Choudhury II

Question 1

proximal portionof stomach secretes what

Answer 1

HCl, pepsinogen, IF, mucus, bicarb, water

Question 2

distal portion of stomach secretes what

Answer 2

gastrin, mucus, somatostatin (endocrine paracrin actions)

Question 3

parietal or oxyntic cells secrete what

Answer 3

HCl, IF

Question 4

chief cells secrete what

Answer 4

pepsinogen, renin

Question 5

endocrine cells in stomach secrete what

Answer 5

ECL cells that secrete histamine
G cells secrete gastrin
D cells secrete somatostatin

Question 6

what is role of HCl

Answer 6

protein breakdown, pepsinogen activation, kills most microbe

Question 7

peptic chief cells secrete what

Answer 7

pepsinogen and its converted to pepsin

Question 8

what is the purpose of the mucus that is secreted by mucous cells

Answer 8

lubrication to protect epithelial cells

Question 9

pyloric glands are where

Answer 9

antrum and pyloric regions of the stomach

have G cells

Question 10

what does gastrin do

Answer 10

stimulates pareital cells HCl and peptic cells (pepsinogen)

Question 11

describe the mucus secreted by surface epithelial cells in stomach and the neck cells

Answer 11

surface is thick alkaline mucus

neck cells secrete thin watery mucus

Question 12

chief cells secrete what

Answer 12

pepsinogen and gastric lipase

Question 13

what stimulates D cells to secrete somatostatin

Answer 13

acid in the stomach

Question 14

how do H+ and Na+ levels in the stomach change as the rate of gastric secretion increases

Answer 14

inverse relationship, more H+ less Na+ the faster the secretion

and- always high in Cl, always low in K

Question 15

H+ concentration in gastric lumen compared to blood

Answer 15

3M fold higher

Question 16

key player in maintaining low pH in gastric lumen

Answer 16

H-K ATPase on the parietal membrane facing gastric lumen

Question 17

What stimulate parietal cells to secrete acid

Answer 17

ACh, gastrin and histamine

Question 18

What R does ACh bind to

Answer 18

M3

Question 19

what R does gastrin bind to

Answer 19

CCKb

Question 20

what R does histamine bind to

Answer 20

H2

Question 21

what are the inhibitors on parietal cells

Answer 21

somatostatin and PGs

Question 22

what are the phases of gastric secretion

which has most acid secretion?

Answer 22

cephalic phase
gastric phase- most acid secretion
Intestinal phase

Question 23

What is a vagotomy and what is it used for?

side effects?

Answer 23

cutting vagus nerve
inhibits gastric acid secretion
used to Tx peptic ulcers
side effects: delay in gastric emptying, diarrhea

Question 24

what is a selective vagotom=y

Answer 24

cutting vagal nerves supplying parietal cells

Question 25

what occurs in cephalic phase

Answer 25

``` conditioned reflexes from impulses to medulla stimulate vagus n Ach release gastrin release pepsinogen release inhibition D cells ```

Question 26

what hormones does the duodenum release in intestinal phase? | role?

Answer 26

secretin GIP CCK inhibit acid secretion

Question 27

what stimulates cephalic phase

Answer 27

sight, smell, taste, chewing

Question 28

what is rennin or chymosin

Answer 28

made by gastric chief cells in infants | proteolytic enzyme that causes milk to curdle in stomach so that it is retained and released more slowly

Question 29

what replaces rennin in adults

Answer 29

pepsinogen

Question 30

What converts pepsinogen to pepsin

Answer 30

pepsin and HCl

Question 31

what stimulates secretion pepsinogen

Answer 31

vagal sitmulation, mediated by Ach | Direct response to gastric acid

Question 32

what is pernicious anemia

Answer 32

absence of IF or B12 leading to neurological disturbances like paresthesias

Question 33

what can cause B12 deficiency

Answer 33

``` decreased dietary intake decreased absorption (decreased IF or autoAb) ```

Question 34

the mucus layer on gastric surface is a diffusion barrier for what

Answer 34

H and pepsin

Question 35

how does aspirin lead to ulcer formation

Answer 35

suppresses the protective mucosal barrier production

Question 36

cycle of acid causing mucosal damage

Answer 36

acid and pepsin break through mucosal barrier and the acid stimulates histamine release which then causes more acid release = viscous cycle

Question 37

what is more common gastric or duodenal ulcer disease

Answer 37

duodenal

Question 38

what is zollinger ellison syndrome

Answer 38

gastrin secreting tumor

Question 39

What pathogen causes gastric ulcers and how

Answer 39

H pylor because increases gastrin secretion

Question 40

what is used to evaluate gastric function

Answer 40

serum gastrin levels and gastric acid secretion

Question 41

what is used clinically to stimulate acid secretion

Answer 41

pentagastrin

Question 42

what is atrophic gastritis

Answer 42

chronic inflammation, with lack of parietal cells, of gastric mucosa from H pylori

Question 43

serum gastrin way elevated by basal acid output and after pentagastrin remain zero most likely?

Answer 43

pernicious anemia

Question 44

serum gastrin super elevated with increased before and after pentagastrin aci output most likely?

Answer 44

gastric ulcer

Question 45

what part of H pylori leads to gastric ulcers

Answer 45

mucosal damage

Question 46

what component of H pylori escapes pH

Answer 46

urease neutralizes gastric acid

Question 47

What muscarinic antagonists are used in PUD

Answer 47

atropine and scopolamine

Question 48

what H2 antagonists are used in PUd

Answer 48

cimetidine ranitidine

Question 49

what PPI are used in PUD

Answer 49

omeprazole and lansoprazole

Question 50

what drug is a PGE1 analog

Answer 50

misoprostol

Question 51

How is sucralfate useful in PUD

Answer 51

polymerizes on GI luminal surface to form protective gel like coating on ulcers

Question 52

what Antacids are usedul in PUD

Answer 52

Al(OH)3 Mg (OH)2 CaCo3