STEP 1: GI

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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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Deck Info

Number of cards 71

Created By evrigsby