Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
88 Cards in this Set
- Front
- Back
Gastin is secreted from G cells in what part of the stomach?
|
Antrum
|
|
Gastrin is secreted in response to what stimuli?
|
increased pH or presence of Amino Acids
|
|
What effect does gastrin have on parietal cells and how is it accomplished?
|
increases HCL production; binds membrane receptor --> increased intracellular Ca --> phosphorylate H+/K+ATPase
|
|
Where are Peyer's patches found in the GI tract? Where are they most noticeable?
|
Small Intestine; Ileum
|
|
Where in the gastric glands are chief cells most prominent?
|
Base of the gland
|
|
Where are the Auerbach plexi found?
|
Between circular and longitudinal layer of muscularis externa
|
|
In what parts of the GI tract do you find glands that extend from the submucosal layer?
|
Esophagus, Duodenum (Brunner's)
|
|
Which salivary gland has a mostly serosal secretion? Mostly mucosal? Mixed?
|
Parotid; Sublingual; Submandibular
|
|
What is a serosal Demilune?
|
Serosal gland cell over mucosal - small canaliculi btwn mucosal cells convey serous material
|
|
How can you distinguish a mucus from a serous secreting cell in a salivary gland?
|
serous = round, central nucleus; mucosal = flat, basal nucleus
|
|
What epithelial cells are found in the neck of a gastric gland? In the body/base?
|
Neck: stem, parietal, neck mucus cell; Base/Body: Parietal, neuroendocrine, chief
|
|
What is the function of M cells in the small intestine?
|
Present Ag to lymphocytes and macrophages
|
|
What happens to the IgA Ab secreted by B cells in the small intestine?
|
It is trancytosed through to luminal surface of an epithelial cell to provide antibacterial protection
|
|
Why is the large intestine capable of absorption and not further digestion?
|
there are no digestive enzymes at the epithelial cell surface
|
|
Enzyme secretion in the pancreas is under control of what hormones?
|
CCK and secretin
|
|
What hormones are secreted by the Islet cells in the pancreas?
|
Glucagon and insulin
|
|
Water soluble vitamins are almost completely absorbed in the upper small intestine, with what exception?
|
B12 absorbed in ileum by B12-IF complex
|
|
What cells make intrinsic factor?
|
Parietal cells
|
|
How do lipids move from the bile-salt micelles to the inside of enterocytes?
|
Lipids move in and out of micelles. When they strike the cell surface they are able to passively diffuse.
|
|
How do chylomicrons enter the lacteals?
|
Chylomicrons are packaged in secretory vesicles and exocytosed from the cell
|
|
Which brush border enzyme is responsible for the conversion of alpha-limit dextrin to glucose
|
Sucrase-Isomaltase breaks 1,6-linkages
|
|
What is the histological marker of Chronic gastritis?
|
infiltration of plasma cells into the lamina propria of mucosa
|
|
The presence of PMN cells in the epithelium of the stomach precludes what type of gastritis?
|
Acute
|
|
Why is chronic autoimmune gastritis restricted to the body and fundus of the stomach?
|
Autoantibodies are targeted against parietal cells
|
|
What are the eventual results of autoimmune chronic gastritis?
|
Megoloblastic anemia, achlorydia first, neuroendocrine stimulation leads to hyperplasia and cardinoid tumor genesis later in the course
|
|
Acute gastritis is usually caused by one of two things: what are they?
|
Chemical (NSAIDS, EtOH, tobacco) or stress (chronic infection, post-op, trauma)
|
|
What is the most common form of tracheoesophageal fistula?
|
Proximal esophagus ends in blind pouch, distal esophagus connected to trachea
|
|
A three week old infant is brought to clinic for projectile vomiting. On exam he is found to have a palpable epigastric mass and visible peristalsis. What is the condition and recommended treatment?
|
Infantile hypertrophic pyloric stenosis (hypertrophy of muscularis propria of pylorus --> narrowing at antrum --> dilation of proximal stomach) Tx: Pyloromyotomy
|
|
Meckel's Diverticulum is a partial persistence of what duct?
|
Vitteline (connects lumen of gut to yolk sac)
|
|
Where is a Meckel's diverticulum most commonly found?
|
terminal ileum
|
|
What is the most common presentation of Meckel's diverticulum?
|
Asymptomatic
|
|
Omphalocele develops from the failure of what embyonic occurence?
|
Return of intestines to abdominal cavity
|
|
Malrotation of the intestines is associated with what complication?
|
Volvulus (because the lg intestine is not fixed in the retroperitoneum)
|
|
Name four congenital abnormalities of the gastrointestinal system.
|
Malrotation, omphalocele, stenosis/atresia, duplication
|
|
Stenosis and atresia typically present in conjuction with other abnormailities or with what disease?
|
cystic fibrosis
|
|
What leads to Hirschpring's Disease?
|
arrest of the neural crest migration at some point before anus
|
|
What segment of bowel is dilated in Hirschpring's Disease?
|
Proximal to aganglionic segment
|
|
What region of bowel is always involved in Hirschpring's Disease?
|
Rectum, segment can be short or long proximal to that
|
|
What ganglia are missing in Hirschpring's Disease?
|
Both Auerbachs and meissners are missing
|
|
What happens to premature infants that leads to Neonatal necrotizing Enterocolits?
|
Hypoemia (such as in RDS) --> blood shunted away from intestine --> organisms invade --> formation of gas gangrene --> perforation and peritonitis
|
|
Gastrischisis differs from omphalocele in what way?
|
lacks an amniotic covering
|
|
What is the difference between ulcer and erosion?
|
erosion destroys superficial mucosa, ulcer penetrates through mucosa
|
|
H pylori predisposes to what type of cancer?
|
intestinal gastric cancer
|
|
What are the two types of gastric cancer?
|
diffuse (individual cells invade and create fibrosis, endophitic) and intestinal (single lesion, exophitic)
|
|
How can you distinguish the different types of hypertrophic gastropathies?
|
Elevated serum gastrin on ZE, Hyperplasia parietal cells leads to H+ overproduction of both ZE and hypersecretory-hypertrophic, no increase in H+ on Menetriers
|
|
What protective factors exist to protect the gastric mucosa from injury?
|
mucus, HCO3-, epithelial layer is hydrophobic and has tight junctions, cells repair and regenerate quickly, rich blood supply
|
|
Gastrointestinal stromal tumor is responsive to what treatment?
|
Gleevac
|
|
What is the histologic presentation of lymphangiectasia?
|
villous distension
|
|
What can cause lymphangiectasia?
|
congenitally dilated lymphatic, any disease that secondarily obstructs the lymphatics
|
|
What is another name for celiac sprue?
|
Gluten Enteropathy
|
|
What are the antibodies targeted against in celiac sprue?
|
gliadin and other grain oligopeptides, or to transaminase at brush border
|
|
What is the histologic presentation of celiac sprue?
|
villous blunting
|
|
Acinar cells in the pancreas produce what?
|
enzymes
|
|
Ductal cells in the pancreas produce what?
|
aqueous solution with HCO3-
|
|
What function do the epithelial cells of the striated duct perform in the pancreas?
|
modify ion content
|
|
How does the CFTR protein aid in HCO3- production in the pancreas?
|
HCO3- is cotransported with Cl- ions, which are then effluxed by CFTR
|
|
CCK stimulates what type of secretion by the pancreas? What about secretin?
|
CCK --> enzymes, secretin --> HCO3- and aqueous solution
|
|
At low flow rates in the pancreas, what are the relative concentrations of HCO3- and Cl-?
|
low flow rates = low HCO3- (high, high) while Cl- is opposite
|
|
Is the salivary secretion more hypotonic at low or high flow rates?
|
low
|
|
What is the typical presentation of esophageal webs and rings?
|
INTERMITTANT dysphagia
|
|
What is the feature of diffuse esophageal spasm that helps distinguish it from achalasia?
|
normal peristalsis still occurs in DES
|
|
Name some of the organisms that cause diarrhea via a predominantly toxic mode of action.
|
E. Coli, Cholera, C. Dif, Campylobacter
|
|
What are some of the conqequences of the transmural inflammation seen in Crohn's Disease?
|
Creeping fat (due to fibrosis at inflammed sites extending into pericolic fat), fissures into muscularis propria, perforation, fistulas
|
|
Infection with what organism characteristically produces pseudomembranous colitis?
|
C. Difficile
|
|
What are the symptoms of amebiasis and what percentage of patients affected are symptomatic?
|
crampy abdominal pain, diarrhea, fever, tenesmus, only 10%
|
|
Describe the pathogenetic mechanisms whereby Appendicitis develops. Which mechanisms is usually limited to pediatric cases?
|
obstruction can happen at any age, viral infection affects kids more than adults
|
|
Of the two types of microscopic colitis, which is associated with a thin watery diarrhea? Lymphocyte infiltration of epithelium? More common in women? Associated with NSAID use?
|
Both; both; Collagenous; Collagenous
|
|
What cells are responsible for the firbrosis seen in chronic pancreatitis?
|
Stellate cells
|
|
What are the genetic mutations that infer a risk for chronic pancreatitis?
|
CFTR, PRSS (trypsinogen gene), SPINK-1 (trypsin inhibitor)
|
|
What is a secretin stimulation test?
|
performed on suspected pancreatitis patients, baseline taken for 1 hr, decreased HCO3- secretion (<80mEq/L) suggests disease
|
|
How can you distinguish between secretory and osmotic diarrhea?
|
Osmotic gap <50 is secretory, secretory persists with fasting and id large volume
|
|
What things can cause a secretory type diarrhea?
|
Bacterial toxins, bile salt malabsorption, laxatives, neuroendocrine tumor and diabetic dz in which enteric nerves are disordered
|
|
What treatments are available to patients with IBD?
|
5ASAs work in UC, antibiotics in CD, prednisone to induce remission in both
|
|
What are some of the risk factors associated with the development of gallstones?
|
obesity, age, female gender, genetics lead to cholesterol hypersecretion; terminal ileum resection and Crohn's lead to decrease in bile acid secretion
|
|
What is the best imaging technique for identifying gallstones?
|
U/S
|
|
What does steatorrhea, if present, suggest about the stage of chronic pancreatitis?
|
late - only happens after 90% gland is damaged
|
|
What is the difference between a pedunculated and a seeile polyp?
|
Presence (if pedunculated) of a vascular stalk; sessile more likely to be malignant
|
|
Where are annular colorectal carcinoma lesions more commonly found (what region of bowel)? What about bulky, exophitic lesions?
|
Distally; proximally
|
|
What is the hallmark dysplastic change in adenomatous polyps?
|
extension of the proliferative zone beyond the mucosal base
|
|
Villous Adenoma at the ampulla of Vater must be carefully evaluated for what common associated finding?
|
underlying invasive carcinoma (these are histologically distinct from other adenomatous polyps)
|
|
What is the least common part region of the bowel involed in colorectal carcinoma?
|
preferentially found at right or left side more than transverse
|
|
In the setting of Hereditary Non-Polyposis Colorectal Carcinoma syndrome, what other tumor might be seen in Tucot's presentation?
|
GBM (as opposed to medulloblastoma seen in tucot's with APC mutation)
|
|
What is one thing you should look for in a diabetic patient who is having trouble controlling their sugars?
|
Periodontal diesase; oral infection
|
|
What is the most commong chronic disease of childhood?
|
Dental Caries
|
|
What health and other issues are associated with dental caries in children?
|
poor eating/nutrition, facial cellulitis, abscess formation, impairment of speech development, academic trouble, poor self-esteem
|
|
Describe some of the endocrine functions of the liver.
|
Making blood proteins (Clotting factors), glycoproteins, and lipoproteins, storing glycogen, metabolizing lipid soluble molecules and toxins
|
|
What is the normal function of the stellate cells and where are they normally found?
|
Take up fats and fat soluble molecules, found in Space of Disse
|
|
What are some features of the hepatocyte and sinusoids that help maximize exchange of nutrients?
|
fenestrated endothelium, micovilli and minimal basement membrane on hepatocyte
|