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Clinical Chem I > GI Tract > Flashcards

GI Tract Flashcards

1
Q

How long is the gi tract?

A

About 8 long.

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2
Q

What organs make up the GI tract?

A

Stomach, small and large intestines, pancreas and gallbladder

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3
Q

What is the function of the GI tract?

A

Efficient digestion and absorption of ingested nutrients

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4
Q

What quantity of food and water enter the small intestine and what quantity reaches the large?

A

~10mL enters the small intestine and only ~1.5mL reaches the large

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5
Q

What is digestion?

A

Digestion is the chemical processing of food into absorbable substance

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6
Q

Where does digestion begin?

A

In the mouth

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7
Q

What are the three phases of the digestive process?

A

Neurogenic
Gastric
Intestinal

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8
Q

What happens in the neurogenic phase of digestion?

A

Sight, smell and taste of food stimulates the brain. The brain sends impulses to the stomach via the vagus nerve and this nerve innervates the stomach inducing peristalsis and gastric secretion of HCl and gastrin

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9
Q

What nerve in from the brain stimulates the stomach to release HCl and gastrin?

A

Vagus nerve

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10
Q

What does the vagus nerve stimulate in the stomach?

A

Peristalsis and gastric secretion of HCl and gastrin

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11
Q

What is the second phase of the digestive process?

A

Gastric phase

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12
Q

What phase in the digestive process is initiated by the entry of food into the stomach and stomach distention?

A

Gastric phase

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13
Q

How is the gastric phase initiated?

A

By the entry of food into the stomach and stomach stretching.

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14
Q

What is the pH of HCL?

A

1-2

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15
Q

What cells release HCl? Why?

A

The parietal cells of the stomach. Due to cell stimulation, stretching and gastrin release

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16
Q

What is the major digestive hormone of the stomach?

A

Gastrin

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17
Q

What cells release gastrin?

A

G cells

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18
Q

What is the function of gastrin hormone?

A

Gastrin causes enzyme and gastric fluid to be released, and the start of stomach motility/churning

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19
Q

This hormone causes enzymes and gastric fluids to be released, and the start of stomach motility.

A

Gastrin

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20
Q

What is the major digestive enzyme of the stomach?

A

Pepsin

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21
Q

What cells release pepsin?

A

Gastric chief cells

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22
Q

This enzyme released by gastric chief cells serve in the hydrolysis of proteins.

A

Pepsin

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23
Q

Food mixed with gastric fluid is called?

A

Chime

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24
Q

What phase of the digestive process begins when chime enters the duodenum?

A

The intestinal phase

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25
Q

What is cholecystokinin (CCK)?

A

A hormone produced by the intestinal mucosa to stimulate the gallbladder, pancreas and intestinal motility

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26
Q

What is the purpose of secretin?

A

To neutralize pH

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27
Q

What happens during digestion in the small intestine?

A

Bile and pancreatic enzymes enter the duodenum to further degrade carbs and proteins, and solubilize fats for absorption into bloodstream.

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28
Q

What intestine absorbs water, sodium and potassium, and contains bacteria to form stool?

A

Large intestine

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29
Q

What cells produce CCK?

A

Intestinal mucosa cells

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30
Q

What stimulates the secretion of CCK by the intestinal mucosa cells?

A

The presence of aa and gastric HCl entering intestine

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31
Q

What are the functions of CCK?

A

Controls the contraction of the gallbladder
Stimulates pancreas to secrete more digestive enzymes in duodenum
Increase motility of small intestine

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32
Q

List the GI tract hormones.

A 
CCK
Gastrin
Secretin 
GIP
VIP
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33
Q

What cells produce secretin?

A

Intestinal S cells

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34
Q

Secretin hormone is produced by S cells of the intestine in response to what?

A

Increase acid in duodenum

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35
Q

What are the functions of secretin?

A
  • Helps inhibit gastric H+ by stimulating HCO3 secretion from pancreas
  • Decrease bile secretion from liver/gallbladder
  • Inhibits stomach motility
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36
Q

Gastrin hormone is produced by the G cells in the stomach in response to what?

A

Distention of stomach and presence of proteins

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37
Q

What are the functions of gastrin?

A

Aid in gastric motility
Stimulate pancreatic secretions and gallbladder emptying
Stimulate secretion of gastric acid, intrinsic factor to protect Vitamin B12 in stomach

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38
Q

What hormone stimulates secretion of intrinsic factor to protect vitamin B12 in the stomach?

A

Gastrin

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39
Q

Where is Gastric inhibitory polypeptide secreted from?

A

Duodenum and Jejenum

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40
Q

What is the function of GIP?

A

Stimulate insulin release from pancreas

Reduces gastric acid secretion and motility

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41
Q

Where is vasoactive intestinal peptide secreted from?

A

From entire small and large intestines nervous system

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42
Q

What is the function of VIP?

A

Smooth muscle relaxation via CNS

Water secretion and electrolyte secretion from pancreas and gut

43
Q

What is the pancreas?

A

A highly vascular organ connected to the small intestine that synthesizes hormones (endocrine) and enzymes (exocrine)

44
Q

What is endocrine?

A

It is an organ secreting hormones or other products directly into the blood

45
Q

What is exocrine?

A

It is glands that secrete their products through duct openings onto an epithelial surface.

46
Q

What are the main regulators of the exocrine functions of the pancreas?

A

CCK and vagus nerve

47
Q

CCK and vagus nerve are the main regulators of what function of the pancreas?

A

Exocrine function

48
Q

What does the pancreatic endocrine tissue make?

A

Hormones

49
Q

What is the endocrine tissue of the pancreas?

A

Islets of Langerhans which are composed of alpha, beta and delta cells.

50
Q

Alpha, beta and delta cells of the pancreas are composed in what?

A

The islets of Langerhans

51
Q

What does the pancreatic exocrine tissue make?

A

Enzymes

52
Q

What is the exocrine tissue of the pancreas?

A

Acinar cells with ducts

53
Q

What do alpha cells do?

A

They produce glucagon

54
Q

Glucagon produced by alpha cells of the pancreas serves what purpose?

A

Stimulates the conversion of glycogen into glucose. Glycogenolysis.

55
Q

Glycogenolysis is stimulated by what?.

A

Glucagon produced by alpha cells

56
Q

What do beta cells do?

A

They make insulin

57
Q

Insulin made by beta cells serves what purpose?

A

Stimulates the formation of glycogen and aids in the entry of glucose into the cells

58
Q

What do delta cells produce?

A

Somatostatin

59
Q

What is the purpose of somatostatin produced by delta cells of the pancreas?

A

Reduces acid production in stomach and motor activity of intestines, releases pancreatic digestive enzymes

60
Q

What hormone releases pancreatic digestive enzymes?

A

Somatostatin produced by delta cells

61
Q

What cells are responsible for the exocrine function of pancreas?

A

Acinar cells

62
Q

What two analytes are used to diagnose pancreatitis?

A

Amylase

Lipase

63
Q

List the enzymes made by acinar cells?

A

Amylase
Lipase
Trypsin
Elastase-1

64
Q

What enzyme breaks down starches and glycogen?

A

Amylase

65
Q

What is the function of the enzyme amylase?

A

Breaking down starches and glycogen

66
Q

What enzyme hydrolysis fats especially triglycerides to produce free fatty acids?

A

Lipase

67
Q

What does lipase do?

A

Hydrolyzes fats, mainly triglycerides in order to produce free fatty acids

68
Q

What enzyme breaks down proteins?

A

Trypsin

69
Q

What does elastase-1 do?

A

Hydrolyzes proteins elastin and collagen

70
Q

What are the symptoms in someone’s with peptic ulcer disease?

A 
Burning pain
Bloating
Belching 
Fatty food intolerance 
Heartburn
Nausea, trouble breathing
71
Q

What is peptic ulcer disease?

A

Defect in intestinal mucosa or stomach lining

72
Q

What factors can be responsible for the development of peptic ulcers?

A

Bacteria H. pylori
Acid production from bicarbonate drugs or Z-E syndrome
Drugs; regular use of NSAIDS/ dry swallowing
Smoking/alcohol
Stress
Spicy foods
Genetics

73
Q

List the lab analysis methods for ulcers.

A

Endoscopy
Blood testing
Fecal testing
Breath testing

74
Q

What enzyme does the bacteria H. pylori produce that helps with the breathing test?

A

Urease that breaks down urea

75
Q

How does the breath test work?

A

A person contaminated with HP will have a breath sample containing radioactive carbon in the form of CO2 after given a food or drink containing urea with radioactive carbon isotope

76
Q

What is Zollinger-Ellison syndrome?

A

This is extreme elevation in serum gastrin levels from gastrin secreting tumor; gastrin a from stomach, pancreas or duodenum which causes greatly elevated gastric HCl from parietal cells and numerous ulcers in stomach and duodenum

77
Q

What cells secrete intrinsic factor?

A

Parietal cells of the stomach

78
Q

What does intrinsic factor do?

A

Protects vitamin B12 in acidic environments

AIDS in B12 absorption

79
Q

What is pernicious anemia?

A

Autoimmune disorder characterized by anemia due to lack of B12 secondary to intrinsic factor deficiency

80
Q

Why does lack of B12 cause anemia?

A

Vitamin B12 is important for DNA synthesis and impaired DNA synthesis causes megaloblastic anemia

81
Q

What is celiac disease?

A

This is an autoimmune response to gluten which results in intestinal inflammation, shortening of the villi that lines the small intestine causing poor absorption of nutrients and diarrhea.

82
Q

What causes lactose intolerance?

A

Hereditary links

Acquired through age

83
Q

How is lactose intolerance tested?

A

Measurement of breath hydrogen

Serum/plasma measurement of glucose

84
Q

How does hydrogen breath test determine lactose intolerance?

A

Increased hydrogen in breath identifies LI

85
Q

What is inflammatory bowel disease?

A

Chronic inflammation of some part of the GI tract.

86
Q

Name two inflammatory bowel diseases.

A

Crohn’s disease

Ulcerative colitis

87
Q

What is Crohn’s disease?

A

Chronic inflammation of the small intestine usually but can be anywhere from mouth to anus in which damaged areas appear in patches that are next to areas of healthy tissues.

88
Q

What is ulcerative colitis?

A

Chronic inflammatory of the large intestine only in which damaged areas are continuous and not patchy, usually starting at the rectum and spreading further into the colon. Inflammation present only in the innermost layer of the lining of the colon

89
Q

What is the disease in which there is inflammation of the large intestine starting from rectum going into the colon with inflammation present only in the innermost lining of the colon

A

Ulcerative colitis

90
Q

What disease is the most common lethal defect in white/European ancestry?

A

Cystic fibrosis

91
Q

What is cystic fibrosis?

A

An autosomal recessive disorder with dysfunctional exocrine glands throughout the body (sweat, pancreas, lung, saliva)

92
Q

What gene is mutated in cystic fibrosis?

A

CFTR

93
Q

What causes death in cystic fibrosis patients?

A

Pneumonia and intestinal malabsorption

94
Q

What test is made to diagnose cystic fibrosis?

A

Sweat tests where sweat electrolytes are tested using pilocarpine nitrate to stimulate sweating and measure chloride which is elevated in CF patients

95
Q

What electrolyte is elevated in CF patients?

A

Chloride

96
Q

What is pancreatitis?

A

Inflammation of the pancreas associated with alcohol abuse, DM, gallbladder disease or lipid disorders

97
Q

What is the major cause of inflammation in pancreatitis?

A

Tissue damage caused by pancreatic enzymes leaked into pancreatic tissue

98
Q

What is the end the acute and chronic phase of pancreatitis?

A

In acute phase, there’s severe pain and elevated pancreatic enzymes in serum while in chronic phase, there’s compromised digestion, malabsorption, hyperglycemia, and elevated enzymes although not as high as in acute phase.

99
Q

What is the most specific marker of acute pancreatitis?

A

Lipase

100
Q

List tumors of the pancreas

A

VIPoma
Insulinoma
Glucagonoma
Pancreatic carcinoma

101
Q

What is the most common pancreatic tumor?

A

Pancreatic carcinoma

102
Q

What is pancreatic carcinoma?

A

Tumor of the pancreatic duct, leading to destruction of pancreas, obstruction of bile duct.

103
Q

The following tests are lab analysis of GI disorders.

A

Breath test for HP
Ab test from serum/plasma
Ag test from stool
Lactose intolerance test (fasting blood glucose after two hours)
Pancreatic enzymes (lipase and amylase)
CF chloride sweat test
Gastric fluid analysis, plasma gastrin analysis, fetal fat, elastase in stool

Clinical Chem I (17 decks)

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