Gi Systems In Health & Disease Tbl#1&2

Front 1

What are cortical neurons related to emotion related to?

Back 1

The limbic system
(emotion)

Front 2

What are the three areas of the cortex that have significant limbic connections?

Back 2

Limbic System Connections
1. Prefrontal cortex (strong link to emotions)

2. Temporal cortex (speech center)

3. Cingulate gyrus (located below the surface of most of the cortex & receives direct input from the hippocampus)

Front 3

What is the hippocampus most related to?

Back 3

Memory generation & recall

Front 4

Where is the subcortical region that appears to excite the cortical neurons and induce the feeling of hunger?

Back 4

A region called the feeding center, located in the lateral hypothalamus.

Front 5

What are 3 things that DECREASE feeding center activity?

Back 5

a) Elevated blood glucose
b) Elevated blood insulin
c) Stimulation of the ventromedial nucleus of the hypothalamus (satiety center)

Front 6

What is the ventromedial nucleus of the hypothalamus often referred to as?

Back 6

The SATIETY CENTER

Front 7

What effect does stimulation of the satiety center have on the feeding center?

Back 7

Stimulation of the satiety center directly inhibits firing of the feeding center

Front 8

What condition would ablation of the satiety center result in?

Back 8

Hyperphagia (overt hunger)
The feeding center never turns off

Front 9

What type of hormone is Ghrelin?

Back 9

Ghrelin is a polypeptide hormone, which is octanoylated.
(addition of an 8 carbon fatty acid chain)

Front 10

Where are Ghrelin receptors primarily found?

Back 10

1. Associated with hunger - The arcuate nucleas & ventromedial hypothalamus

2. Associated w/cognitive adaption of behavior & learning - hippocampus

3.

Front 11

What does the presence of Ghrelin in the blood do?

Back 11

The presence of Ghrelin in the blood stimulates the feeling of hunger.

Ghrelin acts on one group of neurons in the arcuate nucleus AGRP (agouti-related proteins), which stimulate the feeding center

Front 12

What specific group of neurons does Ghrelin act upon?

Back 12

AGRP - agouti related proteins, which stimulate the feeding center

Front 13

What cells release Ghrelin?

Back 13

Oxyntic/parietal cells of the stomach

Front 14

What effect does lack of sleep have upon Ghrelin?

Back 14

Lack of sleep INCREASES Ghrelin levels and may contribute to weight gain through increased hunger

Front 15

How would a gastric bypass affect Ghrelin?

Back 15

Gastric bypass not only reduces stomach volume, but also decreases Ghrelin levels -- further decreasing hunger

Front 16

What other polypeptide hormone is encoded in the same gene as Ghrelin, but DECREASES feeling of hunger?

Back 16

Obestatin

Front 17

What is the obesity vaccine?

Back 17

The obesity vaccine induces antibodies against Ghrelin, decreasing hunger and helping to produce weight reduction through decreased ingestion of nutrients

Front 18

What psychological factors have been identified to increase the sensation of hunger?

Back 18

a) TIME: many people become used to eating at routine times during the day and if such a person sees that it is one of those routine feeding times they can feel hunger which has not been there before viewing the clock

b) SMELL & TASTE: A person can induce a feeling of hunger by smelling or tasting the food. (learned preference involving hippocampus)

c) COLOR/APPEARANCE: The color blue tends to suppress hunger. This is thought to result from few foods being naturally blue. Coloring doods a different color tends to suppress hunger as well (i.e. coloring a bannana red would not stimulate hunger)

Front 19

Why do we stop eating once we have begun?

Back 19

In large part because stomach digestion stimulates the satiety center to inhibit the cortical neurons that cause us to feel hungry

Front 20

How can chewing gum quiet your hunger?

Back 20

Satiety related receptors in the mouth are stimulated and chewing some material may have a satiety effect lasting 20-40 minutes.

Front 21

How does the mechanics of the stomach trigger the satiety center?

Back 21

Ingested food stretches the stomach, triggering stretch receptors that fire action potentials which travel to the CNS via vagal afferents, stimulating the satiety center, which inhibit the feeding center and hunger stops (possible gluttony begins)

Front 22

Where is Cholecystokinin released from?

Back 22

Cholecystokinin (CCK) is released by I cells of the duodenum and upper jejunum due to the presence of food in the small intestine

Front 23

What type of hormone is CCK?

Back 23

a polypeptide hormone

Front 24

Where does Cholecystokinin (CCK) bind to in order to inhibit the feeding center?

Back 24

CCK binds to receptors on POMC (pro-opiomelanocortin), neurons in the arcuate nucleus, and these POMC neurons inhibit the feeding center, terminating feeding behavior.

NOTE: these neurons are also stimulated by cocaine, explaining why cocaine decreases the feeling of hunger.

Genetics in the AGRP neuron system are associated with morbid obesity.

Front 25

What are 3 hormones that stimulate the satiety center?

Back 25

1. Cholecystokinin (CCK)
2. Insulin
3. Glucagon

Front 26

What two pancreatic polypeptide hormones are co-secreted before nutrients arrive in the blood, causing satiety?

Back 26

1. Insulin - released by Beta cells of the Islets of Langerhans

2. Glucagon - released by alpha cells of the Islets of Langerhans

Front 27

What effect does insulin have on POMC neurons & AGRP neurons in the arcuate nucleus?

Back 27

Insulin stimulates the POMC neurons and inhibits the AGRP neurons in the arcuate nucleus.

The end result is an inhibited feeding center and a stimulated satiety center

Front 28

Where is the polypeptide hormone Peptide YY (PYY) secreted from?

Back 28

PYY is secreted by the entire digestive tract, especially the illeum & COLON.

Front 29

What effect does PYY have?

Back 29

PYY levels peak ~1-2 hrs after eating and it provides long term inhibition of the feeding center (via an unknown mechanism)

Front 30

What are the purpose of the glucoreceptor neurons in the satiety center?

Back 30

Glucoreceptor neurons in the satiety center fire when blood glucose is elevated, thereby inhibiting the feeding center

Front 31

How do glucose levels affect the glucosensitive neurons in the feeding center?

Back 31

Postprandial elevated glucose levels decrease the firing of glucosensitive neurons in the feeding center.

(postprandial means after eating)

Front 32

What 3 things does the hypothalamus sense that result in the inhibition of the feeding center?

Back 32

Hypothalamus Senses Presence of in Blood:

1. Glucose

2. Amino Acids

3. Lipids

Front 33

What combination means that any elevation in blood glucose postprandially tends to turn off the feeding center?

Back 33

1. Glucoreceptor neurons in the Satiety Center fire when blood glucose is elevated

2. Glucosensitive neurons in the Feeding Center decrease activity when blood glucose is elevated

Front 34

What is released from adipocytes in response to triglyceride synthesis in those cells?

Back 34

LEPTIN is released from adipocytes in response to triglyceride synthesis in those cells

Front 35

What are the actions of Leptin?

Back 35

Actions of Leptin

1. Inhibition of AGRP neurons (which when active stimulate hunger)

2. Activation of POMC neurons (which inhibit hunger when active)

3. Increased sympathetic nervous system activity (which mobilizes food stores and increases basal metabolic rate - BMR)

4. Decreased insulin release (which inhibits further storage of food stores)

Front 36

What happens if there is a problem in your Leptin system?

Back 36

Dysfunction of the Leptin system will result in obesity

administration of Leptin in a Leptin-deficient animal will result in significant weight loss

(This is a rare condition)

Front 37

** Why do different people have different food preferences?

Back 37

Smell and taste are particularly potent in the limbic system, which is big on memory and recall. These scents and tastes can be engraved in your mind and may be directly associated with pleasant or negative memories

Front 38

What is released in response to fat in the duodenum and stimulates gall bladder contraction?

Back 38

Cholecystokinin (CCK)

Front 39

What neurotransmitter causes slow wave hyperpolarization in the GI tract?

Back 39

Norepinephrine

Front 40

What are the triggers for peristalsis?

Back 40

1. Local distension
2. Vagal innervation
3. Local irritation
4. Activation of myenteric reflex

Front 41

What reflex accounts for slowed stomach emptying as chyme enters the duodenum?

Back 41

Enterogastric reflex

Front 42

Where is bicarbonate for neutralizing chyme acidity primarily produced?

Back 42

Cells in the pancreatic ducts called centroacinar cells

Front 43

Which of the following are FALSE regarding carbohydrate digestion?

A. Digestive products are absorbed as disaccharides

B. Water accompanies absorption of sugars

C. Sodium accompanies absorption

D. Digestion occurs in the mouth, stomach, & small intestine.

Back 43

A. is false

Front 44

How are lipids which are absorbed initially transported in blood?

Back 44

Chylomicrons

Chylomicrons are large lipoprotein particles that transport dietary lipids from the intestines to other locations in the body. Chylomicrons are one of the 5 major groups of lipoproteins (chylomicrons, VLDL, IDL, LDL, HDL) which enable fats and cholesterol to move within the water based solution of the blood stream.

Front 45

What is the precursor of a gastric proteolytic enzyme?

Back 45

pepsinogen

Front 46

What duodenal enzyme activates pancreatic proteolytic enzymes?

Back 46

enterokinase activates trypsin, which activates everything else

Front 47

What is a family of diseases characterized by malabsorption?

Back 47

Sprue (Coeliac disease)

Front 48

What is Ghrelin?

Back 48

A polypeptide hormone released by oxyntic/parietal cells of the stomach, which stimulate the AGRP Neurons in the Arcuate Nucleus in the Hypothalamus. END RESULT IS "I AM HUNGRY"

Front 49

What inhibits AGRP neurons?

Back 49

1. Insulin released from beta cells of the pancreas

2. Leptin released from adipocytes, which also stimulates sympathetics to INCREASE BMR

Front 50

What stimulates firing of AGRP Neurons?

Back 50

Ghrelin released from oxyntic/parietal cells in the gastric pits of the stomach (parietal cells also release HCl)

Front 51

What are the actions of leptin regarding hunger?

Back 51

1. Inhibition of AGRP neurons

2. Activation of POMC neurons

3. Increased sympathetic nervous system activity (increasing BMR)

4. Decreased insulin release

Front 52

What type of neurons in the Satiety Center fire when blood glucose is elevated

Back 52

Glucoreceptor Neurons in the Satiety Center

Front 53

What type of neurons DECREASE the firing of the Feeding Center?

Back 53

Glucosensitive Neurons DECREASE firing of the feeding center

Front 54

What happens in the Hypothalamus when blood glucose is elevated?

Back 54

1. Glucoreceptor neurons in the Satiety Center (ventromedial nucleus) fire, INHIBITING the Feeding Center

2. DECREASED firing of Glucosensitive neurons in the Feeding Center (lateral nucleus)

3. End result is the elevation of glucose in your system after a meal will turn off the feeding center

Front 55

What is the ventromedial nucleus often referred to as?

Back 55

Ventromedial nucleus is referred to as the satiety center

Front 56

How are signals conveyed when the gastric stretch receptors fire action potentials?

Back 56

The sensory information is conveyed to the CNS along Vagal Afferents and stimulates the Satiety Center

Front 57

Where does Cholescystokinin release from?

Back 57

CCK is released from I cells of the duodenum and upper jejunum due to the presence of food in the small intestine

Front 58

What factors influence long term inhibition of the feeding center?

Back 58

1. Peptide YY (PYY)- secreted especially in the colon
2. Elevation of blood glucose
3. Leptin - secreted by I cells in the duodenum and upper jejunum

Front 59

What does lack of sleep do to Ghrelin levels?

Back 59

Lack of sleep INCREASES Ghrelin levels and may contribute to weight gain through increased hunger

Front 60

What does a gastric bypass do to Ghrelin levels?

Back 60

Gastric bypass reduces stomach volume and DECREASES Ghrelin levels - further decreasing hunger

Front 61

What polypeptide hormone is encoded in the same gene as Ghrelin, that DECREASES the feeling of hunger?

Back 61

Obestatin decreases the feeling of hunger

Front 62

How does the obesity vaccine work?

Back 62

The obesity vaccine induces antibodies against Ghrelin, DECREASING hunger and helping to produce weight reduction through decreased ingestion of nutrients

Front 63

What are some psychological factors that affects sensation of hunger?

Back 63

a. Time: Many people become used to eating at routine times during the day, and if such a person sees that it is one of those routine feeding times they can feel hunger which had not been there before viewing the clock

b. Smell & Taste: A person can induce a feeling of hunger by smelling or tasting a favorite food. Note that this is a learned preference (involving the hippocampus for memory formation)

c. Color/Appearance: The color blue tends to suppress hunger. This is thought to result from few foods being naturally blue. Coloring foods a different color tends to suppress hunger as well (e.g. coloring a banana red does not stimulate hunger, whereas a yellow bannana may stimulate hunger)

Front 64

What does AGRP stand for?

Back 64

Agouti-related protein (neurons that stimulate the feeding center)

Front 65

How is Ghrelin activated?

Back 65

Oxyntic/parietal cells of the stomach secrete Ghrelin, which is octanoylated (addition of an 8-carbon fatty acid chain) in its active form

Front 66

What condition may result from ablation of the Satiety Center?

Back 66

Hyperphagia - overt hunger

Front 67

What does POMC stand for?

Back 67

POMC Pro-OpioMelanoCortin (neurons that inhibit the feeding center)

Front 68

What hormones are co-secreted that stimulate satiety before nutrients arrive in the blood?

Back 68

Insulin - Beta cells of the pancreas

Glucagon - Alpha cells of the pancreas

Front 69

What are the 3 areas of the cortex with significant limbic connections?

Back 69

1. The prefrontal cortex (linked to emotions)

2. The temporal cortex (speech center)

3. Cingulate gyrus (receives direct input from the hippocampus, which is associated w/memory generation and recall)

Front 70

What is the function of gastrin, secreted from G-cells of the stomach?

Back 70

Gastrin stimulates release of HCl from parietal/oxyntic cells & pepsinogen from chief cells

Front 71

Where is the polypeptide hormone somatostatin released from?

Back 71

Somatostatin is released from cells in Gastric Glands & also cells of the Pancreas

Front 72

What is the function of Somatostatin?

Back 72

Somatostatin reduces the rate of nutrient absorption (slows down digestion by inhibiting release of gastrin, HCL, Secretin, CCK, Glucagon)

Front 73

Where is Secretin released from?

Back 73

Secretin is released by S-cells of the duodenum in response to a LOW pH (an increase in acidity in the duodenum means that the stomach has begun to empty its contents "CHYME" into the duodenum)

Front 74

What are the effects of Secretin?

Back 74

1. Secretin stimulates the pacreas to release Bicarbonate (to neutralize chyme and thereby allow activation of digestive enzymes)

2. Secretin Inhibits further acid secretion by the stomach and Slows Peristalsis (allowing the duodenum time to digest the food entering from the stomach)

Secretin Also stimulates Brunner's Glands in the duodenum to secrete bicarbonate

Front 75

What is the primary stimulus for release of secretin from the duodenum?

Back 75

LOW pH

Front 76

How does Secretin lower the pH in the duodenum?

Back 76

Secretin stimulates the pancreas to release bicarbonate. It also inhibits further acid secretion by the stomach and slows peristalsis

Front 77

What triggers release of Cholescystokinin from the duodenum and jejunum?

Back 77

Presence of LIPIDS

Front 78

What are the effects of Cholescystokinin?

Back 78

CCK stimulates:
1. Gall Bladder Contractions (releasing bile into the duodenum for Emulsification of lipids)

2. Pancreas to secrete digestive enzymes

3. Slows the rate of gastric emptying (because it takes a while to digest fats)

4. Stimulates the Satiety Center

Front 79

What does VIP stand for? (not very important person, duh)

Back 79

Vasactive Intestinal Polypeptide (VIP)

Front 80

What does VIP do?

Back 80

VIP creates Vasodilation in vessels of the GI tract during digestion (in response to increased parasympathetic input to the enteric nervous system)

Front 81

T/F the PNS plays an important role in regulating GI function?

Back 81

FALSE

The CNS plays an important role in regulating GI function via Autonomic Nervous System with Parasympathetics more active than Sympathetics

Front 82

Does most of the Autonomic Nervous System innervate GI cells?

Back 82

NO

ANS moderates the activity of the Enteric Nervous System (ENS)

Front 83

Where does the Enteric nervous system run?

Back 83

The ENS runs much of the length of the digestive tract (from part way down the esophagus until the external anal sphincter) and consists of about as many neurons as are present in the spinal cord

Front 84

What are the 2 layers of the Enteric Nervous System?

Back 84

1. Myenteric (Auerbach's) Plexus

2. Submucosal (Meissner's) Plexus

Front 85

What does the Myenteric Auerbach's Plexus do?

Back 85

Myenteric Auerbach's Plexus primarily regulates contractions of smooth muscle that result in Peristalsis and Sphincter control

Front 86

What does the Submucosal (Meissner's) Plexus do?

Back 86

The Submucosal (Meissner's) Plexus neurons are associated w/regulation of Secretions and Blood Flow along the length of the digestive tract

Front 87

What are the different sensory receptors for the Enteric Nervous System (ENS)?

Back 87

ENS Sensory Receptors
1. Mechanical (stretch & tension)

2. Thermal (heat & cold)

3. Osmotic & Chemical (glucose & amino acids)

Front 88

Which nerve primarily conveys sensory information along?

Back 88

Afferent fibers of the Vagus

Front 89

Which nerves are involved in parasympathetics in the digestion system?

Back 89

1. Glossopharyngeal IX & Facial VII nerves innervating salivary glands

2. Vagus X nerve most of the digestive tract

3. Sacral nerves innervating the colon

Front 90

Where is the Sympathetic innervation of the GI tract primarily routed through?

Back 90

1. Salivary glands via Superior Cervical Ganglion

2. Rest of GI tract via Splanchnic nerves

Front 91

What is a reflex loop?

Back 91

Sending sensory information toward the CNS and receive motor information.

The digestive reflexes are named for the site of initiation followed by the site affected.

Front 92

What happens in the gastrocolic reflex?

Back 92

Food is sensed in the stomach (GASTRO) and results in increased motility of the colon (COLIC)

Front 93

What happens in the Enterogastric reflex?

Back 93

Something is sensed in the small intestines and makes something happen in the stomach

Front 94

What is the functions of mucous in the esophagus?

Back 94

1. Lubrication (to facillitate movement of food from the mouth to the stomach)

2. Protection against excoriation (scraping) & acidic erosion of the lower portion of the esophagus.

Front 95

What are the stomach's secretions in the blood?

Back 95

Gastrin (G-cells) & Ghrelin (oxyntic/parietal cells)

Front 96

What are the stomach's secretions in the lumen of the digestive tract?

Back 96

1. HCl (Parietal/Oxyntic cells)

2. Pepsinogen (chief cells)

3. Mucous (mucous neck cells)

4. Gastroferrin (for facillitating iron absorption)

5. Intrinsic Factor (Parietal/Oxyntic cells, essential for B12 absorption)

Front 97

What are the small intestine's secretions in the blood?

Back 97

Small Intestine Secretions into Blood

1. Secretin (released in duodenum triggers pancreas to release Bicarbonate, inhibits further acid secretion, & slows peristalsis)

2. CCK (secreted by duodenum and jejunum in response to presense of fats, stimulates gall bladder contractions, pancreatic digestive enzyme release, slows rate of gastric emptying)

Front 98

What are the small intestine's secretions in the intestinal lumen?
(dilute the food to create a solution we can absorb)

Back 98

Small Intestine's Lumen Secretions

1. Serous Mucous

2. Bicarbonate-enriched Mucous

3. Lysozyme (antibacterial)

4. Defensins (antibacterial)

Front 99

What are the colon's secretions?

Back 99

Mucin-rich mucous & PYY

Front 100

What are the hormones that the pancreas secretes into the blood?

Back 100

1. Insulin - Beta cells
2. Glucagon - Alpha cells
3. Somatostatin - Delta cells of the pancreas(Inhibits release of insulin & glucagon, and GI hormones)

Front 101

What are the hormones that the pancreas secretes into the lumen of the GI tract?

Back 101

1. Trypsinogen
2. Chymotrypsinogen
3. Procarboxypeptidase A&B
4. Pro-elastase
5. Pancreatic Lipase
6. Pancreatic Amylase
7. Ribonucleases
8. 2 Liters/day of Bicarbonate-rich fluid

Front 102

What does the Liver synthesize and release into the blood?

Back 102

1. Plasma proteins

2. VLDLs (very low density lipoproteins)

3. HDL's (high density lipoprotein)

Front 103

What does the liver secrete into the lumen of the digestive tract?

Back 103

Bile

Front 104

What does bile help excrete from the breakdown of heme?

Back 104

bilirubin

Front 105

What does bile contain that allows lipid emulsification?

Back 105

Bile salts and bile acids

Front 106

What activates trypsinogen?

Back 106

Enterokinase in the pancrease converts trysinogen to trypsin

Front 107

What does Trypsin activate?

Back 107

Trypsinogen
Chymotrypsinogen
Pro-elastase
Procarboxypeptidase

Front 108

Which enzymes make short polypeptides?

Back 108

Trypsin
Chymotrypsin

Front 109

Which enzyme converts short polypeptides into tripeptides and dipeptides which are ready for absorption by enterocytes?

Back 109

Carboxypeptidase

Front 110

What turns carbohydrates into glucose, galactose, fructose, & disaccharides ready for absorption into enterocytes?

Back 110

Pancreatic amylase

Front 111

What joins together to form taurocholate & glycocholate

Back 111

1. Cholesterol from the hepatic portal blood

2. Taurine & Chlorine

Front 112

What binds the hepatocytes together forming the canaliculi?

Back 112

Tight Junctions

Front 113

Where do the secondary bile acids that form bile salts come from?

Back 113

94% recycled from the hepatic portal system

Front 114

What forms the BAT?

Back 114

1. Bile acids (taurocholate, glycocholate)

2. Bile salts

Front 115

What is dumped into the hepatic canaliculus?

Back 115

1. BAT
2. Plasma Ultrafiltrate
3. Bilirubin
4. Lecithin
5. Cholesterol

Front 116

What do Paneth cells release?

Back 116

Lysozyme & Defensins

Front 117

Where are Paneth cells located?

Back 117

On villi in the small intestine

Front 118

What stimulates Brunner's glands to secrete bicarbonate in the duodenum?

Back 118

1. Parasympathetic innervation via vagus

2. Secretin

Front 119

What INHIBITS Brunner's gland secretion?

Back 119

Sympathetic stimulation

Front 120

Where do liver and pancreas secretions enter the duodenum from?

Back 120

Ampulla of Vader

Front 121

What triggers goblet cells in the duodenum to release mucous w/bicarbonate?

Back 121

tactililty & irritations

Front 122

What is an important ENS transmitter important for stimulating secretions?

Back 122

Seretonin

Front 123

What cell in the duodenum secretes enterokinase (which activates trypsinogen -> trypsin)

Back 123

enterocyte

Front 124

What causes pancreatic duct cells to secrete bicarbonate?

Back 124

1. Secretin
2. Vagal parasympathetics

Front 125

Where is the (Auerbach's) Myenteric plexus located?

Back 125

It is between the circular and longitudinal muscle layers in the muscularis externa. It begins part way down the esophagus and continues to the external anal sphincter

Front 126

Which ENS controls regulation of secretions and bloodflow along the length of the digestive tract?

Back 126

The Submucosal (meissner's) plexus

Front 127

Which ENS controls smooth muscle, resulting in peristalsis and sphincter control?

Back 127

The Myenteric (auerbach's) plexus

Front 128

What happens to cAMP levels for a patient who is taking Cimetidine?

Back 128

Decreased cAMP in parietal cells

Front 129

Why would you have hyperkalemic gastric secretions in a patient who is taking Cimetidine?

Back 129

Because K+ (from the ultrafiltrate) wouldn't be removed as quickly from the lumen of the cell

Front 130

What type of drug is Cimetidine (tagament)?

Back 130

Cimetidine is a H2 receptor antagonist

Front 131

What type of drug is Acetazolamide?

Back 131

Acetazolamide is a carbonic anhydrase inhibitor

Front 132

What type of drug is Omeprazole (prilosec)?

Back 132

Omeprazole is a potassium hydrogen pump inhibitor

Front 133

What type of drug is Ranitidine (zantac)?

Back 133

Ranitidine is a H2 receptor antagonist

Front 134

What intracellular organelles are involved in lipid metabolism?

Back 134

Mitochondria & Peroxisomes

(SER are involved w/lipid synthesis)

Front 135

Reticular fibers in the space of Disse are synthesized by?

Back 135

Stellate cells

Front 136

In hepatic cells fat metabolism is conducted by mitochondria and __________?

Back 136

Peroxisomes

Front 137

All of the following are present in a typical portal triad except a____
lymphatic capillary
branch of the hepatic artery
branch of the hepatic vein
branch of the hepatic portal vein
bile ductule

Back 137

hepatic vein

Front 138

Liver cancer does not cause:
Ascites
decreased absorption of dietary fat
increased clotting tiome
increased body glycogen

Back 138

not increased glycogen

Front 139

What is the difference between diverticulitis and diverticulosis?

Back 139

Diverticulitis has a perforation possible
diverticulosis has an outpouching

Front 140

Of the arious orms of viral hepatitis which one is usually contracted as a food-borne illness?

Back 140

HAV

Front 141

Which of the following is more likely to be observed in a patient with anorexia as opposed to bulimia?
Amenorrhea
Dramatic weight loss
erosion of enamel
A&B only
ABC

Back 141

A&B only

Front 142

Biliary pain associated withj choletithiasis most presents clinically as:

a) left chest pain
b) left flank pain
c) epigastric pain
d) Periumbilical pain which localizes in the lower right quadrant

Back 142

C) Epigastric pain

Front 143

Correctly sequence the structures involved in the digestion absorption and transport of lipids beginnig secretion of bile salts

Back 143

1. micelle
2. enterocyte
3. chylomicron
4. lymphatic system
liver
VLDL
lipoprotein lipase
LDL
Liver
5.

Front 144

Which of the following statements regarding digestion and absorption of carbohydrates and proteins is incorrect?

Carbohydrate digestion begins in mouth but primarily takes place in the ileum
proteins first enter the body as amino acids dipeptides but not tripeptides
Pancreatic secretions entering the duodenum through the sphincter...

Back 144

A

Front 145

What is jaundice?

Back 145

Bilirubin leaking into the blood
blockage of the bile duct (gall stone)
sickle cell

Front 146

What would you expect the pH of the blood in a bulimic patient

Back 146

Alkaline blood because of vomitting
(metabolic alkalosis)