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HECK CCP Flashcards

(58 cards)

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1
Q

Why does gas collect in gut because of pneumatosis intestinalis

A

bacteria byproduct

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2
Q

What is the major cause of SBS

A

necrotizing enterocolitis

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3
Q

What is the clinical presentation of NEC

A

bloody stools, distended abdomen, radiographic presentation pneumatosis intestinalis

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4
Q

Why does NEC not occur before birth

A

because before birth the intestine is sterile, no bacteria colonization

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5
Q

What are risk factors for necrotizing enterocolitis

A

prematurity
intestinal ischemia
bacterial colonization
enteral feeding (milk and formula)

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6
Q

What parts of the intestine are involved in NEC

A

terminal ileum, cecum and right colon

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7
Q

Microscopically what does NEC look like

A

mucosal or transmural necrosis, ulceration and or submucosal gas bubbles

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8
Q

Ischemia can lead to what in cells

A

decreases oxidative phosphorylation in mitchondria which leads to dec Na pump so influx and swelling/bursting also dec ATP so increase anaerobic glycolysis so lactic acidosis and decreaed protein synthesis

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9
Q

What are the results of mitchondrial dysfunction

A

necrosis and apoptosis

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10
Q

What cells are responsible for innate immune defense in intestines

A

paneth cells in the crypts

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11
Q

What type of control is there for proinflammatory and proapoptotic signaling pathways

A

neg feedback

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12
Q

Describe intrinsic and extrinsic paths for apoptosis

A

extrinsic through MAMPs and caspase 8

intrinsic through cytochrome C and caspase 9

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13
Q

What is secreted in SI and what is absorbed

A

secreted: Pancreatic secretions, bile, HCO3
absorbed: water, Na, K, Cl

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13
Q

What is secreted in SI and what is absorbed

A

secreted: Pancreatic secretions, bile, HCO3
absorbed: water, Na, K, Cl

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14
Q

What transport occurs in duodenum and proximal jejunum

A 
Nutrient coupled Na
Na/H exchanger (without Cl-HCO3)
Passive Cl absorption
Cl secretion through CFTR
Carbs, prteins, lipids, Ca Fe, Folate
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14
Q

What transport occurs in duodenum and proximal jejunum

A 
Nutrient coupled Na
Na/H exchanger (without Cl-HCO3)
Passive Cl absorption
Cl secretion through CFTR
Carbs, prteins, lipids, Ca Fe, Folate
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15
Q

Where is folate exclusively absorbed

A

duodenum

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15
Q

Where is folate exclusively absorbed

A

duodenum

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16
Q

What pancreatic secretions are very important to micelles

A

pancreatic lipase and phospholipase A2

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16
Q

What pancreatic secretions are very important to micelles

A

pancreatic lipase and phospholipase A2

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17
Q

What biliary secretions are important to micelles

A

bile salts

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17
Q

What biliary secretions are important to micelles

A

bile salts

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18
Q

Where are majority of GI hormones released

A

duodenum and proximal jejunum

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18
Q

Where are majority of GI hormones released

Study These Flashcards
A

duodenum and proximal jejunum

19
What hormone is secreted still in ileum
CCK
19
What hormone is secreted still in ileum
CCK
20
What hormone is secreted in stomach
gastrin
20
What hormone is secreted in stomach
gastrin
21
What most patients who lost duodenum and jejunum be monitored for
Na, H2O, Fat soluble Vitamins, Ca, Mg, PO4 and Fe3+
21
What most patients who lost duodenum and jejunum be monitored for
Na, H2O, Fat soluble Vitamins, Ca, Mg, PO4 and Fe3+
22
What absorption secretion happens in the ileum
Na absorption through NaH and Cl-HCO3 exchangers Cl absorption Cl-HCO3 exchanger, parallel exchangers (electroneutrality) K absoprtion, passive
22
What absorption secretion happens in the ileum
Na absorption through NaH and Cl-HCO3 exchangers Cl absorption Cl-HCO3 exchanger, parallel exchangers (electroneutrality) K absoprtion, passive
23
What foods and nutrients occur in the ileum
carbs, proteins, lipids, Ca, iron and folate, bile acids and cobalamin
23
What foods and nutrients occur in the ileum
carbs, proteins, lipids, Ca, iron and folate, bile acids and cobalamin
24
what are major problems with consequences of loss of ileum
Vit B12 déficience steatorrhea(no bile salts) diarrhea (increased bile salts in colon
24
what are major problems with consequences of loss of ileum
Vit B12 déficience steatorrhea(no bile salts) diarrhea (increased bile salts in colon
25
What will the diarrhea contents be in cases of loss of ileum
increase H2O, Na, and Cl
25
What will the diarrhea contents be in cases of loss of ileum
increase H2O, Na, and Cl
26
What ions are secreted/absorbed in colon
secreted: K absorbed: water, Na, Cl
26
What ions are secreted/absorbed in colon
secreted: K absorbed: water, Na, Cl
27
What mechanisms are in the colon
``` parallel NaH and ClHCO3 exchangers epithelial Na channel passive Cl absorption ClHCO3 exchanger and parallel ones passive/active K secretion active K absorption ```
27
What mechanisms are in the colon
``` parallel NaH and ClHCO3 exchangers epithelial Na channel passive Cl absorption ClHCO3 exchanger and parallel ones passive/active K secretion active K absorption ```
28
What type of fatty acid does the colon absorb
short chain fatty acid product of bacterial metabolism exchanged for bicarb
28
What type of fatty acid does the colon absorb
short chain fatty acid product of bacterial metabolism exchanged for bicarb
29
What are the consequences with loss of colon
inability to salvage lost water and Na | decreased intestinal transit time
29
What are the consequences with loss of colon
inability to salvage lost water and Na | decreased intestinal transit time
30
consequences of losing ileocecal valve
bacterial overgrowth syndrome colonic bacteria in small intestine results in D lactic acidosis
30
consequences of losing ileocecal valve
bacterial overgrowth syndrome colonic bacteria in small intestine results in D lactic acidosis
31
when absorption adapts after resection what occurs to that area
hypertrophy and hyperplasia
31
when absorption adapts after resection what occurs to that area
hypertrophy and hyperplasia
32
over time how does the bowel change after fast adaptation
bowel will lengthen and dilate
32
over time how does the bowel change after fast adaptation
bowel will lengthen and dilate
33
What transporters specifically increase in adaptive changes after SBS resection
SGLT1 PepT1 and NHE-3(NaH)(with ClHCO3)
33
What transporters specifically increase in adaptive changes after SBS resection
SGLT1 PepT1 and NHE-3(NaH)(with ClHCO3)
34
How can a baby be fed with SI removed
parental(IV)
34
How can a baby be fed with SI removed
parental(IV)
35
What is the determining factor for survival of SI after resection
length of small bowel and presence of the ileocecal valve
35
What is the determining factor for survival of SI after resection
length of small bowel and presence of the ileocecal valve

GI II (12 decks)

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