BNB Gastroenterlogy Flashcards
(29 cards)
What is the primary component of saliva?
Saliva is mostly water, comprising over 90% of its content.
What role do mucin and glycoproteins play in saliva?
Mucin and glycoproteins lubricate food and bind bacteria.
What type of antibody is found in saliva?
Saliva contains the IgA antibody.
What is the function of lysozymes in saliva?
Lysozymes disrupt bacterial cell walls.
What does lactoferrin do in saliva?
Lactoferrin prevents bacterial growth.
Saliva -Two important enzymes for digestion
•alpha amylase (digests carbohydrates)
• Lingual lipase (digests lipids)
Primary biliary cirrhosis- autoimmune condition, presents as —- even before jaundice
Presents as itching , women, worsens as night due to deposition of bile acids in skin. Chances of mis diagnosis- skin condition
Which antibodies are characteristic of PBC primary biliary cirrhosis-
AMA anti mitochondrial
ANA also present
Markedly Elevated ALP
PBC primary biliary cirrhosis is with or without extra hepatic obstructions
Without extra hepatic obstruction
Ie obstruction is in liver only - jaundice presents late and hence with jaundice poor prognosis
Tx for PBC
UDCA - Ursodeoxycholic acid it replaces endogenous bile acids
Or liver transplant
PBC associated with
Autoimmune so- sjogrens sx
Primary sclerosing cholangitis PSC - fibrosis and strictures on biliary tree. Strongly associated with-
UC ulcerative colitis 90% of patients
PSC lab findings-
elevated IgM in 50% Of patients
P ANCA + in 80% of patients- also found in ulcerative colitis
PSC histology- biopsy of bile duct
Periductal fibrosis - onion skin appearance
To confirm dx - cholangiogram - ERCP or MRCP - beading appearance
PSC requires annual screening for —
Cholangio carcinoma - rare CA of epithelial cells of bile ducts , diff from gall bladder CA
Etiology- 2* to PSC and clonarchis sinensis (parasite) chinese liver fluke infection - eating raw fish
PSC mostly arise as a complication of UC
Carcinoid tumour aka
Neuroendocrine tumours
Secrete serotonin aka 5HT, 5 hydroxytryptamine , bioactive amine
Other amines - histamine , catecholamines
Carcinoid tumour symptoms
Diarrhoea - due increased GI motility
Flushing
Increased fibroblasts growth - lesions of rt heart valves - tricuspid and rt pulmonary valvular lesions (carcinoid heart disease)
Carcinoid sx
Symptoms secondary high serotonin levels- diarrhea and flushing
• Liver and lung metabolize (inactivate) serotonin
• No carcinoid syndrome unless metastatic to liver
• No left sided heart symptoms: inactivated in lungs
Carcinoid sx and tryptophan deficiency , vitamin B3 (niacin deficiency)
1% body’s tryptophan»_space; serotonin
In carcinoid sx 70% is converted leading to functional deficiencies of tryptophan»_space; vit B3 (Niacin) deficiency»_space; 2* pellagra
5 HIAA
5-Hydroxyindoleacetic acid
• Metabolite of serotonin
• Appears in urine in carcinoid syndrome
• 24-hour urine sample for diagnosis
Most of fats in diet we consume is
Triglycerides = glyceride + 3 fatty acids
Pancreatic lipase- breaks down triglycerides in monoglyceride and 2 fatty acids
Bile acids secreted by liver from cholesterol
Bile salts r Made from bile acids - cholic acid and chenodeoxycholic acid
Bile salts make fat - emulsify (like a soap) and make soluble in water - more area for pancreatic lipase to work
Bile acids conjugated by __ to male then bile salts
Taurine
Glycine
Rate limiting enzyme for bile acid secretion pathway in liver
7 alpha hydroxylase
