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Glossary of STEP 1: GI

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Created by evrigsby

3 phases of digestion
1. Cephalic: triggred by sight, smell and thought of food. Stimulates vagal and cholinergic mechanisms
2. Gastric: triggered by chemical and volume presence of food in stomach. Stimulates gastrin
3. intestinal: triggered by protein products in intestines, downregulate gastrin secretion with peptide yy

3 chemicals that inhibit gastrin secretion
1. Peptide YY
2. Somatostatin
3. Prostaglandins

Can be absorbed independent of pancreatic enzymes
Monosaccharides:

Glucose
Galactose
D-XYLOSE (used to test brush border enzymatic function vs. pancreatic issues)



Part of small bowel that can be obstructed by SMA
Transverse Duodenum

Think large weight loss - no more intestinal fat to cushion bowel --> clamped between SMA and aorta

Dietary lipids are broken down in the ____ and ABSORBED in the ____.
Duodenum, jejunum
Colicky abd pain, Constipation + HA/Irritability = ______
Lead poisoning
IN CF the pancrease will have ____.
Ducts filled w mucus plugs
Common cause of hemmorrhagic diarrhea

Can only attack these types of cells

Shigella sonnei

M cells - line the base of microvilli in a peyers patch

"Reducing sugar"

Will be found in urine with _____ deficiency.

Fructose

Fructokinase

Most common H Pylori associated ulcer location

also a rare site for cancer to develop, unlike H Pylori infxn in the ____.

Duodenum

Gastric antrum

Stain that can detect the presence of fat in a stool sample
Sudan III
The incidence of _____ infection can greatly INCREASE in individuals taking a PPI
Vibreo Cholera
Lead poisoning should be associated with INCREASED serum levels of ________
Pyridoxyl phosphate
Bloody diarrhea with hepatosplenomegaly + TRAVEL
Typhoid fever
S. Typhi

(Also infects through M Cells)


Can be transmitted between pets and human --> diarrhea and abd pain
Campylobacter
Gastrin has 2 functions:
1. increases secretion of HCl
2. Initiation of cellular proliferation and potentially hyperplasia
A dangerous complication of Ulcerative Colitis: _______
Can be diagnosed with _____
Toxic megacolon
Plain film X-Ray
A common cause of SCID: _____
Pts are young and suffer from _______.
Adenosine deaminase deficiency

Diarrhea and FTT

Inadequately cooked hamburger
EHEC
Shiga/ Shiga-Like toxins kill cells by ____.
Deactivating the 60S ribosomal subunit in cells
Shiga-producing E Coli do NOT ferment _____ or produce ____
sorbitol, glucoronidase
Mastocytosis can lad to increased _____ which will lead to ______
histamine release via mast cells
increased gastrin release, causing gastric symptoms
Secretin stimulates _____ cells to release_____
pancreatic, bicarb
Pts deficient in IgA can have recurrant ____ infections
Giardia
____ produces IgA protease, which ____
Neisseria
Cleaves IgA at the Jprotein that links the secretory dimers






IgA dimers help battle bacteria in ___ tissue by ____
secretory
preventing attachment via pilli and other outer membrane proteins that may allow for penetration and subsequent infection
Pancreatic division leads to _____.

The dorsal bud forms ____
The ventral forms ______


2 ducts that drain into the duodenum

Pancreatic tissue: body, head, tail

Uncinate process, main pancreatic duct



The foregut includes ________.

These are supplied by branches off of the ______

Esophagus through middle duodenum, liver, GB, pancreas

Celiac Trunk

Even though it was not formed from the foregut, the ____ still gets blood from a foregut source, _______ via the _____.
Spleen
Splenic artery, Celiac trunk
Chrone's can lead to Gallstones because ______ cannot be absorbed in the ______ due to ______.

bile acids
terminal ileum
mucosal wall inflammation





Gall stones most often form because the _______ is off.
cholesterol:Bile Acid

increased levels of cholesterol cause stone formation

Villi blunting

Also = _____ (another name)

Gluten intolerance

Celiac Sprue

The inability to digest lactose causes diarrhea because ______________.
Lactose is an osmotic diuretic
increased lactose in the intestines leads to water being drawn INTO the lumen
Osmotic laxatives:
Magnesium ____'s
Polyetheylence Glycol
Lactulose

opiate antidiarrheal: _____
works on ____ receptors

higher doses can cause ____, and toxic doses cause _____.


Diphenoxylate
mu

euphoria and dependence

Dry mouth, blurry vision, sedation, bloating




Pernicious (megaloblastic) anemia is caused by ________.
deterioration of parietal cells -->loss of IF--> low B12 and anemia
Requires very few cells to cause disease when ingested
Shigella
Cells responsible in :
UC = ______

Chron's = _____


UC = Th2

Chron's = Th1

Pt with linear ulcerations in esophagus:
CMV
Parasitic infection from foreign country that affects muscular mucosa --> dysphagia / megacolon: _______

Does so by destroying _____

Trypanosoma Cruzi

myenteric plexus via neurotoxin

(Picornoviruses) Enteroviruses that can colonize GI tract
(Acid STABILE)






Picornoviruses: PERCH

Enteroviruses from this group: PECH

Polio
Echo
Coxsackie
Hep A






Picornovirus that CANNOT cause GI disease b/c it is Acid LABILE
Rhinovirus
A VIPoma will present as ______.

It resides in the ____.

It can be corrected with_____.



Watery, dark diarrhea that does not improve with diet change (including fasting) and has no pus or blood.

It is a pancreatic islet cell tumor

Somatostatin







Walls of a pseudo cyst consist of ____.
fibrous and granulation tissue
A zenker's diverticulum in the esophagus is caused by ____.
Cricopharyngeal muscle weakness
Signet ring cancer
gastric adenocarcinoma of the stomach wall that infiltrates the wall
Whipelli will present as _________.
Abdominal pain, arthritic pain,weight loss, and sometimes psychiatric issues.

Can be cured with ABx's

Will be a middle aged, white male



One last clue that pancreatitis may be caused by alcoholism:
Erythrocytic macrocytosis
Older pt with abd pain 30 minutes after a meal + severe bad cardiac history
atherosclerotic SMA
CEA levels measure _____.
colorectal cancer RECURRANCE
Mallory weiss tears actually occur due to ______.
Repeated increases in intra-abd pressure
(as with puking)
Pancreatic enzymes first exist as ______.
Zymogens
they rely on trypsin to be cleaved
C Diff produces 2 toxins.
Name and Describe
Toxin A: Enterotoxin that causes neutrophil chemoattraction, pulls water into gut --> diarrhea

Toxin B: Cytotoxin that disrupts cellular cytoskeleton

Black, breastfed baby needs ____.
Vitamin D

All babies need Vit K - this is given as a shot at birth

Colon cancer has been linked to this common enzyme ____.

____ can be used as they block the action of the enzyme

COX-2

NSAIDs

PID is often caused by these 2 diseases: ________.
Chlamydia, Ghonnorhea

3rd gen cephalosporin for Ghon
Azithromycin or Doxy for Chlamydia


Esophageal cancer + alcohol and Tobacco abuse = ______
Squamous cell carcinoma

50% of esophageal cancers

Movement in neural crest cells occurs _____.
Caudally down the vegas nerve.
Rectum last.
HNPCC = _________
uncorrected mismatch repair
most common cause for appendicitis:
Obstruction
Anti-inflammatory cytokines: ______
TGF-B, IL-10
Trypsin is stored in ______ .

Destruction of these leads to ____.

pancreatic acinar cells as trypsinogen

pancreatic auto-digestion

Sythetic analogue of somatostatin:

Octreotide

Can solve symptoms of carcinoid syndrome

This polio vaccine provides a greater IgA response on ______ mucosa.
GI

Sabin live attenuated

(as opposed to the salk inactivated)



treat arsenic poisoning with ______
dimercapterol
Crohn's causes the formation of _____ stones.
oxalate kidney
Three major risk factors for pancreatic cancer:
1. Age - 65-75
2. SMOKING
3. Diabetes

Pancreatic cancer will present as:
Abdominal pain, PALE STOOL, dark urine
Opiods can cause ______.
Biliary colic - even to the point of icturis
These compounds can damage pancreatic cells directly.
They increase in the serum with increase in ______.
Free Fatty Acids

Triglycerides

A gallstone can lodge at the ______ and cause intestinal obstruction.
ileocecal junction

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