Week 2

Question 1

Cholesterol esters and Triglycerides are located in the hydrophobic core of the macromolecule, surrounded by phospholipids and apoproteins

Answer 1

Lipoproteins

Question 2

Chylomicrons
VLDL
LDL
HDL

Answer 2

Four types of lipoprotein

Question 3

Relationship of proteins to density

Answer 3

The more protein, the more dense, as protein is more dense than lipids

Question 4

first step of chyloformation

Answer 4

diary fat eaten, salivary lipase secreted, presence of free fatty acids, monoglycerides, cholesterol.

Question 5

Presence of fat globules, hard to break up, what is secreted?

Answer 5

bile salts

Question 6

what do bile salts do?

Answer 6

make surface-optimized fat droplets

Question 7

what breaks up surface-optimized fat droplets into micelles?

Answer 7

pancreatic lipase

Question 8

what breaks up micelles into chylomicrons?

Answer 8

enterocytes

Question 9

name three apoproteins that bind to chylomicrons in the lymphatic system

Answer 9

ApoB48, ApoC2, ApoE

Question 10

what does ApoB48 do?

Answer 10

Micelles secretion of chylomicrons from GI to lymph

Question 11

what does ApoC2 do?

Answer 11

Hydrolyzes conversion of TG to Fatty Acids for absorption (LPL)

Question 12

What does ApoE do?

Answer 12

Mediates reuptake of multiple remnants

Question 13

what organ secretes VLDL?

Answer 13

Liver

Question 14

what does VLDL carry?

Answer 14

Triglycerides and cholesterol

Question 15

ApoC2 activates LPL which then does what?

Answer 15

cut and cleave TG and FA, converts VLDL into IDL that carries TG and cholesterol in it with ApoB100 and ApoE bonded on its surface

Question 16

low density lipoprotein

Answer 16

chylomicrons

Question 17

medium low density lipoprotein

Answer 17

VLDL

Question 18

medium high density lipoprotein

Answer 18

LDL

Question 19

high density lipoprotein

Answer 19

HDL

Question 20

How does lipoprotein change in the small intestine?

Answer 20

from low density to high density

Question 21

which is “bad” type of lipoprotein that forms plaques and causes arteriosclerosis?

Answer 21

LDL

Question 22

what is main component in low density lipoproteins?

Answer 22

triglycerides

Question 23

Main component in “bad” lipoprotein?

Answer 23

cholesterol (50%)

Question 24

Main component in “good” lipoprotein?

Answer 24

Protein (50%)

Question 25

HDL comes from where?

Answer 25

"nascent HDL" comes from LV and SI

Question 26

ApoA1 in bloodstream activates Lecithin-Cholesterol Acyltranserase (LCAT) does what?

Answer 26

converts NaSCENT HDL into Mature HDL that carries ApoE and ApoC2 on its surface

Question 27

how long do glycogen stores last?

Answer 27

1 day

Question 28

how long do fat stores last?

Answer 28

3 days

Question 29

how long do protein stores last?

Answer 29

1+ week

Question 30

after 1-3 days, what is the fuel source?

Answer 30

Hepatic gluconeogenesis, driven by Alanine and Lactate fort the brain

Question 31

since RBCs have no mitochondria, the cannot use what

Answer 31

keynotes

Question 32

insulin drives what state?

Answer 32

"Fed" state (storage of protein, carbohydrates, fat)

Question 33

priority targets for fuel sources

Answer 33

Brain and RBCs

Question 34

what is most common Gi diagnosis in primary care visits?

Answer 34

GERD

Question 35

Definition of GERD

Answer 35

a condition which develops when the reflux of stomach contents causes troublesome symptoms and/or complications Reflux that is not troublesome is not GERD “Troublesome”: mild symptoms 2 or more times/week or severe symptoms 1 or more times/week

Question 36

Sx of GERD

Answer 36

* Chest pain * Chronic cough * Chronic laryngitis * Asthma * GERD often not the sole cause of atypical symptoms * Atypical symptoms without concomitant heartburn/reflux unlikely to be due to GERD

Question 37

Defensive factors in GERD

Answer 37

Lower Esophageal Sphincter Upper Esophageal Sphincter Peristalsis Saliva Bicarbonate

Question 38

Aggressive factors in GERD

Answer 38

Hiatus Hernia Acid Pepsin Bile acids Trypsin Alcohol Acidic foods

Question 39

Nervous activity in GERD

Answer 39

Question 40

Hallmark Sx of GERD is

Answer 40

Heartburn

Question 41

in GERD, LES is

Answer 41

Transiently relaxed, has decreased resting tone

Question 42

Two typical complications of GERD

Answer 42

Erosive Esophagitis Barrett's Esophagus

Question 43

Answer 43

Erosive Esophagus

Question 44

Answer 44

Barrett's Esophagus, replacement of squamous cells to columnar cells, beginning of potential malignancy

Question 45

Problem with sympathetic stimulation from GERD?

Answer 45

Sympathetic stops digestion, stomach stagnates, acidity goes up, reflux happens, gastric emptying is delayed.

Question 46

Answer 46

Esophageal Adenocarcinoma

Question 47

Alarm Sx of GERD

Answer 47

* Weight loss * Bleeding * Dysphagia * Family history of esophageal or gastric cancer

Question 48

EGD (upper endoscopy) prompted by?

Answer 48

* Refractory to treatment * Long duration of symptoms * Atypical symptoms, dysphagia

Question 49

EGD (upper endoscopy) sees normal esophagus in how many patients with heartburn and regurgitation?

Answer 49

2/3

Question 50

Presence of erosive esophagus confirms GERD?

Answer 50

Yes

Question 51

Relationship b/t GERD and BMI

Answer 51

Positive correlation

Question 52

Surgical solutions to GERD

Answer 52

Bariatric Surgery Sleeve Gastrectomy

Question 53

Bariatric surgery

Answer 53

Roux-en-Y Gastric Bypass. Make stomach pouch, connect to duodenum. Connect duodenum to middle LI. Reduces Reflux Clinical trial shows big success

Question 54

Sleep Gastrectomy

Answer 54

Increases Reflux, LES is modified, provoking a decrease in LES resting pressure

Question 55

Major Histamine Producing Cells, Study This!

Answer 55

Question 56

Histamine 1

Answer 56

Question 57

Histamine 2

Answer 57

Question 58

Two types of medications

Answer 58

H2 Receptor Antagonists PPI (Proton Pump Inhibitors)

Question 59

What do H2R receptor antagonists and PPIs do?