The Gut

Question 1

what does the stomach do

Answer 1

breaks down food

Question 2

what does the small intestine do

Answer 2

this is where major absorption takes place

Question 3

what does the large intestine do

Answer 3

• controls water balance and electrolyte balance

Question 4

what is absorbed in the small intestine

Answer 4

FE
CHO
folate
protein 
fat 
B12 - specifics site in the terminal ileum for absorption 
bile acids

Question 5

how much fat is in the faces

Answer 5

less than 17 mmol

Question 6

how much protein is in the faeces

Answer 6

12g

Question 7

how much carbohydrate is in the faeces

Answer 7

• non it is all absorbed and used

Question 8

the absorptive capacity of the small intestine….

Answer 8

remains the same the whole way through

Question 9

what are common GI problems

Answer 9

• Reflux/heartburn
• Dyspepsia – problem with intergestion
• Iron deficiency anaemia
• Diarrhoea
• Pain
• Jaundice

Question 10

what are the problems in the oesophagus

Answer 10

Reflux – oesophagitis
Hiatus hernia
Lack of propulsion
Cancer

Question 11

what is another word for oesophagus

Answer 11

oesophagitis

Question 12

describe oesphagitis

Answer 12

symptoms

• heartburn
• it is positional
• there is poor correlation with symptoms

can be differentiated from angina which can cause pain in the heart

caused
- it is caused when the pH goes below 4 in the intraluminal of the oesophagus

Question 13

describe barrets oesophogus

Answer 13

• long standing reflux
• pre malignant - or adenocarcinoma
• mucosa is usually pale and white but there is redness in it

Question 14

who does barrettes oesophagus tend to effect

Answer 14

middle-aged men

Question 15

how can barrets oesophagus or any oesophagus constriction be shown

Answer 15

• can use barium swallowing

Question 16

what does the stomach produce

Answer 16

• acid
• intrinsic factor gastrin
• pepsinogen (this can be converted to pepsin in the duodenum where it becomes active and digests peptides)

Question 17

what are the problems that can develop with the stomach

Answer 17

Gastritis 0- means inflammation
Gastric Ulcer
Pernicious anaemia
Cancer

Question 18

how does the stomach produce acid

Answer 18

Histamin receptor (H2) stimulates GS
Stimulates ATP and cAMP
Produces protein kinases
Produces acid

Question 19

how can you stop the stomach producing acid

Answer 19

use H2 receptor antagonists blocking the histamine from working and the production of cAMP
use a proton pump inhibitor - this prevents the formation of hydrogen ions

Question 20

what causes peptic ulcers

Answer 20

helicobacter pylori

Question 21

describe helicobacter pylori

Answer 21

it is a Class I carcinogen
increases the Risk of Gastric carcinoma 3-6x
causes most peptic ulcers

Question 22

what makes up the small intestine

Answer 22

duodenum
jejenum
ileum

Question 23

what do the vili do in the small intestine

Answer 23

increase the absorptive area

Question 24

describe the defect of the small intestine

Answer 24

• Defence against antigens
• GALT – Peyer’s patches
-Scattered lymphoid cells

Question 25

the small intestine is..

Answer 25

the biggest lymphoid organ in the body

Question 26

describe the structure of the small intestine

Answer 26

- Villi - Lympathetics and blood vessles - Microvilli - Glycocalyx - Increases surface area

Question 27

what are the symptoms caused by infection of the small intestine

Answer 27

- Diarrhoea/ steatorrhoea - Abdominal pain/discomfort - Weight loss - Nutritional deficiencies e.g. iron

Question 28

what are the problems that can be caused by the small intestine

Answer 28

- Coeliac disease - Crohn’s disease - Infection/infestation

Question 29

how many people does coeliacs disease effect

Answer 29

1:100

Question 30

what does coeliac disease cause

Answer 30

malabsorption

Question 31

how do you diagnose calicos disease

Answer 31

Serology –EMA, tTG (IgA),DGP | Duodenal biopsy –villus atrophy

Question 32

what does Crohn's disease effect

Answer 32

``` Mouth to anus Terminal Ileum ++ Transmural Fissures, fistulae Crohn’s Colitis ```

Question 33

describe ulcerative colitis

Answer 33

- Colon and backwash ileitis - Superficial - Can be precancerous

Question 34

what are the problems that can develop with the colon and rectum

Answer 34

Diverticular disease Inflammatory bowel disease(CD/UC) Cancer Rectum- haemorrhoids

Question 35

describe diverticular disease

Answer 35

- Little bit of stool is stuck of diverticular | - May cause IBS symptoms

Question 36

how do you see the distribution of colorectal cancer

Answer 36

- can be looked at with a simodiscope | - usually look at the whole colon

Question 37

how do you get rid of colonic polyp

Answer 37

use the colonoscopy - cut it from the colon using a wire - suck it onto the end of the endoscope and bring it out