GI motility@

Question 1

Which nerves responsible for lower colon excitatory fxn?

Answer 1

Sacral plexus or sacral parasymp nerves (S1-5)

Question 2

Which nerve has great effect on eosph/stom?

Answer 2

Vagus via cranial parasymp nerves

Question 3

T/F: Food is a stimulator of the MMC?

Answer 3

False, it is an inhibitor; the MMC empties non food materials

Question 4

When does GB and panc emptying happen in the MMC?

Answer 4

I - Quiescent phase

II & III - GB empty, panc/biliary emptying

Question 5

Gastric electrical stim works how?

Answer 5

Improved accomodation, improved vagal fcn, dec sensitivity to distention, inc slow wave amplitude

Question 6

T/F: Gastric elec stim works best in diabetics.

Answer 6

True

Question 7

Skeletal bx with ragged red fibers in what?

Answer 7

mitochondrial neurogastrointestinal encephalomyopathy

Question 8

T/F: MNGIE has atrophy and fibrosis of longitudinal muscle of MP?

Answer 8

True

Question 9

What genetic defect and inheritance of MNGIE?

Answer 9

AR, defect in thymidine phosphorylase

Question 10

CIs to use of neostigmine?

Answer 10

Bradycardia

Question 11

List the 3 muscles of the UES.

Answer 11

Inf pharyngeal constrictor, cricopharyngeus, cervical esophagus

Question 12

Achalasia is a RF for which type of esophageal CA?

Answer 12

SCC

Question 13

Which dzes can cause low LES resting pressure?

Answer 13

DM, scleroderma, thyroid dz

Question 14

Which reflex is abnl in Hirschsprungs?

Answer 14

Rectoanal inhibitory reflex

Question 15

Hirschsprungs AW which dz?

Answer 15

Downs syndrome

Question 16

CIPO tx?

Answer 16

octreotide before bedtime; can worsen if done before meals

Question 17

SCLC paraneoplastic syndrome AB?

Answer 17

Anti-Hu or Anti-neuronal nuclear AB

Question 18

Which nerves give excitatory control of distal colon?

Answer 18

Sacral plexus nerves

Question 19

What gives motor control to UES?

Answer 19

Cranial parasympathetic outflow mediated by vagus nerve

Question 20

What mediates OP swallowing?

Answer 20

Swallowing center in medulla

Question 21

Tx of high up Zenkers?

Answer 21

Cricopharyngeal myotomy with diverticulectomy

Question 22

WHat is responsible for moving nondigestible products through the stomach?

Answer 22

MMC

Question 23

Phase(s) of solid food gastric emptying

Answer 23

Lag and linear phases

Question 24

T/F: Higher caloric density foods have faster gastric emptying.

Answer 24

False, empty slower

Question 25

What is the MMC?

Answer 25

Phase of emptying of the stomach and SI that occurs between meals.

Question 26

Does food stim or inhibit MMC?

Answer 26

Inhibits it

Question 27

What are three phases of MMC?

Answer 27

1. Quiescent | 2&3. Active stages

Question 28

How does fat in the ileum affect gastric emptying?

Answer 28

Fat in the ileum leads to GLP1 release which delays gastric emptying

Question 29

What is the best gastroparesis diet?

Answer 29

Low fat, low fiber

Question 30

What is the SE of domperidone?

Answer 30

breast discharge

Question 31

What is the mechanism of improvement with gastric pacemaker?

Answer 31

Improvement in gastric accomodation

Question 32

What tx of scleroderma induced SIBO can be helpful?

Answer 32

Low dose night time octreotide by inducing MMC overnight

Question 33

What would rectal exam show if internal anal sphincter problem in scleroderma? What would happen on balloon expulsion?

Answer 33

Weak resting sphincter tone, normal balloon expulsion time

Question 34

Achalasia is too much of what neurotransmitter?

Answer 34

ACh

Question 35

Which type of achalasia responds best to dilations?

Answer 35

Type 2

Question 36

Besides achalasia type, which other factors predict good response to dilations?

Answer 36

Age > 45, females, smaller initial diameter

Question 37

Name the 3 types of achalasia

Answer 37

Type 1 - absent peristalsis Type 2 - pan eosphageal pressurization Type 3 - SPastic achalasia

Question 38

What is the best predictor of response in achalasia?

Answer 38

Post dilation LES pressure < 10 mmHg

Question 39

T/F: Hot meals have higher gastric empyting than cold meals.

Answer 39

False, temp does not make a difference

Question 40

What NTs are responsible for ileal brake?

Answer 40

Peptide YY & GLP1

Question 41

Best tx of CIPO?

Answer 41

Night time octreotide

Question 42

Which 2 ABs MC seen in paraneoplastic syndromes?

Answer 42

Anti-Hu AB and anti-neuronal nuclear AB

Question 43

How does neostigmine work?

Answer 43

AChE inhibitor

Question 44

Which conditions put pt at higher risk when getting neostigmine?

Answer 44

Cardiac arrhythmias, asthma, bradycardia, seizures, myasthenia gravis