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AAW - GI > Week 1 > Flashcards

Week 1 Flashcards

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1
Q

innervation to the submandibular gland

A 
superior salivatory nucleus
facial nerve
chorda tympani, 
trigeminal nerve's lingual nerve
submandibular ganglion.
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2
Q

innervation to the parotid

A 
Inferior salvitory nucleus to
glossopharyngeal to
tympanic to
lesser petrosal to
otic ganglion to
auriculotemporal (branch of the mandibular)
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3
Q

innervation to sublingual gland

A

chorda tympani off of facial nerve
lingual nerve
submandibular ganglion

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4
Q

white adipose tissue role in metabolism of sugars

A

Ferments glucose to glycerol 3-phosphate, the backbone for triacylglycerol synthesis.

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5
Q

why do you have high insulin in a hypercatabolic state

A

you need a little insulin around for protein synthesis

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6
Q

amylose

A

a bunch of glucose linked (1,4)

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7
Q

amylopectin

A

chains of glucose in 1,4 linkages that are linked to other chains (1,6)

chemically similar to glycogen, but not as branched

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8
Q

four enzymes at the brush border of the gut epithelial cells

A

breakdown di and tri saccharides into mono

maltase-glucoamylase. An exoglycosidase - cleaves a 1-4 bond of maltose to form two molecules of glucose - it is the exoglycosidase version of alpha-amylase - activity is highest in illium - lysosomal alpha1,4-glucosidase (acid maltase) is defective in pompe disease (pompe trashes the pump - heart liver muscle)

sucrase/isomaltase complex - two extracellular domains with different substrate specificities - the isomaltase activity cuts the 1,6 bonds in amylopectin, the sucrose domain cuts sucrose - activity is highest in jejunum (in the liver, deficiency of the 1,6 debranching enzyme is cori disease (milder form of von girke with no increase in blood lactate))

trehalase - cleaves trehalose - disaccharide of glucose (1,1)

beta-glycosidase complex - b-glycosidase complex is a glycophosphatidylinositol (GPI) glycan anchored protein with two catalytic domains.
Glucosyl ceramide domain: Cuts glucose and galactose from glucosylceramide and galatosylceramide
Lactase domain: Splits the 1,4 bond in lactose to make galactose and glucose. (loss of beta-glucosidase in lysosomes –> gauchers!!)

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9
Q

endoglycosylase

A

e.g. amylase

cuts carbohydrates into di and tri saccharides `

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10
Q

amylase activity is highest in this part of the gi tract

A

duodenum

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11
Q

why did i get diarrhea when i ate a whole tub of cottage cheese that one time

A

Without lactase, bacteria ferment lactose to lactic acid. Water enters the lumen of the gut to balance difference in proton concentration, causing diarrhea.

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12
Q

sucrase

A

cleaves sucrose to fructose and glucose

its how high fructose corn syrup is made ya dingus

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13
Q

in hypercatabolism, what hormone causes muscle protein breakdown

A

cortisol

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14
Q

How does Epinepherine cause the “ebb” phase in hypercatabolism

A

it activate hormone sensitive lipase, which moves fatty acids out of the adipose

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15
Q

Most important hormone for storage in fed state

Most important enzyme for catabolism

A

Insulin

Glucagon (when glucose in gone)

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16
Q

What are Insulin’s actions intracellularly?

A

Tyrosine kinase transmembrane protein, leads to inactivation of Glycogen phosphorylase and activation of glycogen synthase.

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17
Q

where do preganglionic sympathetic neurons lie in the spinal chord

A

intermediolateral cell column

in the thoracolumbar (t1 to l2)

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18
Q

what are the names for the nerves that leave the intermediolateral cell column and go straight to the organs without going into the prevertebral ganglia

A

splanchnic

the go to peripheral ganglia

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19
Q

pregangionic parasympathetic origins for the gut

A

vagus and S2,3,4

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20
Q

what does the vagus “turn into” below the level of the trachial bifurcation

A

the esophageal plexus

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21
Q

nerve that supplies motor to the diaphragm

A

phrenic

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22
Q

what part of the colon does the vagus supply

A

the midgut and foregut derived parts

transverse colon, proximal colon

BASICALLY IT STOPS AT THE SPLENIC FLEXURE SHE SAID

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23
Q

which part of the vagus - anterior or posterior - supplies the greater curvature of the stomach

A

posterior supplies greater

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24
Q

what supplies the posterior and lower portions of the colon with parasympathetic activity

A

pelvic splanchnic

(cell bodies in s234)

they leave the motor neurons they were traveling with and enter the inferior hypogastric plexus

then they follow the inferior hypogastric plexus to the organs right there, or they can travel all the way up to the superior hypogastric plexus (which is near the inferior mesenteric artery) and ride with that to innervate sections of the hindgut

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25
pudendal nerve
from s234 carrying sensation and voluntary motor to the external urinary and anal sphincter
26
Odynophagia vs dysphagia
Odynophagia - pain on swallowing vs dysphagia - symptom resulting from the failure to move a food bolus from the mouth to the stomach
27
esophageal dysphagia solids only - intermittent solids only - progressive solids/liquids - intermittent solids/liquids - progressive
solids only - intermittent - lower esophageal ring solids only - progressive - peptic stricture or cancer (esp. if >50) solids/liquids - intermittent - diffuse spasm, NEMD, Nutcracker solids/liquids - progressive - Achalasia, scleroderma (CREST)
28
where and what are the names of the four papillae of the tounge
filliform - cover most of the tounge - keratinized and v-shaped fungiform - larger papilli that are fewer in number and scattered throughout the tounge circumvallate - large round papillae at the posterior of the tounge foliate papillae - on the sides
29
what papilla are keratinized
filliform
30
what papillae are club shaped
fungiform - they have a expansive lamina propria, non-keratinized
31
what papillae are supplied by cranial nerve 7
fungiform
32
what papillae are supplied by the glosopharingeal
circumvallate
33
smallest type of ducts
intercalated ducts
34
what gives striated ducts their striated apperance
ER
35
myoepithelial cells
specialized smooth muscle cells between serous and/or mucous cells and basement membrane assist in discharge from the secretory cells
36
what alveoli stain very darkly
serous alveoli, because they have a lot of ER for making protein
37
what type of epithelium is on the papillae of the tounge
stratified squamous
38
pyogenic granuloma
polypoid red lesion composed of lobular reactive proliferation of capillaries usually on the gingiva in children, young adults, pregnant women
39
what gives leukoplakia its white appearance
hyper or parakeratosis
40
actinic chelitis
leukoplakic lesion of the lower lip with loss of the distinct demarcation between the lower lip vermilion border and the skin of the lip actinic keratosis of the bottom lip hyperkeratosis and connective tissue solar elastosis
41
adenoid cystic carcinoma
slow growing salivary gland neoplasm relentless in its growth and can invade the perineurium of nerves around it Despite surgical resection, 50% disseminate to lungs, bone, liver, and brain, often decades after removal. While 5-year survival rate is 60-70%, survival drops to 30% at 10 years and 15% at 15 years
42
you see a bunch of eosinophils and neutrophils on an esophageal biopsy is it eosinophillic esophagitis?
no in EE you don't see neutrophils
43
chondromyxoid stroma and epithelium what you thinkking
pleomorphic adenoma
44
patient comes in with pellagra like symptoms and neutral aminoaciduria
hartnup disease, inherited mutations in the B(not) transporter ( SLC6A9 transporter) failure to absorb tryptophan (tryptophan is used to synthesize niacin)
45
cystinuria defect
defect in the B(not)+ (SLC7A9 transporter) gene leads to basic aminoaciduria causing kidney stones cannot uptake cystine (not cysteine)
46
structure of glutathione
glycine-cystine-glutamate glutamate is "rotated" 180 degrees
47
enzyme that can cleave glutathione
gamma-glutamyl transpeptidase (GGT) increased in various liver and biliary diseases (just as ALP can), but not in bone disease; associated with alcohol use
48
AMPK role
inhibits protein synthesis by activating TSC1 and 2, which blocks mTORC1 promotes autophagy and catabolism metformin makes it active, tricking the cell into thinking that it is in an energy deprived state
49
key cofactors in aminoacid metabolism
pyridoxal phosphate (B6) (PLP) - transaminations (ALT and AST use it), deaminations, carbon chain transfers. Synthesis of cystathionine, heme, niacin, histamine, and neurotransmitters like serotonin, epi, norepi, dopamine, and GABA (def causes - seizures, diarrhea, sideroblastic anemia (impared heme synthesis and iron excess), EEG abnormalities) tetrahydrofolate (B9) - one carbon transfers (def causes - megaloblastic anemia) tetrahydrobiopterin - ring hydroxylations (phe -> tyr) (def causes - PKU - seizures, developmental delays, fair skin, eczema, musty body odor) (PKU also can be from Phe hydroxylase def)
50
what activates lipoprotein lipase
ApoC-II its in the capillary beds
51
what hormone causes the pancrease to secrete its enzymes
secretin
52
what turns triacylglycerols in micelles into 2 fatty acids and a 2-monoacylglycerol
pancreatic lipase the products can be taken up by gut epithelial cells
53
nascent chylomicrons vs mature
mature contains Apoc-II, ApoE both have ApoB-48
54
what particle functions to distribute fat synthesized from carbohydrates to tissues
VLDL
55
where is vit A stored in the liver
Stellate cell
56
what molecule changes shape in you rod cells in the retina to signal to the brain that light is hitting it
cis-retinal gets converted to trans-retinal cis retinal is bound to opsin. when it becomes trans-retinal, it dissociates and activates a g-protein coupled sodium channel which opens and HYPERpolarizes the rod cell. it is then recycled to cis-retinal
57
retinoic acid's effect on b-cells
stimulates them to move to the gut
58
main functions of vitamin K
carboxylation, coagulation
59
function of coumadin
blocks vitamin K epoxide reductase, cannot regenerate the hydroquinone version of vitamin K
60
vitamin D can be synthesized de novo from what
cholesterol
61
cholesterol gets converted to this form of vitamin D when hit with UV light
cholecalciferol gets 25-hydroxylated in liver 1-hydroxylase in kidney (active form) (responsive to parathyroid hormone)
62
TRPV6 function
takes up calcium at the brush border is upregulated when activated vitamin D does its business as a transcription factor
63
calbindin function
once calcium gets into the gut epithelial cell, this transports it from the TRPV6 channel to the Ca/ATPase which puts Ca into the blood
64
how does vit D prevent colorectal cancer
stabilizes beta-catenin
65
this blocks the action of parathyroid hormone
calcitonin also it is a medullary thyroid carcinoma tumor marker
66
function of calmodulin
Carries calcium around the cell and example he talked about: If epi or norepi hits a muscle cell, it activates phopholipase C, making IP3, which makes the ER secrete Ca, which binds calmodulin and then: shuts off glycogen synthase turns on glycogen phosphorylase
67
high doses of this can be used to treat hyperphosphatemia secondary to kidney failure
Ca | blocks phosphorous uptake
68
mutation in thiazide sensitive NaCl transporter what are your ion disturbances
gitelman syndrome hypomagnesemia, hypokalemia, hypocalciuria
69
bacteria breaks down stuff to provide fuel for colonocytes what is the stuff?
they break down fiber into short chain FA get uptaken by monocarboxylate transporter
70
SCFAs effect our immunity how
act as a ligand for GPR43 e.g. in the macrophage inflammatory cytokines go down, IL-10 goes up (antiinflammatory.
71
GPR43 in adipose
decreased fat storage as TAG, and insulin sensitivity when activated
72
what does PKB/Akt do
it is a downstream signal of insulin binding. inactivates glycogen synthase kinase activates protein phosphatase 1 (PP1), which makes: - glycogen synthase is DEPHOSPHORYLATED and ACTIVE - glycogen phosphorylase is DEPHOSPHORYLATED AND INACTIVE. INSULIN --> DEPHOSPHORYLATION --> SYNTHESIZE GLYCOGEN
73
what happens to glucagon if you eat a protein rich meal
After eating a protein rich meal, elevated amino acids in the blood increase the secretion of glucagon by pancreatic alpha cells. In this case, excess amino acids are used by the liver for gluconeogenesis
74
in the fed state, gut epithelial cells use what as their primary fuel
glutamine, aspartate, gluatmate
75
insulin and glucagon which for PKA, which for PKB (downstream molecules)
insulin for PI3 --> PKB (think beta cells) | glucagon for cAMP --> PKA (think alpha cells!)
76
Insulin and glucagon - which one causes a net phosphorylation event? dephosphorylation?
glucagon --> PKA --> phosphorylation Insulin --> PKB --> dephosphorylation glucagon as an example: Glucagon causes: Glycogen phosphorylase kinase phosphorylation and activation: Glycogen phosphorylase is subsequently phosphorylated and activated (remember glycogen phosphorylase breaks down glycogen stores for use) Also Glycogen synthase is phosphorylated and inactivated by glucagon
77
what happens to glycogen synthase when it is phosphorylated
it is inactivated
78
the ATP power to drive gluconeogenesis comes from what source
the FAD2H and NADH reduced by fatty acid beta oxidation
79
glucose enters the gut epithelial cell from the blood to be used as fuel. how is it used? What is the primary source of food for the enterocyte in the fasting state\?
it is fermented to pyruvate, which is used as a nitrogen acceptor from glutamate to make alanine, which is exported back into the blood primary source of food is glutamine, but from the blood, not from the lumen (glutamine is also the primary food source for lymphocytes)
80
what signalling molecule mobilizes FA from adipose tissue during hypercatabolism
epinephrine activating hormone sensitive lipase
81
nitrogen balance equation
Nitrogen balance = nitrogen intake – (urinary urea nitrogen + 2)
82
where is apob-48 made | 100?
RNA editing produces ApoB-48 in intestinal epithelial cells. The unedited transcript produces full length ApoB-100 in hepatocytes

AAW - GI (7 decks)

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