GI Flashcards Preview

Nick's MD1 > GI > Flashcards

Flashcards in GI Deck (358):
1

Which cells of the GIT release secretin?

S cells

1

What is a normal ratio of villus height to crypt depth?

4:1

1

What degree of amplification is achieved in the small intestine by the microvilli?

600

1

What effect does caesarian section have on microbiota?

Restricts microbiota diversity

1

What caues pancreatic release of alpha amylase?

Cholecystokinin

1

Where is the final stage of peptide digestion?

At the brush border and in the enterocyte

1

Which germ layer does the wall of the gut come from?

Mesoderm

1

What do the names of  proton pump imhibitors end with?

-prazole

1

Which drugs were used to treat peptic ulcers before PPIs were invented?

H2 antagonists

1

What is magnesium hydroxide used to treat?

Antacid treatment

1

Where is the vomit centre?

dorsolateral reticular formation in floor of 4th ventricle in medulla oblongata

1

Which receptors should be targetted for treatment of nausea associated with motion sickness?

Muscarinic and H1

1

What do we call the macrophages on the inner walls of hepatic sinusoids?

Kupfer cells

1

Some people who are overfed will not put on weight...why not?

They increase NEAT non-exercise activity thermogenesis eg fidgeting 

1

How is acute viral hepatitis differentiated from chronic hepatitis?

Acute infection shows elevated IgM

Chronic infection shows to IgG

1

What percentage of regular IVDUs are HCV positive?

50-60%

1

What are the most common viral causes of chronic hepatitis?

HBV and HBC

1

How is chronic hepaptitis staged?

Degree of fibrosis

1

What is the most common type of steatosis?

Macrovesicular

2

How does the vagus nerve directly stimulate acid release in the stomach?

Vagal preganglionic cell ACh --> AChNR on post ganglionic --> releases ACh --> AChMR on Parietal cells --> HCl

3

What percentage of diarrhoea is due to bacteria in developed countries?

18%

3

Where does human papiloma virus like to infect?

Basal keratinocytes of transformational zone of cervix

3

What is the hallmark pathological feature of acute and chronic viral hepatitis?

Apoptosis

4

What must be produced to cause haemolytic-uremic syndrome?

Shiga toxin aka verotoxin

4

Which intestinal lumenal transporter is inactivated during diarrhoea?

Na/Cl co-transporter

4

What type of muscle is in the esophageal wall?

Skeletal muscle proximally and smooth muscle distally

4

In which parts of the GIT are stem cells present?

All parts

4

What do Brunner's glands in the GIT do?

Secrete an alkaline mucous (mucous and bicarbonate) to neutralise acid from stomach

4

What do G cells of the GIT release?

Gastrin

4

What do we call delayed gastric emptying?

Gastrophoresis

4

What is the definition of chronic gastritis?

Stomach inflammation sustained for > 3 months

4

What is the role of M cells in the GIT?

Located over lymphoid aggregates and let antigens and microbes into gut for access to adaptive immune system

4

What happens to dietary fibre?

Metabolised by bacteria in proximal colon to produce short chain fatty acids, which are then absorbed in distal small bowel and proximal colon

4

What percentage of live births have a birth defect?

3%

4

In the portal lobule model of the liver, what is at the centre?

Portal triad

4

Which hepatitis viruses have a vaccine?

A, B and D

4

How is HAV excreted?

In faeces

4

What colour is bilirubin?

Yellow

4

How is bilirubin trasnported in the blood?

Bound to albumin

5

Which bacteria uses Tir to gain entry to the host cell?

Enteropathogenic E. coli

6

What is the leading cause of liver transplant?

HCV

7

Infrequent or normal frequency, but much more watery with larger volumes would suggest what type of diarrhoea?

Diarrhoea of small intestine

7

Which state of Australia has the highest rates of hepatitis A?

Norther Territory

7

What is choledocholithiasis?

blockage of the bile duct

9

Where do hepatic sinusoids drain?

Central vein

10

What do parietal cells of the stomach produce?

HCl and intrinsic factor

11

What % of people with long-standing GORD develop Barrett's oesophagus?

5-8%

12

How is hepatitis E virus transmitted?

Faecal-oral

13

How can antibiotics cause diarrhoea?

Broad spectrum antibiotics can alter gut microbiota and cause overgrowth of Clostridium difficile

13

Which cells secrete HCl in the stomach?

Parietal cells

13

A new drug is on the market, it is called braprazole.  What type of drug is it likely to be?

Proton pump inhibitor

14

What is an omphalocele?

Failure of hernaited gut to retract into coelom before it closes over

14

Name two D2 antagonists used to treat nausea

Metoclopramide (maxolon)

Prochlorperazine (stemetil)

15

What is kernicterus?

Bilirubin-induced brain dysfunction

15

What is a councilman body?

Apoptotic hepatocyte

16

How is acute hepatitis defined in terms of blood tests?

Raised ALT < 6 months

17

What gives urine its yellow colour?

Urobilin

18

Which two toxins does enterotoxic E. coli use?

Heat labile toxin (LT) and head sensitive toxin (ST)

19

What will the sight, smell and taste of food trigger?

Salivation, gastric acid secretion, pepsin secretion and relaxation of gastric corpus and fundus

20

What do we call a finger-like extension of the mucosa of the GIT?

Villus

20

What defines Marsh type 2 coeliac disease?

Crypts enlarge

20

What drug is a systemic antacid?

Sodium bicarbonate

21

What does the submucosa contain?

Dense, irregular connective tissue with nerves, small ganglia and blood vessels

21

How much can the stomach increase in size when full of food?

300-400%

21

What catalyses biliverdin --> bilirubin?

Biliverdin reductase

22

Which genes are implicated in coeliac disease?

HLA-DQ2 and HLA-DQ8

23

What is the degree of leptin synthesis proportional to?

Size of fat storage

24

Which zone of the acinar model is most vulnerbale to paracetemol toxicity?

Zone 3

24

What is the main form of cell death in chronic hepatitis?

Apoptosis

25

In regulation of eating, the arcuate nucleus of the hypothalamus projects to which other hypothalamic areas?

Paraventricular nuc.

Lateral hypothalamus

27

What is the main immediate treatment goal in diarrhoea and how is this achieved?

Replace fluids and electrolytes with oral rehydration

27

What type of epithelium is in the esophagus?

Stratified squamous, non-keratinizing

27

How does alpha amylase work?

Breaks alpha 1,4 linkages between glucose molecules

27

What happens to fatty acids and monoglycerides inside enterocytes?

They are formed into triglycerides in the smooth endoplasmic reticulum, then packaged into chylomicrons and secreted into lymphatics

27

What liver pathology is seen in alcoholic hepatitis?

Mallory bodies and hepatocyte swelling

27

How much does 1 standard rink raise BAC by?

0.015%

28

How is glucose absorbed by enterocytes?

SGLT1 Sodium-dependent glucose trasnporter 1

29

What is the lifespan of a hepatocyte?

150 days

30

What defines Marsh type 1 coeliac disease?

Increased lymphocyte:enterocyte ratio (>30/100)

31

What is the normal ratio of T cells to enterocytes in the duodenum?

1:4

31

Which part of polypeptides do trypsin, elastase and chymotrypsins act on?

Interior bonds of peptides

32

Whih hepatitis viruses are most easily transmitted through contaminated food?

A and E

33

Where is alcohol absorbed?

30% in stomach

70% in gut

34

What stimulates G cells to release gastrin?

Amino acids

35

Which cells make bile?

Hepatocytes

36

Where does the last part of carbohydrate digestion occur?

Disaccharidases and isomaltases at the brush border of mucosal enterocytes

36

In the classic lobule model of the liver, what is at the centre?

Central vein

37

What hormone do enterochromaffin cells release?

Serotonin

37

Which enzyme conjugates bilirubin?

Glucuronyl transferase

39

What does low hemopexin indicate?

Haemolytic anaemia

40

What percentage of the liver's blood supply is from the portal vein?

75%

42

Where are Peyer's patches found?

Ileum

43

What does the allantois give rise to?

BLadder and urogenital tract

45

What is the main function of the muscularis mucosae layer of the GIT wall?

Mixing lumenal contents

45

How is fructose absorbed by enterocytes?

GLUT5

46

What would happen to a person without leptin receptors?

They would eat more and become obese

47

What is the average incubation period for HEV?

40 days

48

What percentage of the liver's oxygen supply is from the portal vein?

50%

50

What type of epithelium is present in the gall bladder?

Simple columnar

52

What do chief cells of the stomach produce?

Proteases eg pepsinogen

54

Broad spectrum antibiotics can cause overgrowth of what in the gut?

Clostridium difficile

56

What does sessile mean?

A polyp that is not attached via a stalk

57

Where does fat digestion begin?

In the mouth with a lingual lipase

58

What is intrinsic factor essential for?

Absorption of VitB12

59

Where are monosaccharides absorbed?

Tips of villi in duodenum and jejunum

59

What does a rising IgG titre indicate in a viral hepatitis?

Acute infection

61

What % of gastric ulcers are due to Helicobacter pylori?

70%

62

What percentage of energy is expended on basal metabolism?

65-75%

63

What is fatty liver known as?

Steatosis

64

What are the side effects of magnesium hydroxide?

Diarrhoea

65

In dysentery caused by entamoeba histolytica, what will be noted in a stool sample sent for lab investigation?

Fewer bacteria, because ameoba eat bacteria

67

In which layer of the GIT are scattered immune cells found?

Lamina propria

68

What is growth hormone release inhibitor better known as?

Ghrelin

70

Define cirrhosis

Diffuse nodules of regenerating hepatocytes surrounded by bands of fibrosis

71

What pathology is seen in acute viral hepatitis?

Lobular dissaray and apoptosis

72

What is the average incubation period for HBV?

60-90 days

73

What divides the functional/physiological right from left lobes of the liver?

Middle hepatic vein

74

Which cells synthesise leptin?

Adipocytes

75

Where are colonic lymphatics?

In the submucosa

76

Does fat boy or skinny boy have a higher basal metabolic rate?

Fat boy

77

What is stage 4 chronic hepaptitis known as?

Cirrhosis

78

What are the 3 levels of anatomical structure that increase surface area in the small intestine?

Plica circulare, villi, microvilli

79

In what part of the stomach is pepsinogen II secreted?

Cose to pylorus

79

How is hepatitis C virus transmitted?

Percutaneous or permucosal

80

What is the problem in Crigler-Najjar syndrome?

Deficiency of UDP-glucuronyl transferase causes accumulation of toxic unconjugated bilirubin and kernicterus

81

What does low haptoglobin indicate?

Haemolytic anaemia

82

By what stage of the GIT is digestion pretty much complete?

Half way along jejunum

83

Which zone of the acinar model is most vulnerable to ischaemia?

Zone 3

84

What is the most significant pathway for alcohol conversion to acetaldehyde?

Alcohol dehydrogenase

85

What is the gold standard for diagnosis of coeliac disease?

Small bowel biopsy during gluten exposure

87

When does colon cancer become invasive?

When it breaches muscularis mucosae

90

What does pepsinogen do?

Hydrolyses bonds between an aromatic amino acid (phenylalanine and tyrosine) and another amino acid

91

What percentage of diarrhoea is due to viruses in developed countries?

40%

92

How many mls of water are excreted per day in the faeces?

100ml

93

What do I cells of the GIT release?

Cholecystokinin

94

What catalyses haem --> biliverdin?

Haem oxygenase

95

What does pedunculated mean?

A polyp attached by a stalk

96

What do enterochromaffin cell-like cells release?

Histamine

98

What are the pacemaker cells of rhythmic gut movement?

Interstitial cells of Cajal

100

What defines Marsh type 3 coeliac disease?

Villi are shortened and blunted: villous:crypt ratio is

102

What is/are the key histological feature/s of the duodenum?

Brunner's glands, fewer goblet cells

104

What effects does distension of the stomach have?

Activates stretch receptors --> vago-vagal reflexes --> acid and pepsin secretion Stretch --> hypothalamus --> decrease appetite

106

How does diarrhoea cause death in the delayed phase?

Malnutrition

107

How big is a hepatic sinusoid?

0.7 x 2 mm

108

What shape are enterocytes?

Columnar

109

Which receptors should be targetted for treatment of nausea associated with exposure to toxins?

D2 and 5-HT3

110

What is the most common familial colorectal cancer syndrome?

Lynch syndrome

112

What type of nausea would a D2 antagonist be used to treat?

Chemical/toxin/drug associated

113

Which bacteria typically causes travelle's diarrhoea?

Enterotoxic E. coli (ETEC)

115

At what time point does hepatitis become chronic?

> 6 months

116

What are the important receptors for motion sickness/dizziness/vertigo associated nausea?

Muscarinic and H1

117

Where do HBV and HCV replicate?

Hepatocytes

118

In what form does hyperbilirubinaemia in the newborn cause neurotoxicity?

Kernicterus

119

What type of drug is ranitidine?

H2 antagonist

120

In a hepatic sinusoid, what is the gap between endothelium and hepatocytes? 

Space of Disse

121

What is the quality of diarrhoea of small intestine?

Infrequent or normal frequency, but much more watery with larger volumes

122

What's a good antibiotic for anaerobic organisms?

Metronidazole

124

Which nerve mediates peristalsis along the esophagus?

Vagus

126

Which parts of the GIT have serosa as their outer layer?

Parts of the gat not attached to anything --> secretes fluid to stop them sticking

128

How much water does the small intestine absorb per day?

8.5 L/day

130

In haemolysis, what is the intermediate product betwen haem and bilirubin?

Biliverdin

132

How is a bile duct discriminated from a portal vein and hepatic artery on microscopy?

Bile duct has columnar epithelium

133

Which GIT cells secrete intrinsic factor?

Parietal cells

135

Where is vitamin B12 absorbed?

Terminal ileum

136

What degree of amplification is achieved in the small intestine by the villi?

30x

138

What % of gastric ulcers are due to NSAIDs?

25%

138

What are the important receptors for the chemoreceptor trigger zone?

D2 and 5-HT3

139

How is hepatitis D virus transmitted?

Percutaneous or permucosal

140

Frequent stools of low volume would suggest what type of diarrhoea?

Diarrhoea of colon

141

Which hepatitis is most easily transmitted perinatally?

HBV

143

What is a rare but potential side effect of H2 antagonists?

Gynecomastia 

144

What colour of soft drink/lolly will be be sweeter, even with the same amount of sugar?

Red

146

How is entamoeba histolytica transmitted?

Faecal-oral spread

148

What causes damage to hepatocytes in viral hepatitis?

The immune response

149

What is achalasia?

Failure of smooth muscle of lower esophageal sphincter to relax causing dysphagia

150

What percentage of oxygenation does blood in the hepatic sinusoids contain?

20%

151

What is a prebiotic?

A dietary supplement that promotes beneficial bacteria

153

Between which layers of the GIT wall are the myenteric ganglia?

Between circular layer and longitudinal layer of muscularis externa

154

Where do hepatitis viruses A and E replicate?

In hepatocytes and in intestinal epithelia 

156

What causes the secretion of pancreatic lipolytic enzymes?

Cholecystokinin

158

??? --> ROH + H2O + NADP+ 

RH + NADPH + H+ + O2 --> 

161

What is the prevalence of coeliac disease?

1%

162

Which enzyme breaks down alpha 1,6 bonds in polysaccharides?

Isomaltase 

163

How is giardia intestinalis transmitted?

Faecal-oral 

164

Which cells in the GIT release somatostatin?

D cells

165

Which glands in the GIT secrete an alkaline mucous (mucous and bicarbonate) to neutralise acid from stomach?

Brunner's glands

168

What forms does conjugated bilirubin take?

Bilirubin mono-glucuronide and

bilirubin di-glucuronide

170

Familial adenomatous polyposis is due to a mutation in which gene?

APC

171

What does secretin trigger?

Secretion of bicarbonate rich solution from pancreas

172

What is colitis?

Inflammation of the bowel

173

What liver pathology does paracetemol toxicity cause?

Coagulative necrosis predominantly in zone 3

174

Which GI cells release gastrin?

G cells

175

Which cells proteases in the stomach?

Chief cells

176

What are 2 commonly used H1 antagonists for motion sickness?

Promethazine

Pheniramine

177

Which nerve mediates the cephalic phase of digestion?

Vagus

178

What is the antonym of mesenchymal?

Epithelial 

179

What are the layers of the GIT?

1 Epithelium 2 Lamina propria 3 Muscularis mucosae 4 Submucosa 5 Muscularis externa - innter circular layer 6 Muscularis externa - longitudinal layer 7 Serosa/adventitia

180

What does the mesobephric duct become?

The vas deferens

181

How much water can the colon absorb in a day?

4-5 L/day

182

How is hepatitis A virus transmitted?

Faecal-oral route

183

What % of pancreas is endocrine?

1-2%

184

What do S cells of the GIT release?

Secretin

185

What % of people infected with HCV will clear the virus?

30%

186

What is/are the key histological feature/s of the ileum?

Peyer's patches, more goblet cells, shorter villi

188

What type of epithelium is present in the anal canal?

Stratified squamous, non-keratinised

190

How is chronic hepatitis graded?

Degree of interface inflammation

191

Which cells of the GIT release defensins?

Paneth cells

192

How does enteropathogenic E. coli infect enterocytes?

It inserts Tir (translocated intimin receptor) into host cell via type 3 secretion. Tir is then expressed on host cell membrane. EPEC is then able to bind to Tir via intimin.

193

What will most labs do to investigate a faeces sample from a GI infection?

Microscopy and culture

194

What is the most effective treatment for recurrent C. difficile pseudomembranous colitis?

Faecal transplant

195

What do Harris-Benedict equations estimate?

Energy expenditure

196

What is/are the key histological difference/s between small intestine and large intestine?

Small intestine has villi; large intestine does not. Large intestine has more goblet cells

197

How does diarrhoea cause death in the acute phase?

Fluid and electrolyte imbalance

198

Through what does bile flow in liver lobules?

Through canaliculi to bile ducts

200

What are the most common classes of cause of unintentional weight loss?

Malignancy

GI disease

Endocrinological

Anorexia nervosa

Infection

202

How are most infections from toxoplasma gondii acquired?

Undercooked meat

204

What gives faeces its brown colour?

Stercobilin

206

What inactivates pepsin?

Neutral pH

208

Name 2 proton pump inhibitors

Omeprazole and esomeprazole

209

What is a probiotic?

A live organism that promotes health when ingested in sufficient quantities

210

Oral rehydration mixtures typically contain what?

NaCl, KCl, NaHCO3, glucose

212

What colour is urobilinogen?

Clear

213

What is the chief function of the muscularis externa in the GIT wall?

Movement of contents along gut

214

What % of the world is HCV positive?

3%

216

What is ERCP?

Endoscopic retrograde cholangiopancreatography

217

How much alcohol is in a standard drink?

10g

218

What effects does early-life exposure to hepatitis viruses have on clinical course?

Less severe acute infection and higher chance of chronic infection

219

What is the difference between a gastric erosion and acute gastric ulcer?

Erosion is limited to mucosa, whereas an acute ulcer penetrates into the submucosa

220

What are the 2 most common causes of steatosis?

Alcohol and obesity

222

Which immunoglobulin is most common in the gut?

IgA

223

What do D cells in the GIT release?

Somatostatin

225

What degree of amplification is achieved in the small intestine by the folds of Kirkring?

3x

226

Which hormone is released from the stomach in a fasted state and stimulates appetite?

Ghrelin

228

What type of cells infiltrate in interface inflammation of chronic hepatitis?

Lymphocytes

229

How much water is excreted in faeces per day?

About 100 ml/day

230

What do we call the GI control systems that are activated prior to eating?

Cephalic phase of digestion

231

What are the three classes of anti-diarrhoeal agents?

Anti-motility. Anti-secretory. Binding agents.

232

What is the average incubation period for HAV?

30 days

233

Which pathogen typically causes antibiotic-associated diarrhoea?

Clostridium dificille

234

Name 6 examples of when you would treat diarrhoea with antibiotics.

Cholera. Systemic infection. Immunocompromised. Severe shigella infections. Protazoal infections. Pseudomembranous colitis.

235

What percentage of absorption of products of digestion is done in the small intestine?

85%

236

Which reflex mediates signals from the upper GIT that regulate upper GIT functions such as swallowing and acid secretions?

Vago-vagal reflex

237

Which part of the villus is secretory in the small intestine?

Crypts

238

RH + NADPH + H+ + O2 --> 

ROH + H2O + NADP+

240

Are gut bacteria predominantly aerobic or anaerobic?

99.9% are anaerobic

241

What do we know about clostridium species?

Gram positive

Rod

Anaerobe

Spore forming

242

How long does an acute HAV infection typically last?

2-3 weeks

243

Which organ is most commonly defective at birth? 

Heart

244

Which protein transports conjugated bilirubin into the bile canaliculus?

cMOAT (aka MRP-2)

245

What is the problem in Dubin-Johnson disorder?

Genetic defect in cMOAT causes accumulation of non-toxic conjugated bilirubin

246

What is the most common form of hiatus hernia?

Sliding

247

What changes to liver architecture may there by after extensive repair?

More fibrous and different lobular structure

248

What are the effects of gastrin?

Causes parietal cells to release acid

249

Define dysentery

Blood, pus and mucous in faeces

250

What effect will injection of neuropeptide Y have on eating?

Increase

251

What is endangered with a fracture of the medial epicondyle of the elbow?

Ulna nerve

252

Define mesenchymal cells

Cells that lost contact with each other

and move independently and alone

253

Injecting cocaine and amphetamine regulated transcirpt (CART) will have what effect on eating?

Decrease

255

What is the most common genetic mutation that can cause obesity?

MC4R

Melanocortin 4 receptor

256

How do proton pump inhibitors work?

Irreversible inhibition of H+/K+ ATP ase

257

How do prostaglandins protect the mucosa from injury?

Promote HCO3- secretion, inhibit acid secretion, maintain blood flow

258

What is gastrophoresis?

Delayed gastric emptying

259

Define coeliac disease

Immunologically mediated disease... in genetically susceptible individuals... driven by gluten... which results in chronic inflammation... of the small bowel mucosa

260

What blood test is indicative of acute HBV infection?

Anti-HBc IgM

261

What is a very common non-human host of giardia intestinalis in Australia?

Possum

262

What % of duodenal ulcers are due to Helicobacter pylori?

92%

263

What are the most common pathogenic agents in dysentery?

Enteroinvasive E. coli/Shigella Entamoeba histolytica

264

Which hepatitis viruses tend to cause chronic disease?

HBV and HCV

265

What effects does CCK cause as a hormone?

Contractions of gall bladder to force bile down into duodenum. Releases digestive enzymes from pancreas. Stimulates satiety centre in hypothalamus

266

How can you distinguish an artery from its partner vein?

Usually smaller and more tortuous

267

All derivatives of endoderm are _______

Epithelial tissues

268

What catalyses acetaldehyde --> acetate

Aldehyde dehydrogenase

269

What happens to goblet cell frequency along the course of the GIT?

Increases

270

What are the side effects of sodium bicarbonate?

Alkalosis

Kidney problems

Oedema

271

What is the most commonly used H2 antagonist?

Ranitidine

272

What will be seen in the stool of an invasive diarrhoea?

Blood and pus

273

Blood, but not pus, in diarrhoea suggests which organism?

Enterohaemorrhagic E. coli

274

_______ consists of an open chain of four pyrrole rings

Bilirubin

275

What happens with withdrawal of antacids?

Rebound acidity

276

Where is alanine transferase located?

Cytoplasm of hepatocytes

277

What is the most common cause of liver cancer?

HBV

278

What is the gold standard for measuring energy expenditure?

Double labeled water (Deuterium/oxygen 18)

279

How do antacids work?

Neutralise stomach acid

280

What activates cholesterol esterase?

Bile

281

What catalyses trypsinogen --> trypsin?

Enterokinase and trypsin

282

What is the role of smooth ER in hepatocytes?

Fat and steriod metabolism

283

What effects does somatostain have in the GIT?

Inhibits histamine release from enterochromaffin cell-like cells Inhibits HCl release from parietal cells

284

Bilirubin consists of an open chain of _______

four pyrrole rings 

285

What do we call a fertilized ovum?

Zygote

286

What are the American (more stringent) criteria for Barrett's esophagus?

Evidence of columnar epithelial lining in esophagus; AND

Evidence of goblet cells in esophagus

287

What is the function of paneth cells?

Secrete anti-microbial peptides (defensins)

288

What do paneth cells release?

Defensins

289

What is the average incubation period for HCV?

6-7 weeks

290

Which germ layer does the epithelium of the gut come from?

Endoderm

291

How is hepatitis B virus transmitted?

Percutaneous or permucosal

292

Elevated ALT levels in hepatitis indicate what?

Replicating virus

293

What percentage of faeces is bacteria?

60-70%

294

Inflammation around the portal tract is known as what?

Interface inflammation

295

What would happen to energy intake if all microbiota were removed from a person?

Energy intake would need to increase

296

Which enzyme activates IL-1?

IL-1 converting enzyme (ICE) aka caspase 1

298

Which cells of the GIT release cholecystokinin?

I cells

299

What is the pathological hallmark feature of steatohepatitis? 

Hepatocellular ballooning degeneration

300

Where does pinworm live?

Anus

301

Pharmacologically, what are the two most important inputs to the vomit centre?

Chemoreceptor trigger zone (CTZ)

Vestibular input

302

Which protease acts at the carboxy terminals of peptides?

Pancreatic carboxypeptidase

303

What is koilocytosis?

A ring around nucleus

305

What is the defining feature of enterohaemorrhagic E. coli?

It produces shigatoxin

306

Barrett's esophagus infers what relative risk for esophageal adenocarcinoma?

30-60

307

Particularly offensive smelling diarrhoea stool suggest what type of organism? 

Anaerobic

308

What is a commonly used antimuscarinic drug for motion sickness?

Hyoscine hydrobromide

309

What is the largest internal organ?

Liver

310

Where do central veins drain to?

Hepatic vein

311

Which enteroendocrine cells release serotonin?

Enterochromaffin cells

312

What type(s) of collagen are found in the liver?

1 and 3

313

What type of epithelium is present in the small intestine?

Cilliated simple columnar

314

What is the pathogen in cholera?

Vibrio cholerae

315

What is the last macronutrient to pass through the pylorus after a meal?

Fat

316

How much alcohol can a person typically clear in 1 hour?

1 standard drink = 0.015% BAC = 10 g alcohol

317

What stimulates D cells to release somatostatin?

Luminal acid

318

What effects do artificial sweeteners have on GI activity?

Bind to L cell receptors to increase glucose absorption

319

What is the quality of diarrhoea of colon?

Frequent stools of low volume

320

How much water does the colon absorb per day?

1.4 L/day

321

What are the extra-intestinal complications of entamoeba histolytica?

Liver or brain abscesses

322

How do goblet cells contribute to immunity?

Secrete mucins, lysozyme and lactoferrin

323

With sustained alcohol intake,  what is induced to high levels and provides an alternative pathway for EtOH metabolism?

 CYP2E1 aka MEOS Microsomal Ethanol Oxidising System

324

What colout is bile?

Dark green to yellowish brown

325

 How much bile can the human liver produce per day?

Close to 1 litre per day

326

 What is family of molecules, composed of a steroid structure with four rings, a five or eight carbon side-chain terminating in a carboxylic acid?

Bile salts

327

What are the most important bile acids in humans?

Cholic acid, deoxycholic acid, and chenodeoxycholic acid

328

What percentage of bile salts are reasorbed and were are they reasbosrbed?

95% are reabsorbe din the terminal ileum

329

Which hormones regulate pancreatic juice secretion?

Secretin and cholecystokinin

330

Which cells of the pancreas secrete bicarbonate?

Duct cells

331

Which cells of the pancreas produce digestive enzymes?

Acinar cells

332

What is the predominant component of bile?

Cholesterol

333

Which 3 substances can trigger exocrine secretions from the pancreas?

ACh (from vagus), CCK and secretin

334

What activates pancreatic lipase?

Co-lipase

335

Define cirrhosis

Nodules of regenerating hepatocytes surrounded by bands of fibrosis tissue

336

Which hepatitis viruses can cause cirrhosis?

B and C

337

Which chronic liver diseases can lead to cirrhosis?

All of them

338

Which cells are stimulated to cause fibrosis in cirrhosis?

Stellate cells

339

What is a potential consequence of splenomegaly in cirrhosis?

Thrombocytopenia 

340

What is the most common cause of portal hypertension?

Cirrhosis

341

How is portal hypertension defined?

Increase of >8mmHg in the portal vein 

OR

Increase of >5mmHg in pressure gradient between portal vein and hepatic vein

342

What are the 3 cardinal consequences of portal hypertension?

Splenic enlargment.  Ascites.  Varices at sites of porto-systemic anastamoses

343

What are the 3 main points of anastomosis between the portal and systemic venous systems?

Esophagus.  Rectum.  Umbilicus

344

Which liver enzymes are located in hepatocyte cytoplasm?

AST, ALT, LD

345

Which liver enzymes are associated with the biliary membrane?

GGT and ALP

346

Which enzyes are released with hepatocellular damage?

AST and ALT

347

Is ALT or AST more specific to liver damage?

ALT

348

Where is ALT present?

Cytosol of hepatocytes

349

Where is AST present?

Cytosol and mitochondria of liver, muscle and blood cells

350

What is suggested if AST > ALT?

Acute liver damage

351

What is suggested if ALT > AST?

Chronic or resolving liver damage

352

Which of AST and ALT has a longer half life?

ALT

353

What does elevated GGT levels suggest?

Biliary disease

354

What is the most common cause of raised liver enzymes?

Obesity

355

Pain from an ulcer in the duodenum is made _______ with eating

Better

356

Pain from an ulcer in the stomach is made _______ with eating

worse