanchnic

91
Q

What genetic abnormality is present in a lot of gastric cancer cases?

A

E-cadherin (CHD1) gene mutation [p53 mutation is often present too, but who cares]

92
Q

Where is the myenteric plexus located?

A

between longitudinal and circular smooth muscle layers

93
Q

Where is alcohol absorbed?

A

stomach

94
Q

What’s the purpose of propulsive movements?

A

move feces to the rectum and stimulate the defecation reflex

95
Q

What stimulates motilin release?

A

increased in fasting state; under neural control

96
Q

What’s the function of the submucosal plexus?

A

local control of: secretion, absorption, and contraction of muscular mucosa

97
Q

What are the “Rules of 2” for Meckel’s diverticulum?

A

2 inches long 2% of population 2 feet from ileocecal valve presents in first 2 years of life May have 2 epithelia (gastric/pancreatic)

98
Q

In which quadrant does most of the jejunum lie?

A

left upper quadrant

99
Q

What’s different about the wall of the gall bladder when comparing it to the tube wall of the rest of the GI system?

A

it has no submucosa. so only 3 layers

100
Q

What are the functions of a striated duct?

A

reabsorption of Na+ and secretion of K+ and HCO3-

101
Q

Where is gastrin released from and what does it do?

A

released from G cells (anrum of stomach and duodenum); triggers release of gastric acid (HCl) from parietal cells of the stomach and also stimulates growth of gastric mucosa

102
Q

Leukoplakia is precancerous ___% of the time.

A

25%

103
Q

Where are the circumvallate papillae located?

A

In the anterior two third of dorsal surface of tongue in front of sulcus terminalis

104
Q

how many slow waves will the ileum produce per minute?

A

8

105
Q

In Barrett’s esophagus, what type of epithelium replaces the normal epithelium of the esophagus?

A

simple columnar

106
Q

The severity of pregnancy induced nausea seems to correlate with _____ levels.

A

serum HCG levels

107
Q

which salivary gland tumor is strongly associated with smoking?

A

Warthin tumors

108
Q

What is the exocrine portion of the pancreas?

A

composed of pancreatic acini

109
Q

how many slow waves will the jejunum produce per minute?

A

10

110
Q

What are the factors that inhibit saliva secretion?

A

sleep, fatigue, fear

111
Q

What is the ventral mesentery derived from?

A

septum transversum

112
Q

What causes pyloric stenosis and how does it present?

A

caused by hypertrophy of pyloric muscles of stomach presents with projectile, non-bilious vomiting in newborns after eating and can have palpable olive size mass at right costal margin in epigastric region

113
Q

Gastrin and ACh stimulate histamine release from _____ cells.

A

enterochromaffin like cells

114
Q

Through which inguinal ring will direct hernias pass through?

A

superficial inguinal ring

115
Q

Pleomorphic adenomas are benign but they can develop into ____.

A

malignant mixed tumors

116
Q

What is the single most important process in the small intestine that enables absorption?

A

establishment of a Sodium electrochemical gradient across the epithelial cell boundary of the lumen (apical membrane)

117
Q

Presents with severe regurgitation and nonbilious projectile vomiting at 2-3 weeks old

A

hypertrophic pyloric stenosis

118
Q

What injuries/diseases effect zone 3 of the liver?

A

toxins (alcohol, tylenol) and ischemic injury (b/c it’s furthest from hepatic arteries)

119
Q

Which Parasympathetic ganglia stimulate the secretion from the submandibular gland?

A

submandibular ganglion

120
Q

What’s the most important factor for increasing small intestine surface area?

A

microvilli

121
Q

Where is cobalamin (B12) absorbed?

A

terminal ileum

122
Q

What are some distinguishing features between jejunum and ileum?

A

Ileum has more arterial cascades, shorter vasa recta, fewer plica (foldings), and more mesenteric fat

123
Q

Describe the enterogastric reflex.

A

acidic pH in stomach or duodenum decreases gastric production of HCl, gastric motility, and gastric emptying

124
Q

What is the primary function of the small intestine?

A

digestion and nutrient absorption

125
Q

What do chief cells secrete?

A

pepsinogen

126
Q

In what patient population are pyogenic granulomas more common?

A

young people and pregnant women

127
Q

What are the retroperitoneal structures?

A

SADPUCKER Suprarenal gland Aorta and IVC Duodenum (2nd-4th part) Pancreas (except tail) Ureters Colon (descending & ascending) Kidney Esophagus (thoracic portion) Rectum (partial)

128
Q

What structures comprise the borders of Hasselbach triangle?

A

-inferior epigastric -rectus abdominus - inguinal ligament

129
Q

What do Paneth cells secrete?

A

-TNF-alpha -lysozyme -defensin

130
Q

What injuries/diseases effect zone 2 of the liver?

A

yellow fever necrosis

131
Q

How do babies with annular pancreas present?

A

–Newborns are intolerant of feeding and have vomiting. –Can be bilious containing vomit if the obstruction is distal to the bile duct.

132
Q

What inhibits release of gastrin?

A

acidification of antrum (pH <1.5)

133
Q

Describe the vagovagal reflex.

A

when food enters the stomach, stretch signals are sent via afferent fibers to the CNS. CNS then sends back an efferent signal to the stomach telling it to relax and accommodate the food. This is a big deal if vagal innervation is blocked. Your stomach intra gastric pressure would rise b/c you would never relax your stomach to accommodate the food you just ate

134
Q

Describe pain reflexes.

A

lead to an overall inhibition of GI tract functioning

135
Q

How do glucose and galactose enter an intestinal enterocyte?

A

secondary active transport via SGLT1; does not require energy, just a concentration gradient

136
Q

Describe the ‘Incretin effect’

A

Amplification of insulin secretion elicited by hormones secreted from the GI tract

137
Q

What are some common GERD risk factors?

A

Smoking Alcohol Caffeine Fatty foods Chocolate

138
Q

What are the 3 major functions of gastric acid?

A

1) bacteriostatic 2) converts pepsinogen to pepsin 3) initiates protein digestion (in concert w/ pepsin)

139
Q

How does fructose enter an intestinal enterocyte?

A

facilitated diffusion via GLUT5; does not require energy, just a concentration gradient

140
Q

Liver growth into the septum transversum separates the ventral mesentery into two parts:

A

lesser omentum and falciform ligament

141
Q

Which salivary gland has purely serious secretion?

A

parotid

142
Q

How does scopolamine work?

A

Potent anticholinergic medication, administered transdermally, generally used at times when patient knows they will be in situations likely to trigger nausea (such as when flying). use prophylactically

143
Q

What’s different about nausea and vomiting caused by motion sickness?

A

-Neurons transmit signals from the vestibular system to the NTS; these inputs depend much more on histaminergic (H1-receptors) and muscarinic (M1-receptors) transmission of signals than neurons from other areas. -Treatments are different

144
Q

What’s the mechanism by which gastric outlet obstruction causes nausea and vomiting?

A

Distension of the gastric antrum activates mechanoreceptors which trigger afferent nerve fibers that travel via the vagus nerve (mostly) and transmit the signal to the NTS

Serotonin released by NTS neurons triggers dopamine release in the emetic center (via D2 receptors)

145
Q

“dry mouth”

A

xerostomia

146
Q

What’s the treatment for HSV infections?

A

self limited; acyclovir or valacyclovir reduces pain and morbidity

147
Q

What are mucoepidermoid carcinomas composed of?

A

mucuous cells and epidermal cells mucoepidermoid. duh.

148
Q

Peptic ulcer disease includes both gastric and duodenal ulcers. Which are much more likely to be associated with underlying malignancy?

A

gastric ulcers

149
Q

Describe the defecation reflex at the spinal cord.

A

Rectal distention also initiates this reflex. Afferent signals go to sacral cord and then back to the descending and sigmoid colon, and rectum by way of parasympathetic fibers in pelvic nerves. It greatly intensifies the intrinsic reflex

150
Q

What injuries/diseases affect zone 1 of the liver?

A

viral hepatitis injuries

151
Q

Which portion of the small intestine is the major site of nutrient absorption?

A

jejunum

152
Q

What’s the hallmark of pancreatic acini?

A

centroacinar cells

153
Q

What structures comprise the border of the femoral triangle?

A

-sartorius -inguinal ligament -adductor longus

154
Q

What are the clinical features of Budd-Chiari syndrome?

A

-painful hepatomegaly -ascites -liver failure -varices

155
Q

In Barrett’s esophagus, the risk of dysplasia is proportional to the ____.

A

length of Barrett’s >3cm= ++++ risk

156
Q

About 95% of secreted bile salts are reabsorbed and recycled via 4 mechanisms. Which one plays the biggest role?

A

carrier mediated active absorption in the terminal ileum

157
Q

where is cholecystokinin (CCK) released from and what does it do?

A

released from I cells (duodenum and jejunum); potent stimulator of pancreatic enzyme secretion, inhibits gastric emptying, and empties gall bladder by causing gall bladder to contract and sphincter of Oddi to relax

158
Q

Which salivary tumor is unique in that it can present bilaterally?

A

Warthin tumor

159
Q

impaired motility of the stomach

A

gastroparesis thought to be due to damage/destruction of neurons of the myenteric plexus

160
Q

Where is secretin released from and what does it do?

A

released from S cells in the mucosa of duodenum and jejunum; “nature’s anti-acid”–> inhibits gastric acid secretion and stimulates pancreatic bicarb secretion

161
Q

In which developmental abnormality, omphalocele or gastroschisis, is the gut tissue covered by amnion?

A

omphalocele; amnion covers the umbilical cord into which the gut herniates

162
Q

Direct inguinal hernias exit ____ to the inferior epigastric vessels.

A

medial

163
Q

What do delta cells (5%) of islets of langerhans cells secrete?

A

somatostatin

164
Q

What is omphalocele?

A

failure of the gut to return to the peritoneal cavity after umbilical herniation

165
Q

What is seen radiographically with a patient who has annular pancreas?

A

“double bubble sign” –gaseous dilation of the stomach and proximal duodenum

166
Q

What kind of ulcers are seen on endoscopy of patients with HSV esophagitis?

A

punched out ulcers

167
Q

how many slow waves will the stomach produce per minute?

A

3

168
Q

In what region of the gall bladder will you find mucous glands?

A

neck of the gall bladder

169
Q

What do beta cells (70%) of islets of langerhans cells secrete?

A

insulin

170
Q

Which protein has a long half life and is therefore best used to measure chronic liver disease?

A

albumin (made by liver)

171
Q

Where is motilin released from and what does it do?

A

M cells in duodenum and jejunum; stimulates upper GI motility = produces migrating motor complexes (MMCs)

172
Q

For salivary gland tumors, malignant potential is inversely proportional to ____.

A

gland size

parotid=likely benign

sublingual=likely malignant

173
Q

What genetic (molecular) abnormalities are common in gastrointestinal stromal tumors (GIST)?

A

gain of function mutations in KIT (75-80%) and PDGRA (8%)

174
Q

describe the colonoileal reflex

A

filling of the colon inhibits the motility of the ileum

175
Q

which clotting factor has the shortest half life and is therefore best used to measure acute liver injury?

A

factor 7

176
Q

what determines the strength of GI smooth muscle contraction?

A

frequency of spike potentials

177
Q

Where are Peyer’s patches mainly found?

A

ileum

178
Q

What does histamine do in the GI tract?

A

stimulates gastric acid secretion by acting on parietal cells of the stomach

179
Q

What are the types of lingual papillae found in the adult tongue?

A

Filiform papillae, Fungiform papillae, Circumvallate papillae

180
Q

In which quadrant does most of the ileum lie?

A

right lower quadrant

181
Q

What are the two most important incretins?

A

GIP and GLP-1

182
Q

Describe the cribriform pattern of adenoid cystic carcinomas.

A

a sheet of tumor cells that have small punched out, round spaces. these spaces are filled with basement membrane substance

183
Q

Paneth cells are found in the small intestine. What role do they play?

A

Paneth cells provide defense to GI tract

184
Q

What do Parietal cells secrete?

A

HCl and intrinsic factor

185
Q

Which salivary gland contributes the most to saliva secretion?

A

submandibular

186
Q

What is Budd-Chiari syndrome associated with?

A

pregnancy, hyper coagulability, polycythemia vera, liver cancer

187
Q

What do alpha cells (20%) of islets of langerhans cells secrete?

A

glucagon

188
Q

inflammation of the salivary gland

A

sialadentis

189
Q

Where is glucagon like peptide 1 (GLP-1) released from and what does it do?

A

L cells of small intestine; increases insulin secretion during hyperglycemia, increases satiety, decreases food intake, and inhibits gastric emptying and secretion

190
Q

true action potentials, ultimately leads to a muscle contraction

A

spike potentials

191
Q

What’s the most common congenital anomaly of the GI tract? What causes it?

A

Meckel’s Diverticulum; caused by persistence of vitelline duct

192
Q

What’s the primary function of the large intestine?

A

absorb water and electrolytes

193
Q

What’s the treatment for gastrointestinal stromal tumors (GIST)? think about meds in particular

A

-complete surgical resection **- if metastatic, use imatinib (tyrosine kinase inhibitor). will really work if KIT or PDGFRA are mutated however, secondary mutations can lead to resistance so you may need to add another tyrosine kinase inhibitor

194
Q

Which type of bilirubin are we able to directly measure?

A

conjugated bilirubin

195
Q

What’s the purpose of haustral contractions?

A

mixing movements that facilitate fluid and electrolyte absorption (they accomplish minimal propulsion)

196
Q

What are the pacemaker cells of GI smooth muscle?

A

interstitial cells of cajal

197
Q

What are the side effects of dopamine receptor blocking agents used to treat nausea and vomiting?

A

-Can cause side effects related to dopamine blockade, including dystonia (acutely) and tardive dyskinesia (with chronic use). -Also cause drowsiness

198
Q

When do migrating motor complexes (MMC) occur?

A

occur between meals —- inter-digestive state

199
Q

Erythroplakia is precancerous ___% of the time.

A

50%

200
Q

There are many triggers for nausea and vomiting. Where will all the paths eventually converge?

A

All pathways converge in the nucleus tractus solitarius (NTS) which then connects to the emetic center in the medulla

201
Q

HCl secretion by parietal cells of the stomach is stimulated by:

A

-gastrin -histamine -Parasympathetic stimulation

202
Q

Oral squamous cell carcinomas are often secondary to smoking, tobacco, or alcohol. What is a newer association?

A

HPV infection (16&18)

203
Q

What kind of onset is typical of esophageal squamous cell carcinoma?

A

esophageal SCC has an insidious gradual nature

204
Q

which enzyme initiates a cascade that activates all pancreatic proteases in the lumen of the small intestine?

A

enterokinase

205
Q

what’s the usual presentation of Zollinger-Ellison syndrome?

A

-peptic ulcer disease (ulcers can be in unusual location like distal duodenum) -erosive esophagitis -diarrhea

206
Q

What do all gastric lymphoma translocations result in?

A

activation of NF-kappaB –> promotes B cell growth and survival

207
Q

Which clotting factors are measured by prothrombin time (PT)?

A

factors 7,10,5,2,1

7 is extrinsic pathway. all others are part of common pathway

208
Q

HCl secretion by parietal cells of the stomach is inhibited by:

A

-somatostatin -prostaglandins -gastric inhibitory peptide (GIP)

209
Q

Bilirubin is a product of heme metabolism from old blood cells. What does the liver do with bilirubin?

A

conjugates bilirubin so that it will be water soluble and capable of being excreted by the body in stool or urine

210
Q

What does the falciform ligament connect?

A

liver to anterior abdominal wall

211
Q

What is the importance of the tonic activity of the lower esophageal sphincter?

A

prevent reflux of gastric contents in to the esophagus

212
Q

most common malignant tumor of the salivary glands

A

mucoepidermoid carcinoma

213
Q

What med can be given to treat hepatic encephalopathy (sometimes as a result of TIPS procedure)?

A

Lactulose. it’s an osmotic laxative that converts ammonia into ammonium (can’t go back into blood). Gases terrible gas and diarrhea.

214
Q

What causes Zollinger-Ellison syndrome?

A

a tumor that secretes gastrin and thereby causes acid hypersecretion

215
Q

What stimulates release of secretin?

A

acid in duodenum and fatty acids in lumen of duodenum/jejunum

216
Q

blood supply of forgut

A

celiac trunk (comes off abdominal aorta at T12-L1)

217
Q

What are the cell types found in a taste bud?

A

3 types; Taste cell, supporting cell and basal cell

218
Q

What are the two main signals that stimulate secretion of pepsinogen?

A

1) vagal stimulation (ACh) 2) indirect response to gastrin [first aid says local acid]

219
Q

Adenoid cystic carcinomas are rare. Unlike other salivary gland tumors, they are often painful. Why?

A

the tumor spreads via the nerves (which is highly unique)

220
Q

fancy medical name for canker sores

A

aphthous ulcers or aphthous stomatitis

221
Q

Where will you find Brunner’s glands and what are their functions?

A

found in submucosa of duodenum; secrete alkaline mucus that neutralizes the acid chyme coming from the stomach, protecting the duodenum

222
Q

HSV infected tissues show what histologically?

A

eosinophilic Cowdry’s type A viral inclusion bodies

223
Q

Which liver zone is closest to the central vein?

A

zone 3

224
Q

Where is the chemoreceptor trigger zone (CTZ)?

A

area postrema in the floor of the 4th ventricle

GI/Nutrition (4 decks)

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