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163 Cards in this Set

  • Front
  • Back
Parietal cells secrete:
1. H+
2. intrinsic factor
3 things that stimulate parietal cells:
1. Vagus - Ach (M3)
2. Gastrin (CCKb)
3. Histamine (H2)
Parietal cells can by inhibited by _
omeprazole at the H+/K+ ATPase
2 things that inhibit and action:
SST, Prostaglandins; Gi stimulated, lowers cAMP level
Histamine stimulates H+ secretion by _
activating Gs (increase cAMP)
Potentiation effects is possible, because:
Gastrin and Vagus act thru IP3/Ca+2 and Histamine acts thru cAMP (Gs)
ACh potentiates _ and _
gastrin, histamine
Atropine blocks _ and _
1. direct action of ACh
2. potentiation effects
Gastric H+ secretion can be inhibited by:
1. low pH (negative feedback)
2. SST (Gi)
3. prostaglandin (Gi)
Stimulation of Gi in parietal cell _
decreases cAMP
3 ways in which SST inhibits:
1. Gastrin release
2. Histamine release
3. Gi -> decr cAMP
low pH (less than _) is usually after _
3, meal ingestion
ACh blocker is _, Histamine blocker is _
atropine, cimetidine
peptic ulcer is a lesion of the _ or _ mucosa
gastric, duodenal
2 causes for peptic ulcer:
1. no protective layer (mucous, bicarb)
2. excess H+, pepsin
5 protective factors for stomach:
1. mucus
2. bicarb
3. prostaglandins
4. mucosal blood flow
5. growth factors
5 damaging factors:
1. H+
2. pepsin
3. H pylori
4. NSAIDs
5. stress, smoking, alcohol
H pylori causes peptic ulcers by:
1. releasing cytotoxins
2. urease (urea -> NH3)
Gastric ulcers damages _, leading to gastrin incr/decr?
gastric mucosa, increased (response to lack of H+)
prostaglandins: protect or damage gastric mucosa?
protect (inhibit parietal cells)
to protect: incr/decre mucosal blood
increase
NSAIDs are protective or damaging?
damaging (inhibit mucous secretion)
pepsin is damaging or protective?
damaging
Vagotomy is _
cutting off vagus n.
Vagotomy stimulates/inhibits parietal cells?
inhibits
vagus works thru _ receptor on parietal cells
M3
Chief cells secrete _
pepsinogen
Cells located on the stomach body:
1. parietal
2. chief
Cells located on the antrum:
G cells
BPCAGM (Buena Park, CA, GM)
body has parietal and chief; antrum has g cells and mucous
H+ in the parietal cells is produced by _ enzyme
carbonic anhydrase (HCO3- leaves to the blood side, basolaterally)
Omeprazole inhibits _
H+/K+ ATPase (on parietal cells)
If vomit, why does your body suffer from alkalosis?
bicarb is never secreted, because it is not stimulated by the H+ in the duodenum
Gastrin is released by _
1. eating a meal
2. small peptides
3. distension of the stomach
4. vagal stimulation
Zollinger-Ellison Syndrome is:
1. gastrin secreting tumor of pancreas
2. increased H+
3. not subject to - feedback
H pylori also causes duodenal ulcer, because it inhibits:
1. SST
2. intestinal bicarb
Atropine:
1. blocks H+
2. inhibit ACh on parietal
Cimetidine:
1. blocks H2 receptor (histamine)
2. also blocks potentiation
Omeprazole:
inhibits H/K ATPase
Pancreatic juice: low flow _, high flow_
NaCl; NaHCO3 (but always isotonic)
Pancreatic juice has much higher _ and lower _ concentration than plasma
higher: bicarb; lower: Cl-
Secretin secretes:
mostly fluid from pacnreas
CCK secretes:
mostly pancreatic enzymes
Secretin is scereted by _ cells in the _
S, duodenum
secretin acts on _ cells to increase _ secretion
ductal, bicarb
Pancreas: acinar produces _, but ductal replaces _ with _
Na, Cl; ductal replaces Cl with bicarb
CCK is secreted by _
I cells
CCK is in response to _, _, _
1. peptides
2. a.a.
3. FA
CCK's second messenger is _ and _
IP3 and Ca+2
CCK has potentiating effects?
Yes, act thru IP3/Ca+2
ACh is released in response to:
H+, peptides, FA
ACh stimulates enzyme secretion by acinar cells, potentiates effect of _
secretin
Cystic fibrosis is a defect in _ channel
chlroide (CTFR gene)
Cystic fibrosis affects pancreatic secretion, because:
bicarb/Cl- sends Cl- into the cell (if Cl- not work, cannot secrete enzymes)
Cystic fibrosis can lead to:
malabsorption, steatorrhea
Fat soluble vitamins are _
ADEK
Fat soluble vitamins are incorporated into _ and absorbed with _
micelles, lipids
Water soluble vitamins are absorbed by _
Na+ dependent cotransport
Water soluble vitamins are absorbed by _ dependent
Na+
Vit B12 is absorbed in _ and requires _
ileum, intrinsic factor
R factor is in the _
saliva (which has to be removed before reaching ileum)
Gastrectomy is _
cutting of GI tract
intrinsic factor is produced by _
parietal cell
lack of Vit B12 leads to _
pernicious anemia
Active form of Vit D is _, produced by _
1,25 dihydroxy-cholecalciferol; kidney
1,25 dihydroxy-cholecalciferol induces synthesis of _
ca binding pn., calbindin D-28K
Vit D deficiency causes _ and kids and _ in adults. _ can also cause this.
rickets; osteomalacia; renal failure
Calcium may not be absorbed due to _
renal failure
2 things that increase Ca+ absorption:
1. PTH
2. thiazide diuretics
Ca absorption competes w/ _ in the _ area
Mg, DAL
90% of calcium is absorbed at _ and _
proximal tubules, DAL
loop diuretics will cause calcium excretion/absorption?
excretion (Na+ secreted, Ca also not absorbed)
Ca reabsorption is coupled to _ absorption
Na (that is why loop diuretics cause less Ca absorption)
Iron is absorbed bound to _ or _ or _
1. Hb
2. myoglobin
3. Free iron
Heme iron is degraded in _, releasing free Fe+2
intestinal cells
Fe+2 circulates in blood bound to _
transferrin
Free iron in intestinal cells bind to _ and is released to blood
apo-ferritin
Iron bound to transferrin transports it from _ to _
small intestine; liver
Iron is carried from liver to bone marrow for synthesis of _
Hb
Anemia is most commonly caused by _
iron deficiency
Gallbladder is contracted by _ and _
CCK, ACh
CCK is released in response to:
1. aa, small peptides
2. FA
(from I cells)
Carbohydrate: only _ are absorbed
monosaccharides (Glu, Gal, Fru)
Glu and Gal are transported thru _
SGLT1 (Na+ depending cotransport)
SGLT1 uses _ to drive _
Na+, glucose/galactose into cells
3 border enzymes are:
maltase, alpha-dextrinase, sucrase
Fructose is transported by _
facilitated diffusion (passive); GLUT5
Fructose is passive/active?
passive
lactose intolerance is from deficient _
lactase (osmotic diarrhea)
Na/K pump on the basolateral keeps the intracellular _ low
Na+
Poisoning of Na/K ATPase inhibits absorption of:
glucose, galactose (no Na+ gradient)
Na+ gradient is used to absorb:
glucose, galactose
Sugar is absorbed from lumen to cell by _ and from cell to blood by _
SGLT1, GLUT2
Proteins can be done by _ and _
endopeptidases (interior peptide), exopeptidases (one aa at a time from the C terminus)
Is pepsin essential for pn digestion?
no, not essential
chief cells produce _
pepsinogen (activated to pepsin by H+)
optimum pH for pepsin is btw/ _ and _
1-3
when the pH is above 5, pepsin is _
denatured
Trypsin, chymotrypsin, elastase, carboxypeptidase A, B are:
pancreatic proteases
Trypsinogen is activated to _
trypsin
trypsin cleaves:
trypsinogen, chymotrypsinogen, proelastase, procarboxypeptidase A, B
pepsin is denatured at pH _
above 5
Glucose and galactose enter the blood thru _ by active/passive?
GLUT2, passive
after digestion, pancreatic proteases _
degrade each other / absorbed with dietary proteins
Proteins can be absorbed in ___ forms
aa, di-, tripeptides
aa are absorbed using _
Na+ dependent cotransport
Na+ dependent cotransport are used to absorb:
glucose, galactose, a.a. (separate carriers for each type), [kidneys: glucose, bicarb, a.a., phosphate, lactate]
aa enter cells by _, then enter blood by _
Na+ dep cotransport; facilitated diffusion
dipeptides and tripeptides are absorbed faster/slower than free a.a?
di-, tri-peptides are absorbed FASTER
di-, tri-peptides are absorbed using _
H+ dependent cotransport
di-,tri-peptides enter the cell by _, then leave as _
H+ dependent cotransport; free a.a (facilitated diffusion)
Lipid begins digestion in _
mouth (lingual lipases)
most lipids are digested in the _ by _
intestines, pancreatic lipases
CCK functions are BIG P
1. bicarb secretion
2. inhibit gastric emptying
3. gallbladder (enzyme, growth)
4. pancreatic enzymes
CCK is activated by
1. aa/peptides
2. FA
Lipids are emulsified by _ and then digested by _
bile acids, pancreatic lipases
CA Salt:
conjugated bile acid = bile salt
6 causes of steatorrhea:
1. pancreatic disease (pancreatitis CF)
2. gastrin secretion (i.e. ZE)
3. ileal resection (deplete bile due to low reabsorption)
4. bacterial growth (deconjugate bile early, not efficient in lipid emulsification)
5. tropical sprue (decreased # of intestinal cell for absorption)
6. apoB not synthesized (inability to form chylomicrons)
bile salt is deconjugated by _
bacteria (deconjugated so that it can be absorbed)
tropical sprue causes _
decreased # of intestinal cells
chylomicrons require _
apoprotein B48 (specifically for chylomicron)
Micelles bring lipid digestion products to the _
absorptive surface of intestinal cells
FA, monoglycerides, and choleserol _ across the lumninal membrane.
diffuse
is glycerol contained in the micelles?
no, glycerol is hydrophobic
Lipid enter the cell by _, then become re-esterified to _, then exit by _ to _
diffusion, chylomicrons, exocytosis, lymph vessels (thoracic duct)
bile contains (4 components):
1. bile salts
2. phospholipid
3. cholesterol
4. bile pigment
bile is produced by _
liver (hepatocytes)
primary bile is converted to secondary by _
bacteria in intestines
secondary bile acids are (2 types):
1. deoxycholic acid
2. lithocholic acid
CA salt:
conjugated bile acid forms bile salt
bile acids are conjugated with _ or _
glycine, taurine
Gallbladder functions to _
concentrate and store bile
Choleretic agents incr/decr the formation of bile?
increase
Tight epithelium is seen on _, while leaky is seen on _
colon; SI and gallbladder
_ bind the epithelial cells to one another
tight junctions
Electrolytes and water can cross intestinal epithelial cells by either: _ or _ pathways
1. transcellular
2. paracellular
I Kiss Meg's Pn's
ICF has K, Mg, and Pn's
ENaCh'l Bicar
ECF has Na, Cl, Bicarb
K+ is actively/passively secreted in the _
actively; colon
K+ secretion is stimulated by _, in both colon and kidneys
aldosterone
Diarrhea: _ is lost, causing _
K+, hypokalemia
Dietary K+ is absorbed in _ by active/passive thru para/transcellular route?
SI, passive, paracellular
Water is secondary to _ absorption
solute
Colon has higher/lower water permeability than SI?
colon has lower water permeability
water is absorbed isomotically in the _ and _
SI, gallbladder
GI tract secretes electrolytes from _ to _
blood to lumen
GI tract: secretion is in _, absorption in _
crypts, villi
Primary ion secreted into the SI is _
Cl-
Na+ is secreted into the lumen by passively following _
Cl-
Vibrio cholerae is aka _
cholera toxin
cholera toxin causes _, by stimulating _
diarrhea, Cl- secretion
Cholera catalyzes _, the alpha subunit of Gs pn coupled to adenylyl cyclase to _
ADP ribosylation; permanently activated
cholera: intracellular cAMP increases/decreases; opening _ channels
cAMP incresases; Cl-
_ and _ follow Cl- into the lumen, leading to secretory diarrhea
Na, water
_ cause diarrhea in a similar fashion as cholera
some strains of E Coli
Na is absorbed thru 4 ways:
1. passive diffusion (thru Na+ channels)
2. Na+/glucose and Na+/a.a.
3. Na/Cl cotransport
4. Na/H exchange
In the small intestines, 3 paths are most imp. for Na+ absorption:
1. Na/glucose
2. Na/a.a
3. Na/H exchange
(similar to renal proximal tubule)
Colon: Na+ is absorbed by _
passive diffusion
Na+ absorption is stimulated by _
aldosterone (K+ secretion is also stimulated by this)
Na+ is pumped out against its gradient by _
Na/K ATPase (this creates the gradient for other absorption)
Na/K ATPase is on the _ membrane
basolateral
Cl- absorption accompanies _ absorption
Na+
Cl- absorption accompanies Na+ absorption by 3 ways:
1. passive diffusion paracellularly
2. NaCl cotransport
3. Cl-/HCO3- exchange