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MEDSCI201 > Endocrinology of the gut > Flashcards

Endocrinology of the gut Flashcards

1
Q

Pancreatic secretions components

A

pancreatic duct: water,ions and digestive enzymes - acinar cells. Bicarbonate

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2
Q

Bile

A

Made by liver, stored in gall bladder - bile salts and bilirubin

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3
Q

Tail of pancreas

A

Connect to duodenum via pancreatic duct

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4
Q

Arterial routes

A

Delivering blood to three separate capillary beds. Foregut, midgut, hindgut

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5
Q

Venous return

A

All via hepatic portal system.
One single separate capillary bed for the gut leading to the liver’s own capillary bed

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6
Q

2 separate lymphatic systems

A

Lacteals - draining the villi layer
One draining the muscle layer

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7
Q

Lymph nodes

A

Dense areas of lymphocytes and macrophages.

Role: Homeostasis of immune, fluid pressure and nutrient transport

Have defined structure with capsule of connective tissue and areas of lymph nodule tissue and sinus tissue

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8
Q

Sympathetic innervation

A

From spine predominatly motor

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9
Q

Foregut (& adrenal medulla)

A

T5-8
Pre-ganglionic fibres synapse near target organs

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10
Q

Midgut

A

T9-12

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11
Q

Hindgut (& kidney, bladder)

A

L1-3

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12
Q

Parasympathetic

A

Vagus nerve for foregut and mid-gut. Pelvic splanchnic nerve for hindgut. 75-80% sensory, 20% motor

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13
Q

Vagus nerve

A

Afferent and efferent
Sensory neurons in vagus nerve trunks are sending information from mechano -(baro-) and chemo-receptors in GI tract to brain

Brain signals secretory or contractile messages controlling gastric capacity

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14
Q

ENS (Enteric Nervous System)

A

Two layers - myenteric and submucosal

Operates independently of CNS

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15
Q

Submucosal plexus

A

GI blood flow - detecting nutrients and secreting hormones

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16
Q

Myenteric plexus

A

contraction and relaxation of gut wall

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17
Q

Neurotransmitter

A

Epinephrine and Norepinephrine can move through circulation like a hormone (neurohormone)

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18
Q

Gut-brain axis

A

Bidirectional communication between gut and brain
Involves neural, hormonal, and immunological pathways
Neural: Enteric nervous system communicates via vagus nerve
Hormonal: Gut hormones like serotonin, dopamine influence mood, appetite
Immunological: Gut immune cells produce cytokines affecting brain function

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19
Q

Endocrine cells

A

Glands are for absorption but also secrete substances
Pits have different specialised cells.

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20
Q

Neuronal & endocrine control of gastric function

A

Includes negative and positive feedback

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21
Q

Vagal innervation via ENS

A

Stimulates parietal cells (secrete acid / HCl)
ECL cells (Histamine - stimulates parietal cells
G cells in antrum - (Gastrin - stimulates ECL cells

Inhibits: D-cells in the corpus & antrum (SST)

All acting to enhance HCl secretion for digestion in stomach - chyme

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22
Q

pH < 2 stimulates D-cells in atrum

A

Stimulation of D-cells - inhibit parietal & ECL cells

Chyme enters the duodenum (lowers pH. Stimulates S-cells (Secretin - stimulate D cells & stimulates pancreas to release bicarbonate)

Both working to counteract release of HCl and bring pH up for enzymes to work

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23
Q

Gastrin cells (G cells) in stomach

A

Predominate in antrum - secreted when food present Stimulate chief cells (pepsinogen -> pepsin), ECL cells (produce histamine) which stimulate parietal cells (HCl and intrinsic factor which helps uptake of Vit B12)

24
Q

Upper intestine cells

A

Secreted in response to chyme entering duodenum

Secretin cells
Cholecystokinin cells

25
Q

Secretin cells

A

Stimulate D cells to produce somatostatin (inhibit gastrin) and stimulate bile and pancreatic duct to secrete bicarbonate and water.

26
Q

Cholecystokinin cells (CCK, I cells)

A

stimulates pancreatic acinar cells to secrete digestive enzymes and stimulates the gallbladder to release bile

27
Q

Somatostatin (SST, D cells)

A

Inhibit parietal cells and ECL cells, thereby inhibiting the function of G-cells

28
Q

L cell secretions

A

GLP-1
GLP-2
Oxyntomodulin
PYY

29
Q

GLP-1

A

Many actions - brain, gut (slow gastric emptying) and pancreas - maintain blood glucose levels

30
Q

GLP - 2

A

Main target is gut - increase nutrient transport and enhance gut surface area

31
Q

Oxyntomodulin

A

Suppress appetite

32
Q

PYY

A

Lower enzyme, bicarb and bile secretion - slow gastric emptying

33
Q
A
34
Q

K cell hormone

A

GIP (Gastric inhibitory peptide)

35
Q

GIP (Gastric Inhibitory Peptide)

A

Pancreas - enhance insulin secretion and decrease glucagon secretion

36
Q

P/D1 cells

A

Secrete Gherlin

37
Q

Ghrelin

A

Stimulates hunger. Gastric motility and emptying

38
Q

Microbiome

A

Gut - brain axis
Produce chemicals that interact with neurons and hormone producing cells.

39
Q

Fecal microbiota transplant

A

Treat GI disease. Future hopes - obesity, insulin resistance.

40
Q

Microbiome and appendix

A

Disturbances in ecosystem result in commensal populations of microbiome repopulate from the appendix

Appendix is important for linking immune function and the microbiome.

41
Q

Gastrointestinal neuroendocrine tumours (NETS)

A

NET - tumour origination in a neuroendocrine cell, cause overproduction of hormone driving symptoms or reducte hormone production.

42
Q

GI-nets

A

Serotonin
Gastrin
Glucagon

43
Q

PNets

A

Insulin
Glucagon
Somatostatin
Gastrin
Vasoactive intestinal polypeptide (VIP)

44
Q

Gastrinoma (Zollinger Ellison Syndrome)

A

Stomach ulcers and diarrhea

45
Q

Insulinoma

A

Hypoglycemia

46
Q

Glucagonoma

A

Hyperglycemia and diabetes

47
Q

Somatostatinoma

A

Gallstones, intolerance to fat in the diet and fatty diarrhea

48
Q

GLP-1 RA

A

activates GLP1 receptors (mimics GLP1) e.g Ozempic

49
Q

DPP4 inhibitors

A

Reduces breakdown of GLP-1 and GIP (gliptins)

50
Q

GIP/GLP-1 receptor co-agonist

A

e.g. tirzepatde recently approved overseas

51
Q

GIP/GLP-1/ Glucagon receptor

A

Retatrutide in trials

52
Q

Bypass surgery

A

Most effect treatment for obesity and co-morbidities (diabetes, myocardial infarction and stroke)

53
Q

Gut hormones and bypass surgery success

A

Gut hormones: PYY & GLP-1 higher after surgery and stay higher.

54
Q

GDF15

A

Metformin is great at driving weight loss induced GDF15 and its source is the gut and kidney.

55
Q

Expression of GDF15

A

Healthy adults - low levels, upregulates in stress and intense exercise.

Pregnant - highly upregulated (produced by placenta)

Upregulated in several disease states including obesity and is secreted by tumours

MEDSCI201 (20 decks)

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