(F) L5: GITP Function: Stomach

Question 1

Major Zones

• Important for mucus secretion
• The mucus protects the lining of the stomach

Answer 1

Cardiac

Question 2

Major Zones

Consists of the 2 significant cells: Parietal and Chief Cells

Answer 2

Body

Question 3

Major Zones

• The location or secretion site of HCl, enzymes, mucus, and intrinsic factors due to the presence of the different cells

Answer 3

Body

Question 4

Major Zones (Body)

These cells secrete mucus

Answer 4

Surface Epithelial Cells

Question 5

Major Zones (Body)

These secrete HCl and intrinsic factors

Answer 5

Parietal Cells

Question 6

Major Zones (Body)

This gives the stomach its acidic pH, which is important for digestion

Answer 6

HCl

Question 7

Major Zones (Body)

This binds with vitamin B12 in order to be protected from the stomach’s acidity

Answer 7

Intrinsic Factors

Question 8

Major Zones (Body)

These are responsible for the synthesis and secretion of serotonin

Answer 8

Enterochromaffin Cells

Question 9

Major Zones (Body)

These produce pepsinogen (type 1 or 2)

Answer 9

Chief Cells

Question 10

Major Zones (Body)

This, when combined with HCl will be deactivated and converted to pepsin

Answer 10

Pepsinogen

Note: Pepsin is the activated form of pepsinogen

Question 11

Major Zones

This houses the antrum, pyloric canal, and sphincter

Answer 11

Pyloric

Question 12

Major Zones (Pyloric)

This portion is made up of G cells which secretes gastrin

Answer 12

Antrum

Question 13

Major Zones (Pyloric)

This is the primary GI hormone that stimulates the parietal cells to secrete gastric acid or HCl

Answer 13

Gastrin

Question 14

Major Zones (Pyloric)

These portions (2) are important to prevent the direct passing through of the stomach contents into the intestines

Answer 14

1. Pyloric canal
2. Sphincter

Question 15

What is the end product of digestion in the stomach?

Answer 15

Chyme/Gastric Secretion

Question 16

Stimuli for Gastric Secretion

Gastric secretions occur in response to various stimuli, when gastric fluid decreases in pH, it is usually less than what?

Answer 16

3.5

Note: That pH is deadly for most microbes

Question 17

Stimuli for Gastric Secretion

This acid protects the stomach from foreign microorganisms

Answer 17

Gastric Acid

Question 18

Stimuli for Gastric Secretion

Consists of the vagal nerves (for smelling) which stimulates the stomach to secrete gastric fluid

Answer 18

Neurologic Stimuli

Question 19

Stimuli for Gastric Secretion

This is due to the expansion of the mucosal lining

Answer 19

Stomach Distention

Question 20

Stimuli for Gastric Secretion

The stomach secretes these breakdown products of proteins (usually amino acids, proteins, and polypeptides) which usually means that something needs to be digested

Answer 20

Secretagogues

Question 21

Stimuli for Gastric Secretion

The most potent stimulus for gastric fluid secretion

Answer 21

Gastrin

Question 22

Regulators of Gastric Secretions

These (2) are produced by the pancreas, not the stomach

Answer 22

1. Secretin
2. Cholecystokinin (CCK)

Question 23

Regulators of Gastric Secretions

These (2) inhibit gastric secretion

Answer 23

1. Gastric Inhibitory Polypeptide (GIP)
2. Vasoactive Intestinal Polypeptide (VIP)

Question 24

Regulators of Gastric Secretions

Produced by the pancreas:
A. Is secreted by K cells
B. Is secreted by H cells
C. Both
D. Neither

Answer 24

C. Both

Question 25

# Regulators of Gastric Secretions Gastric Inhibitory Polypeptide (GIP) A. Produced by the stomach B. Produced by K cells C. Both D. Neither

Answer 25

B. Produced by K cells | Note: It is NOT produced in the stomach, only present

Question 26

# Regulators of Gastric Secretions Vasoactive Inhibitory Polypeptide (VIP) A. Produced by the pancreas B. Produced by H cells C. Both D. Neither

Answer 26

D. Neither | Note: VIP is Vasoactive INTESTINAL Polypeptide, inhibitory is GIP

Question 27

# Regulators of Gastric Secretions GIP and VIP A. Produced by the pancreas B. Inhibits gastric secretion C. Both D. Neither

Answer 27

C. Both

Question 28

# Gastric Diseases - A HYPERsecretory and HYPERacidic stomach is present - Related with pancreatic cell carcinoma/gastrinoma (tumors that produce gastrin) - An increased gastrin leads to further stimulation of HCl secretion - Presents with abdominal pain, dyspepsia, weight loss, chronic diarrhea, and GI bleeding

Answer 28

Zollinger-Ellison Syndrome

Question 29

# Gastric Diseases TOF: A hyposecretion of gastric fluid leads to a hyperacidity of the stomach

Answer 29

False (HYPERSECRETION)

Question 30

# Gastric Diseases An increase in gastrin stimulates the stomach to secrete more of what?

Answer 30

HCl

Question 31

# Gastric Diseases - No production of HCl and IF due to autoantibodies against the parietal cells - May also be related to megaloblastic anemia due to the lack of B12

Answer 31

Achlorhydia

Question 32

# Gastric Diseases TOF: Achlorhydia is the opposite of Zollinger-Ellison Syndrome

Answer 32

True

Question 33

# Gastric Diseases Overproduction A. Zollinger-Ellison Syndrome B. Achlorydia C. Both D. Neither

Answer 33

A. Zollinger-Ellison Syndrome

Question 34

# Gastric Diseases Autoantibodies against the parietal cells leads to the defective production of what? (2)

Answer 34

1. HCl 2. IF

Question 35

# Gastric Diseases - Is related to megaloblastic anemia - There is gastric atrophy (absence of HCl) resulting to a stomach pH of only 6 - Prone to intestinal infections

Answer 35

Pernicious Anemia

Question 36

# Gastric Diseases - No production of IF and no reabsorption of Vitamin B12 - RBC production is decreased

Answer 36

Megaloblastic Anemia

Question 37

# Gastric Diseases No production of HCl and IF A. Pernicious Anemia B. Megaloblastic Anemia C. Achlorhydia D. All of the above

Answer 37

D. All of the above | Note: C lacks both, A lacks HCl, and B lacks IF

Question 38

# Gastric Diseases Is associated with damage to the stomach lining

Answer 38

Peptic Ulcer

Question 39

# Gastric Diseases Is caused by H. pylori that can resist acidic pHs due to its mucus

Answer 39

Helicobacter pylori infection

Question 40

# Gastric Diseases H. pylori is able to resist what pH by producing what?

Answer 40

Acidic pH is resisted by the mucus

Question 41

# Gastric Function Tests This is done during the fasting state

Answer 41

Basal Acid Output (BAO)

Question 42

# Gastric Function Tests This is done by taking the BAO after stimulation with gastrin-like substances like pentagastrin or histamine

Answer 42

Maximal Acid Output (MAO)

Question 43

# Gastric Function Tests The measurement of HCl after fasting to measure the basal state

Answer 43

Basal Gastric Secretion Determination (same as BAO)

Question 44

# Gastric Function Tests A state in which a patient has not eaten, or ingested anything

Answer 44

Basal State

Question 45

# Basal Gastric Output Determination It is required that the patient is at a fasting state for how many minutes (+ a good night's sleep) before collection?

Answer 45

60 minutes

Question 46

# Basal Gastric Output Determination After the insertion of a nasogastric tube (NGT) for how many minutes, the patient is positioned with the trunk upright and slightly inclined to the left?

Answer 46

10-15 minutes

Question 47

# Basal Gastric Output Determination This position is done order to ensure that the fluid collected really comes from the stomach

Answer 47

Doggy style eme lang, INCLINED TO THE LEFT dapat | If you see this, send a pic of a goat sa bamboorat gc with no context

Question 48

# Basal Gastric Output Determination After the patient has been in the left sided position for 60 minutes, what is collected/aspirated?

Answer 48

Gastric Juice

Question 49

# Basal Gastric Output Determination Concentration of free HCl is determined by what method?

Answer 49

Titration

Question 50

# Basal Gastric Output Determination TOF: If gastric pH is less than 3.5, titration is not needed

Answer 50

False (titration is not needed if GREATER than 3.5)

Question 51

# Basal Gastric Output Determination Male or Female Normal Values? 1. 0.2 to 3.8 mEq/hr. 2. 1 to 15 mEq/hr

Answer 51

1. Female 2. Male

Question 52

# Basal Gastric Output Determination TOF: In the stimulation test, a patient is stimulated by giving food, or test meals after testing

Answer 52

False (BEFORE)

Question 53

# Basal Gastric Output Determination In the stimulation test of parietal cells to produce HCl, what substance replaces histamine due to its production of adverse effects?

Answer 53

Pentagastrin | Note: BOTH can still be used, pentagastrin is just more preferred

Question 54

# Basal Gastric Output Determination This is performed when there are abnormalities in the maximal acid output (MAO)

Answer 54

Gastric Acid Stimulation Test

Question 55

# Basal Gastric Output Determination Male or Female Values of Gastric Acid Stimulation Test? 1. 18 to 28 mEq/hr. 2. 11 to 21 mEq/hr

Answer 55

1. Male 2. Female

Question 56

# Gastric Function Tests - An indirect measurement - The analyte amounting to 1000 to 4000 pg/mL serves as an indicator for Zollinger-Ellison Syndrome - Elevated levels are seen in pancreatic alpha cell tumors - Normal values lie within 50 to 150 pg/mL

Answer 56

Plasma Gastrin

Question 57

# Gastric Function Tests Plasma gastrin levels of what range indicate Zollinger-Ellison Syndrome?

Answer 57

1000 to 4000 pg/mL

Question 58

# Gastric Function Tests Elevated plasma gastrin levels are seen in what kind of tumor?

Answer 58

Pancreatic Alpha Cell Tumor

Question 59

# Gastric Function Tests What is the normal reference value range of plasma gastrin?

Answer 59

50 to 150 pg/mL

Question 60

What gastric disease are these symptoms referring to? 1. Abdominal pain 2. Dyspepsia 3. Weight Loss 4. Chronic Diarrhea 5. GI Bleeding

Answer 60

Zollinger-Ellison Syndrome