Week 2 Flashcards
What does the body of the stomach secrete?
Mucus
HCL
Pepsinogen
Intrinsic factor
Antrum of the stomach purpose
Mixing and grinding and releasing gastrin
Gastric glands:
Chief cells at the bottom, then parietal cells, then mucous neck cells…what do they each secrete?
Mucous neck cells = mucus
Chief cells = pepsinogens which are inactive enzymes, activated once in lumen (ie zymogen)
Parietal cells = HCL and intrinsic factor
What connects parietal cells together?
Tight junctions
Where is carbon dioxide formed in our blood?
Mitochondria
Where atp is made
Oxidative phosphorylation
How does carbon dioxide get across the basolateral membrane?
It’s a very small molecule that can just simply diffuse across
No transporter needed
T or F
Vagal stimulation results in stimulation of a profuse watery salivary secretion
F
Facial and glossopharyngeal
T or F
Pancreatic cellulase hydrolyses the B- 1,4 glycosidic bond in cellulose
F
We don’t express cellulase!
What stimulates bicarbonate secretion from brunners glands
Secretin
CCK causes the sphincter of Oddi to relax. What causes gallbladder contraction, leading to bile expulsion?
Also CCk
In the stomach, pepsinogens are secreted by the parietal cells in response to lowering pH
T or F
F
Pepsinogen is secreted by chief cells
Parietal cells are responsible for producing HCl, which lowers pH and activated the Pepsinogen into pepsin
Where are bile salts reabsorbed?
In the distal ileum
This means that only 0.5g of the total 5g bile salt pool needs to be synthesised each day.
Bile salts are reabsorbed in the distal ileum. What about intrinsic factor and vitamin B12?
Absorbed in the terminal ileum.
Try and think of these things being completely utilised in the small intestine.
Segmentation contractions are initiated by arrival of food in the stomach
T or f
True
Lipase is water soluble or lipid soluble?
Water soluble
This is a requirement of emulsification
If it was lipid soluble how could it emulsify lipids?
What environment does pepsin require?
An acidic one
What is trypsinogen secreted by?
Acinar cells in the pancreas
When proteins are broken down into amino acids, they are absorbed by being coupled to what co-transport?
Amino acid- sodium co-transport. Mainly in the jejunum thi
score in terms of risk of bleeding on anti coagulants with atrial fibrillation?
Orbit score
Not hasbled
Score to decide on warfarin ?
Chadsvasc
Score greater than 2 = offer anticoagulation
Anticoagulant example not warfarin
DOACs
Direct oral anti coags
Such as edoxaban
Not indicated where there is a mod-severe mitral stenosis or where there is a mechanical heart valve replacement
What’s the issue with mitral stenosis?
Basically the heart needs to work harder because you’re narrowing
What blood tests do you need to take regularly for warfarin?
Internalised normalised blood trst
What’s the pro of warfarin compared to doacs?
The reduction in thrombo-embolic events with a disc compared to warfarin is small
Pro for doac Vs warfarin?
Improved safety profile (reduced risk of major bleeding) and conscience with less blood test monitoring required
What blood test before starting a doac?
Renal function as the dose of a doac is based on creatinine clearance
Why consider giving a PPI with doacs for risk of bleeding?
Because they are protective…
Risk of GI bleeding so with PPI encourage healing of ulcers etc
NSAIDs and bleeding?
Increases bleeding risk
