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Nutrition And energy > Week 2 > Flashcards

Week 2 Flashcards

0
Q

What is CCK secreted by?

A

I cells

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1
Q

What does the Sphincter of Oddi relax in response to?

A

CCK-PZ

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2
Q

What stimulates CCK secretion?

A

Fatty acids and some aa

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3
Q

Where is secretin secreted from?

A

S cells.

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4
Q

What stimulates secretin release?

A

Acid in SI

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5
Q

What does CCK cause?

A

Pancreatic secretion and gall bladder emptying.

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6
Q

What does secretin cause?

A

Cause bicarbonate secretion from ducal cells in liver and pancreas?

Inhibits gastric acid.

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7
Q

How is bile charged?

A

Bile is negatively charged and it’s components are secreted by hepatocytes.

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8
Q

What do the bile ducts add to the bile?

A

Bile ducts add bicarbonate, water and salt. These are stimulated by secretin and the process involved CFTR. (cystic fibrosis link)

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9
Q

What does the gallbladder reabsorb and secrete?

A

The gall bladder reabsorbs salt and water.

It secrete protons which acidify bile, preventing Ca2+ precipitate forming (preventing gallstones)

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10
Q

What do the pancreatic ducts secrete?

A

The pancreatic ducts secrete bicarbonate, effect increased by CCK (via vagus).

CFTR is needed, so in cystic fibrosis secretions become thick and cause pancreatic fibre.

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11
Q

What does the pancreas secrete?

A

Procarboxypeptidases, protease inhibitors and pancreatic alpha amylase.

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12
Q

What do the crypts in small intestine secrete?

A

The crypts in the small intestine secrete bicarbonate.

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13
Q

What is the name of the circular folds of the small intestine?

A

The circular folds are called pilca circulares to increase the surface area.

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14
Q

How is a migrating motor complex (MMC) stimulated and how often?

A

MMC’s are stimulated by motilin and when emoty a MMC is generated every 90 minutes.

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15
Q

What is a MMC?

A

It is caused by muscular contractions which move substances along. The behind bolus contracts and front relaxes.

The longitudinal smooth muscle contracts reducing length between segments.

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16
Q

Where is mucus secreted from?

A

Goblet cells.

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17
Q

What absorbs glucose and galactose?

A

SGLT1 absorbs glucose and galactose (sodium glucose transporter)

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18
Q

How is fructose absorbed?

A

Fructose is passively absorbed by Glut5 transmitter.

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19
Q

How is trypsin activated?

A

Enterokinases from crypt cells activate trypsin.

20
Q

What are di/tri peptides taken up by?

A

Di and tri peptides are taken up by Na+ linked active transporters and small amounts are taken up by endocytosis.

21
Q

How is fat digested?

A

Bile salts break up lipid micelles before pancreatic lipase cleaves off fatty acids leaving monoglycerides which combine with bile salts and are emulsified.

This diffuses across brush border and repackaged as chylomicra.

22
Q

How are bile salts recycled?

A

Salts are actually absorbed into distal ileum and a deconjugated becoming lipophillic.

23
Q

How is iron absorbed?

A

Iron is absorbed into cell via a proton gradient. Iron is carried by ferriportin out of the cell.

Iron is reoxidised to Fe3+ by hephaestin before binding to transferrin when carried in blood

24
Q

Where is calcium absorption and how?

A

Calcium absorption occurs early in duodenum. It is controlled by Vitamin D and parathyroid.

If low PTH released and kidney reabsorbs more calcium. If acidotic calcium fails to bind to albumin. Hypercalcaemia.

25
Q

Which vitamins are fat soluble?

A

Vitamins A,D,E and K are fat soluble.

26
Q

What do water soluble vitamins require to be absorbed?

A

Water soluble vitamins require Na+ linked transporter to be absorbed.

27
Q

How does vitamin B12 get absorbed?

A

Vitamin B12 can only be absorbed when bound to intrinsic factor (from gastric parietal cells)

28
Q

The large intestine is designed to move substances much, but what are the two ways it can?

A

Haustration: slow movement of circular muscles squeeze contents.

Mass Movement: formulated into large peristaltic waves, cleans through large bowel.

29
Q

How is large intestine motility coordinated?

A

Motility is mostly intrinsic via enteric nervous system triggered by gastrocolic reflex (increased motility in response to stretch receptors in stomach).

But the orthocolic reflex also has an effect. (Stimulated by standing upright and then reclining over night)

30
Q

Digestion in the large intestine is carried out by bacteria, not human enzymes. What do they digest?

A

Fibre to short chain fatty acids (secondary active transport by Na+ transporter).
Urea to amino acids
Bilirubin to urobilinogen and stercobilins.
Bile acids to secondary bile acids
Conjugated bile acids to unconjugated.

31
Q

How is salt absorbed in the large intestine?

A

EnaC channels allow Na+ transport! causing Cl- flux followed by water.

This is stimulated by aldosterone.

32
Q

How is chloride secreted in large intestine?

A

Chloride secretion stimulated by cyclic AMP and Ca2+.

Cholera and E. Coli increase cAMP.

C diff increases Ca2+

33
Q

What does the pectinate line of rectum mark?

A

Signifies end of upper 2/3(hind gut) to lower 2/3(proctodeum).

Also marks where epithelium becomes stratified squamous from columnar.

34
Q

What are lamina proprial lymphocytes?

A

They are mostly T helper cell related (CD4)

TH1 - cell mediated response
TH2 - antibody mediated response
TH17 - cell mediated (related to irritable bowel syndrome).

35
Q

What are the two types of bases to disease of mucosal immune system?

A

Two types are failure to establish oral tolerance and failure to maintain oral tolerance.

36
Q

What is oral tolerance?

A

Oral tolerance is the immunological unresponsiveness from orally administered antigen. This prevents a response to normal flora occurs through T reg cells.

Fine balance between TH 1,2 and 17 (eradication) and T reg (toleration of pathogens).

37
Q

Are food allergies a failure to establish or maintain oral tolerance?

A

Food allergies are a failure to establish oral tolerance.

38
Q

How are food allergies caused?

A

Food allergies are caused by IgE hypersensitivity and mast cells.

An example of T cell mediated immunity is coeliacs and protein enterocolitis.

39
Q

What happens in coeliac disease?

A

T cell mediated hypersensitivity to wheat gluten. HLA DQ2 allele in 95% of patients. Causes villi wasting away. T cells attack villi.

40
Q

What is food protein induced endocolitis syndrome (FPRIES)?

A

Food protein induced endocolitis syndrome mimics food allergy but resolves with time.

It is a cell mediated T cell reaction it soy, cow milk, egg, fish, rice or chicken.

41
Q

What is inflammatory bowel disease?

A

Breakdown of oral tolerance. CD4 t helper cell mediated.

Crohns most commonly affects ileum and colon. NOD2 mutation, involved in intercellular processing of bacterial antigens

42
Q

How would you treat Crohns?

A

To treat Crohns you would use T helper cell inhibitors, T reg cell proliferators add attenuated helminths.

43
Q

Why is it hard to develop mucosal vaccines?

A

It is hard to develop mucosal vaccines as it is hard to induce immune activation and not oral tolerance.

44
Q

Give an example of an inert delivery system?

A

An example of an inert delivery system would be vibrio cholerae enterotoxin.

45
Q

What are inert delivery systems?

A

Enteric coated capsules, biodegradable microspheres.

46
Q

Give an example of a live recombinant system.

A

Antivirulent salmonella or E. coli enterotoxin.

47
Q

Give an example of a plant derived antigen.

A

Bordetella pertussis (part of whooping cough vaccine)

Nutrition And energy (6 decks)

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