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GI > Week 3 > Flashcards

Week 3 Flashcards

0
Q

extensions that increase surface area in small intestine

A

microvilli(plasma membrane), villi (lamina propia), plicae circulares(mucosal folds)

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1
Q

three regions of the small intestine

A

duodenum, jejunum, ileum

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2
Q

most common cell found lining villus

A

enterocytes (terminal digestion and absorption of water and nutrients)

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3
Q

What cells secrete mucin?

A

goblet cells

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4
Q

how often is the intestinal epithelium replaced in humans?

A

every 3-6 days

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5
Q

what is the lamina propria’s immune defense system?

A

Gut-Associate Lymphoid Tisse (GALT)

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6
Q

What is a collection of lymphoid nodules in the GALT?

A

Peyer’s Patches

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7
Q

What can be found in the submucosa?

A

Brunner’s gland: alkaline mucus

Meissner’s plexus: fluid secretion in small intestine

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8
Q

parts of the large intestine

A

cecum, appendix, colon, rectum, anus

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9
Q

Does the large intestine have villi? What cells are absent from the crypts?

A

No. Paneth cells.

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10
Q

How do hemorrhoids occur?

A

Enlargement of hemorrhoid plexuses, especially in pregnancy and old age

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11
Q

What are mucus’s role in host defense?

A

mucus-commensal interactions, bacterial exclusion, containment of secreted antibodies/antimicrobials

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12
Q

What are the paneth cell AMPS?

A

defensins (form pores), lysozyme (hydrolyze peptidoglycan), phospholipase A2 (hydrolysis FA in bacterial cell wall), RegIIIy (bind peptidoglycan), CRS (like cryptdins)

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13
Q

Which secreted immunological defenses are most commonly found in mucosal secretions?

A

sIgA (most common), IgM, IgG—low levels IgE(allergic)

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14
Q

IgA biological activities

A

inhibit adherence, mucus trapping, virus neutralization, enzyme/toxin neutralization, inhibition of antigen penetration

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15
Q

Which disease is associated with local IgA deficiency?

A

Meningitis (proteases)

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16
Q

Where in the GI tract is the greatest diversity of microbial species?

A

colon

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17
Q

If you live in the west and eat a typical western diet, what bacteria would be prevalent in your gut?

A

bacteriodes enterotype

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18
Q

What is the microbe shift in inflammatory bowel disease?

A

from obligate anaerobic bacteria to facultative anaerobe species (esp. proteobacteria)

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19
Q

Three stages at which enzyme secretion is controlled

A

cephalic (Ach)
gastric (ACh, gastrin)
intestinal (CCK, secretin)

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20
Q

Two signals for bicarb secretion by pancreatic duct cells

A

acetylcholine, secretin (most powerful)

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21
Q

Where are fats absorbed in the GI tract?

A

duodenum, jejunum

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22
Q

What are the functions of thiamine/B1?

A

cofactor pyruvate dehydrogenase (decarboxylation)
cofactor pentose phosphate pathway (NADPH)
maintains neural membranes and normal nerve conduction

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23
Q

Deficiency in this nutrient can cause polyneuropathy, dilated cardiomyopathy, wernicke-korsakoff syndrome

A

thiamine, vitamin B1

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24
Q

Deficiency in this nutrient can cause dermatitis, enteritis, alopecia, adrenal insufficiency

A

pantothenic acid/vitamin B5

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25
Q

Deficiency in this nutrient can cause cheilosis, dermatitis, corneal neovascularization

A

riboflavin/vitamin B2

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26
Q

Deficiency in this nutrient can cause dermatitis, alopecia, enteritis

A

biotin/vitamin B7

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27
Q

Deficiency in this nutrient can cause convulsions, dermatitis, peripheral neuropathy, and sideroblastic anemia

A

pyridoxine/vitamin B6

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28
Q

Deficiency in this nutrient can cause megaloblastic anemia, fetal neural tube defects

A

folate/vitamin B9

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29
Q

Deficiency in this nutrient can cause megaloblastic anemia, fetal neural tube defects, demyelination, and neural degeneration

A

cobalamin/vitamin B12

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30
Q

Where are most B and fat soluble vitamins absorbed?

A

duodenum, jejunum

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31
Q

Where is B12 and Vitamin D absorbed?

A

Ileum

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32
Q

Where is microbiota produced biotin absorbed?

A

large intestine

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33
Q

Deficiency of this nutrient can cause hemolytic anemia, muscle weakness, demylination

A

vitamin E/tocopherol

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34
Q

Deficiency of this nutrient can lead to night blindness, susceptibility to infection, dry scaly skin, corneal degeneration, alopecia, osteoporosis

A

vitamin a (carotenes, retinoids)

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35
Q

Functions of iron and zinc?

A

Iron: O2 transport, energy metabolism
Zn: wound healing, spermatogenesis

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36
Q

Function of Iodine and Cu?

A

Iodine: thyroid hormones
Cu: antioxidant, e- transport, collagen cross-linking, development

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37
Q

Function of fluoride and selenium?

A

Fluoride: dental health
Selenium: antioxidant, thyroid hormone function

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38
Q

problems in pregnancy related to obesity

A

gestational diabetes, macrosomia, eclampsia

39
Q

What growth chart do you reference for a premature infant?

A

Fenton 2003

40
Q

What ages is the WHO growth chart appropriate for?

A

Birth to 24 months

41
Q

Growth chart for people from 2 to 20 years old?

A

CDC growth chart

42
Q

Growth chart for patient with cerebral palsy

A

Brooks

43
Q

What supplements are given to breastfed babies?

A

Iron: by six months

Vitamin D: shortly after birth

44
Q

What age should cow’s milk be offered to infant?

A

12 months (whole milk)

45
Q

What percent of the total intake should be carbs, protein, and fat?

A

Carbs: 50-60%
Protein: 10-15%
Fat: 25-30%

46
Q

How do commensals contribute to host defense?

A

compete for resources with more virulent organisms, produce their own AMPs, keep innate immune cells in attentive state

47
Q

What signals the epithelium to proliferate and differentiate in order to cover an ulcer?

A

TGF-B

48
Q

Where are innate receptors for PAMPS expressed?

A

in cytoplasm, and on basolateral membrane but not on luminal surface

49
Q

What do NLRs recognize?

A

Bacterial wall components (peptidoglycan)

50
Q

What cytokines are important for immune gene expression?

A

TNF, IL-1, IL-6

51
Q

What TLR is activated in fungal infection but not in bacterial?

A

TLR 3

52
Q

When is IL-12 produced?

A

When dendritic cells have recognized and consumed foreign bacterial/fungal component

53
Q

What cytokines activate endothelial cells?

A

TNF, IL-1

54
Q

How does dendritic cell become mature?

A

Phagocytoses foreign component and enter lymph vessel

55
Q

Where do the mature dendritic cells migrate to from the lymph vessel?

A

Peyer’s patch

56
Q

What cytokine activates T cells (to differentiate into Th1)?

A

IL-12

57
Q

What cytokines lead to differentiation of T cells into Th17?

A

IL-6, IL-23, and TGF-B

58
Q

What cytokine stimulates B cell to produce IgG?

A

Interferon Gamma (IFNg)

59
Q

How do each of the complement pathways begin?

A

Alternative: cleaved C3 binds microbe
Classical: IgM binds microbe
Lectin: MBL binds microbe

60
Q

Cells that are important for defense against parasites

A

Granulocytes:

Eosinophils, basophils, mast cells

61
Q

How are granulocytes activated?

A

Ag-bound IgE binds FcERI

62
Q

What are the four phases of nutrient absorption?

A

Intraluminal:
Terminal:
Transepithelial:
Lymphatic:

63
Q

What is a normal bowel movement?

A

1 BM every three days to 3 BMS every day

64
Q

If the patient has watery diarrhea that has large volume and is less frequent, where is the disease/problem most likely located?

A

Small bowel

65
Q

If patient has small, regular stools with tenesmus, where is the problem most likely located?

A

large bowel

66
Q

What kind of diarrhea ceases with fasting or cessation of offending substance?

A

Osmotic diarrhea

67
Q

Which type of diarrhea will have a large osmotic gap?

A

Osmotic diarrhea

68
Q

Diarrhea association: potato salad

A

Staph aureus

69
Q

Diarrhea association: Chinese food

A

Bacillus cereus

70
Q

Ulcerative Colitis-
Continuous or discontinuous inflammation?
What portion of the GI tract?

A

Continuous

Colon only

71
Q

Ulcerative Colitis: clinical presentation

A

bloody, mucus diarrhea

urgency

72
Q

Ulcerative colitis: endoscope

A

pseudopolyps
cecal patch
backwash ileitis

73
Q

Crohns:
Continuous or discontinuous inflammation?
What part of GI tract involved?

A

Discontinuous

Mouth to anus involvement possible

74
Q

Findings the favor Crohns over UC

A

rectal sparing
isolated terminal ileum involvement
fistulas
granulomas on biopsy

75
Q

Endoscopic findings specific to Crohn’s

A

Aphthous ulcers
Cobblestoning
Discontinuous lesions

76
Q

Systemic Crohns complications

A

Erythema nodosum
Pyoderma gangrenosum
Episcleritis/Uveitis

77
Q

Most prominent non-genetic factor in IBD

A

colonizing bacteria

78
Q

Traveler with diarrhea that is treated but reoccurs. Normal lab values, normal endoscopic findings. What is it?

A

Irritable Bowel Syndrome

79
Q

Most people with this remain asymptomatic throughout their lives. But low fiber diets and obstruction may lead to inflammation or perforation.

A

diverticular disease

80
Q

Periumbilical pain that moves to right lower quadrant pain. McBurney’s sign.

A

Appendicitis

81
Q

What zones are vulnerable to ischemic colitis?

A

Watershed: splenic flexure

sigmoid colon and rectum

82
Q

What kind of patient does ischemic colitis typically occur in?

A

Older person, coexisting cardiac or vasculature disease

83
Q

Chronic watery, nonbloody, diarrhea with normal radiologic and endoscopic studies. But colonoscopy shows:

A

dense subepithelial collagen layer, incr. lymphocytes

for collagenous colitis disease

84
Q

What does lysozyme do?

A

Kills gram positive bacteria

85
Q

What diseases are associated with xerostomia?

A

cystic fibrosis, Sjögren’s syndrome

86
Q

What cells secrete intrinsic factor?

A

parietal

87
Q

What mediates gastric motor function?

A

interstitial cells of cajal

88
Q

What increases the rate of gastric emptying?

A

ghrelin

89
Q

What is gastroparesis?

A

Syndrome of objectively delayed gastric emptying in absence of mechanical obstruction

90
Q

Where in the stomach does H. pylori live? What effects does it have in the early stage of infection?

A 
Antrum
Inhibits somatostatin (increase gastrin secretion)
91
Q

What condition is associated with polyhydramnios?

A

Esophageal atresia

92
Q

What is a concerning complication with choledochal cysts?

A

biliary adenocarcinoma

93
Q

What happens if a baby experience bilious emesis (yellow or green)?

A

Surgical emergency

94
Q

“Double bubble” polyhyramnios

A

duodenal atresia

95
Q

Inherited thrombophilia may be related to what congenital anomaly?

A

Jejunoileal atresia

96
Q

What are the results of granulocyte activation?

A

Smooth muscle contraction, disruption of parasite tegument, stimulation of macrophages and endothelial cells

GI (3 decks)

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