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Disease Mechanisms > Ch 17: GI Tract > Flashcards

Ch 17: GI Tract Flashcards

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1
Q

what are the two types of organs of the digestive system

A

ailmentary canal organs
accessory organs

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2
Q

what do acessory organs do

A

assist in digestive but have no direct contact with food

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3
Q

what are 5 examples of accessory organs

A

teeth
tongue
salivary glands
pancreas
gallbladder

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4
Q

what two things are absorbed in the stomach

A

water
alcohol

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5
Q

what are the three main things absorbed in the duodenum

A

iron
calcium
fats

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6
Q

what are the two things absorbed in the jejunum

A

sugars
proteins

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7
Q

what are two things absorbed in the ileum

A

bile salts
vitamin B12

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8
Q

what are three things absorbed in the colon

A

water
electrolytes
vitamin K

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9
Q

the sympathetic nervous system provides innervation to the GI tract through which nerves

A

splanchnic nerves

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10
Q

the parasympathetic nervous sytem innervates the GI tract through which nerve

A

vagus nerve

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11
Q

what are the two plexi of the enteric nervous system

A

myenteric (auerbach) plexus
submucosal (meissner) plexus

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12
Q

where is the myenteric (auerbach) plexus located

A

muscularis externa (propria)

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13
Q

where is the meissner plexus

A

within the submucosa

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14
Q

what is malaborption syndrome

A

defective absorption of fats, vitamins, proteins, carbs, electrolytes, minerals, and water

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15
Q

what causes malabsorption syndrome

A

disturbance in one of four phases of nutrient absorption

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16
Q

what are the four phases of nutrient absorption

A

intraluminal digestion
terminal digestion
transepithelial transport
lymphatic transport

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17
Q

celiac disease, a type of malabsorption syndrome, is caused by defects in which two phases of nutrient absorption

A

terminal digestion
transepithelial transport

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18
Q

disaccharidase deficiency, a type of malabsorption syndrome, is caused by defects in which phase of nutrient absorption

A

terminal digestion

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19
Q

inflammatory bowel disease, a type of malabsorption syndrome, is caused by defects in which three phases of nutrient absorption

A

intraluminal digestion
terminal digestion
transepithelial transport

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20
Q

what is celiac disease (celiac sprue/gluten sensitive enteropathy)

A

immune mediated disorder triggered by ingestion of gluten like wheat, rye, or barley

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21
Q

what genetic component is involved in celiac disease

A

mutations in:
HLA-DQ2
HLA-DQ8

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22
Q

what are three characteristics of celiac disease

A

intraepithelial lymphocyte activation
loss of absorptive villi
crypt hyperplasia (crypts get deeper)

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23
Q

explain the celiac sprue mechanism

A

gliadin causes epithelial cells to make IL-15
IL-15 causes proliferation of cytotoxic T cells that express NKG2D receptors
stress causes enterocytes to express surface MIC-
A
cytotoxic T cells destroy enterocytes
damage allows passage of other gliadin peptides
gliadin has amino group removed by a transglutaminase
deaminated gliadin binds to HLA(DQ2 or DQ8) on APC to activate helper T-cells
helper T cells release IFNy and activate B cells
B cells make antibodies which cause tissue damage

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24
Q

what are some clinical manifestations of celiac disease

A

diarrhea
bloating
fatigue
anemia - malabsorption of iron/vitamin B12
dermatitis herpetiformis

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25
what is dermatitis herpetiformis
itchy, blistering skin lesions seen in 10% of those with celiac disease
26
what is hirschsprung disease
a birth defect characterized by the absence of the intramural neural plexus (ganglion cells) in the distal colon which causes a blockage
27
what is another name for hirschsprung disease
congenital aganglionic megacolon
28
hirschsprung disease is associated with what other disease
down syndrome
29
who, males or females, are most affected by hirschsprung disease
males if in females, aganglionic segment is longer
30
what is the mechanism of hirschsprung disease
mutation in tyrosin kinase causes failure of ganglion cells of the Meissner and auerbach plexuses to migrate to wall of rectum or they undergo premature death both lead to loss of peristaltic contractions
31
where will you see dilation in hirschprung disease
proximal to the affected segment cause everything backs up
32
what portion of colon is always affected in hirschsprung disease
rectum
33
what are the clinical mainfestations of hirschsprung disease
can't pass meconium after birth leads to abdominal distention and bilious vomit
34
what are the 4 complications of hirschsprung disease
enterocolitis fluid and electrolyte disturbances perforation peritonitis
35
what is an aquired megacolon
abnormal dilation and enlargment of the colon due to underlying conditions that affect the colon's ability to move stool efficiently
36
what is the main symptom of chagas disease
acquired megacolon - dilation of colon
37
which two bugs cause chagas disease which leads to aquired megacolon
kissing bug trypansoma cruzi parasite
38
what is inflammatory bowel disease (IBD)
group of diseases that are characterized by chronic inflammation of the GI tract
39
who are most at risk for IBD
young people in teens and 20's caucasians
40
what are the two main types of IBD
crohn disease ulcerative colitis
41
which part of the bowel is affected in both crohn and ulcerative colitis
crohn: ileum, ICV, and cecum ulcerative colitis: colon and rectum
42
what is the distribution like of crohn and ulcerative colitis
crohn: skip lesions ulcerative colitis: diffuse
43
do crohn and ulcerative colitis have strictures
crohn: yes ulcerative colitis: rare
44
what is the wall appearance of crohn and ulcerative colitis
crohn: thickened ulcerative colitis: normal
45
what is the inflammation pattern of crohn and ulcerative colitis
crohn: transmural (entire thickeness) ulcerative colitis: mucosa and submucosa
46
what are the ulcers like in crohn and ulcerative colitis
crohn: deep, knife like ulcerative colitis: superficial
47
do crohn and ulcerative colitis have granulomas
crohn: yes, noncaseating ulcerative colitis: no
48
do crohn and ulcerative colitis have malabsorption
crohn: yes ulcerative colitis: no
49
do crohn and ulcerative colitis have malignant potentials
crohn: if colon invovlement, yes ulcerative colitis: yes
50
do crohn and ulcerative colitis have toxic megacolon
crohn: no ulcerative colitis: yes
51
what is the mechanism of IBD
interactions between gut microbes and immune system in predisposed individuals leads to improper mucosal immune activation
52
what are the three genetic and environmental elements that contribute to IBD
altered mucosal immunity defects in autophagy and cellular stress response host microbial interactions
53
what is an example of altered mucosal immunity leading to IBD
helper T17 cells expand in diseased intestine
54
what are two gene examples of defects in autophagy and cellular response which leads to IBD
mutations in: ATG16L1 IRGM
55
what percentage of crohn disease cases affect the small intestine (ileum)
40%
56
what percentage of crohn disease cases affect the small intestine and colon
30%
57
what percentage of crohn disease cases only involve the colon
30%
58
which disease can be characterised by irregular cobblestone appearance of mucosa
crohn disease
59
what are three things that can trigger reactivation of crohn disease
physical emotional stress specific dietary items smoking
60
which disease is characterized by slightly red and granular colonic mucosa with a line of demarkation
ulcerative colitis
61
what is toxic megacolon
dilation of the colon due to inflammation of muscularis propria and neuromuscular dysfunction
62
what are three clinical manifestations of ulcerative colitis
blood diarrhea with string mucoid material lower abdominal pain cramps relieved by defecation

Disease Mechanisms (19 decks)

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