Gastrointestinal Drugs (F)

Question 1

What are the acid-peptic diseases?

Answer 1

1. gastroesophageal reflux
2. peptic ulcer
3. stress-related mucosal injury

Question 2

What are the natural defenses against acid-peptic diseases?

Answer 2

1. mucus
2. bicarbonate secretion
3. prostaglandins
4. blood flow
5. cellular regeneration

Question 3

What causes 90% of peptic ulcers?

Answer 3

Helibacter pylori or use of NSAIDs

Question 4

What are the epithelial cells that secrete hydrochloric acid and intrinsic factor? 1. Where are they located? 2

Answer 4

1. parietal cells

2. gastric glands in lining of fundus and body of stomach

Question 5

What does parietal receptor stimulation cause?

Answer 5

1. inc cytosolic calcium
2. stimulation of protein kinases
3. secretion from H+/K+-ATPase proton pump

Question 6

What is released by G cells? 1. What does it bind to (and on which cells)? 2. What is the main effect of this substance mediated through? 3

Answer 6

1. gastrin
2. gastrin-CCK-B receptors (on parietal and enterochromaffin-like (ECL) cells)
3. release of histamine from ECL cells

Question 7

What is the role of histamine?

Answer 7

stimulate H+/K+-ATPase proton pump

Question 8

What causes the termination of acid secretion?

Answer 8

1. rise in H+ and CCK concentration

2. somatostatin release by D cells

Question 9

What are the places in the brain that coordinate the act of vomiting?

Answer 9

1. CN VIII
2. CN X
3. nucleus tractus solitarius

Question 10

What are the four sources of afferent input to the vomiting center?

Answer 10

1. chemoreceptor trigger zone
2. vestibular system
3. vagal and spinal afferent nerves from GI
4. CNS

Question 11

What are the receptors involved in the chemoreceptor trigger zone that is a part of the vomiting center input?

Answer 11

1. D2 receptors
2. neurokinin 1
3. 5-HT3 serotonin receptors

Question 12

What are the receptors involved in the vestibular system that is a part of the vomiting center input?

Answer 12

1. M1 muscarinic

2. H1 histamine receptors

Question 13

What are the receptors involved in the vagal and spinal afferent nerves from GI that is a part of the vomiting center input?

Answer 13

5-HT3 serotonin receptors

Question 14

What is chronic inflammation of all or part of the digestive tract?

Answer 14

inflammatory bowel disease (IBD)

Question 15

What is the type of IBD that has ulcers in lining of intestine and rectum?

Answer 15

ulcerative colitis

Question 16

What is the type of IBD that has inflammation spread deep into tissues?

Answer 16

Crohn’s disease

Question 17

What is the treatment pyramid for mild IBD?

Answer 17

1. 5-aminosalicylates
2. topical corticosteroids
3. antibiotics
4. Budesonide

Question 18

What is the treatment pyramid for moderate IBD?

Answer 18

1. oral corticosteroids
2. immunomodulators
3. anti-TNF antibodies

Question 19

What is the treatment pyramid for severe IBD?

Answer 19

1. IV corticosteroids
2. Anti-TNF antibodies
3. surgery
4. natalizumab
5. cyclosporine

Question 20

What is pancreatic insufficiency caused by?

Answer 20

1. cystic fibrosis
2. chronic pancreatitis
3. pancreatic resection

Question 21

What is a disease that has malabsorption of nutrient and fluids in small intestines and following surgical resection or disease of the intestines?

Answer 21

short-bowel syndrome