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S2 Case 1 - IBD > Upper GI Disorders: Mouth + Oesophagus > Flashcards

Upper GI Disorders: Mouth + Oesophagus Flashcards

1
Q

What is the GI tract made up of?

A

Mouth
Oesophagus
Stomach
Pancreas
Small intestine
Large intestine
Liver

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2
Q

What are the main GI disorders?

A

Gastro oesophageal reflux disease (GORD)
Peptic ulcer disease (PUD)

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3
Q

What is an oral ulceration?

A

Break in oral epithelium

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4
Q

What is oral ulceration caused by?

A

Physical or chemical injury
Drugs

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5
Q

What is stomatitis?

A

Inflammation of lining of any of soft-tissues of mouth

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6
Q

What is stomatitis caused by?

A

Poor oral hygiene
Poorly fitted dentures

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7
Q

What is leukoplakia?

A

Painless white patches on side of tongue/cheek

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8
Q

What is oesophagus made up of?

A

Upper oesophageal sphincter
Oesophageal body
Lower oesophageal sphincter
Diaphragm

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9
Q

What does the UOS prevent?

A

Air entering oesophagus + reflux

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10
Q

What does LOS prevent?

A

Reflux

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11
Q

What is GORD?

A

Exposure of unprotected oesophageal epithelium to acid

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12
Q

What is the stomach made up of?

A

Fundus
Body
Pylorus

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13
Q

What is present at body of stomach?

A

Parietal cells (HCl)
Mucous cells
Chief cells

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14
Q

What is present at pylorus of stomach?

A

Mucous cells
G cells
D cells
NO ACID SECRETING CELLS

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15
Q

What is aspirin used for?

A

Pain killer
Blood thinner

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16
Q

Describe how parietal cells secrete acid

A

Resting cell H+/K+-ATPase in cytoplasmic vesicles
Stimulated cell H+/K+-ATPase membrane fused
Increase SA + membrane pumps

17
Q

What are the positive regulators of parietal cell?
(Stimulate to release acid)

A

Acetylcholine
Histamine
Gastrin

18
Q

What is the negative regulator of parietal cell?

A

Somatostatin

19
Q

Describe acetylcholine positive regulator

A

Enteric neurons released from
Direct parietal cell stimulation

20
Q

Describe histamine positive regulator

A

ECL cells
Direct parietal cell stimulation
Paracrine activity

21
Q

Describe gastrin positive regulator

A

G cells
Endocrine action
Stimulate histamine release
Directly stimulates parietal cell proliferation

22
Q

Describe somatostatin negative regulator

A

D cells
Directly inhibits parietal cell secretion
Inhibits gastrin + histamine release

23
Q

What is the Ach receptor in acid secretion pathway?

A

Muscarinic M3 receptor

24
Q

What is the histamine receptor in acid secretion pathway?

A

H2

25
Q

What is gastrin receptor in acid secretion pathway?

A

CKKB/CCK2 receptor

26
Q

What does Ach + gastrin act through in acid secretion pathway?

A

G-coupled receptors
Increase Ca2+ + diacylglycerol
Through PLC-inositol 1,4,5-triphosphate (IP3) pathway

27
Q

What does histamine act through in acid secretion pathway?

A

G-coupled receptors
Increase cAMP

28
Q

What gastrin + Ach dependent on?

A

Ca2+

29
Q

What is histamine dependent on?

A

cAMP

30
Q

What are the 3 stages of acid secretion stimulation?

A

Cephalic phase
Gastric phase
Intestinal phase

31
Q

Describe cephalic phase
1

A

Sight/smell/ thought food

32
Q

Describe gastric phase
2

A

Food in stomach
Mechanoreceptor neural reflex
Peptides in food stimulate G cells = gastrin
Food increase pH = prevent D cell activity

33
Q

Describe intestinal phase
3

A

Chyme enter duodenum
Feedback prevent chyme acidity
Duodenal stimulation of hormones
Decrease food, decrease pH = stimulates D cell activity

34
Q

What happens to gastric secretion following food?

A

Food in stomach buffers acid + raises pH
Suppresses D cells
Gastrin + HCl released
Stomach distention, digestion triggers secretion vol + HCl
Food leaves stomach = acid increases = pH falls
= D cells stimulated = somatostatin inhibits HCl production

35
Q

How is HCl secretion controlled?

A

Direct stimulation of ECL
Direct stimulation of G cells
Inhibition of somatostatin
Pyloric antrum exposure to peptides

36
Q

Describe the mechanism of HCl secretion

A

CO2 diffuses into parietal cell
Hydrated to carbonic acid by carbonic hydrase
H2CO3 dissociated to H+ + H2CO3-
H+/K+-ATPase actively transport H+ out, K+ in
Na+ actively reabsorbed
K+ recycles to gastric lumen via K+ channel
Cl- exits passively from cells via Cl- channel

37
Q

What are the protective functions of prostaglandin acid regulation?

A

Increase mucus secretion
Increase cell regeneration
Increase HCO3- release
Increase H+ secretion
Increase blood flow

38
Q

What is present to protect against acid?

A

Intrinsic mucosal protection

S2 Case 1 - IBD (18 decks)

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