Quiz #3 Tutor Review

Select the characteristics that were discussed with respect to gastritis?

Acute gastritis refers to a condition that results fairly quickly / Risk factors for gastritis include excessive alcohol consumption and smoking / There can be cases of gastritis that could cause bleeding

Zollinger-Ellison syndrome will produce multiple ulcerations to the intestinal tract that appear similar to peptic ulcers. True or false?

True

Please select the type of contractions that occur in the small intestine.

Peristalsis / Segmentation

Chronic gastritis may lead to excessive degeneration of the mucosa which can decrease acid production. True or false?

True

Pick the option that correctly describes the small intestine.

The duodenum has the ampulla of Vater which allows for bile and enzymes to enter the intestine / The small intestine is responsible for the completion of digestion to allow for absorption to occur

Pick the statement that correctly applies to Peutz Jager syndrome.

All the options are correct / The changes associated with this condition are usually seen in children

Please select the option that is correct with respect to the Crypts of Lieberkuhn.

The immature cells found in the crypts produce intestinal fluid that helps the absorption process in the small intestine

Which of the following is correct with respect to peptic ulcers?

Ulcers are often going to affect the stomach and the duodenum

A patient with Peutz-Jeghers Syndrome will need to be monitored because of the higher risk of these individuals developing a malignancy. True or false?

True

As discussed carbohydrates are digested in the stomach from the action of ptyalin that was released by the gastric glands. True or false?

False

Symptoms that were described for gastritis include abdominal pain and nausea but can also exist without producing any symptoms. True or false?

True

In lecture we discussed risk factors that increase the chance of developing a peptic ulcer of the stomach. Select all the options that are correct.

Infection of H pylori / Excessive use of NSAIDs

Which of the following statements is correct with respect to the action of the small intestine?

Eating a hamburger will cause a stretching of the stomach which would also cause contractions of the small intestine / Eating an apple would cause contraction of the small intestine because secretin would be released

Excessive NSAID use can be problematic for the stomach because it inhibits COX enzymes that are essential for the production of acid. True or false?

False

What is the name of a condition that results in an overproduction of gastrin?

Zollinger-Ellison

Select all of the options that may be affected with achlorhydria. Select all that apply.

There will be increased incidence of intestinal infections / This condition may cause duodenal secretions of secretin to be reduced

Select all the options that are correct with respect to the ileocecal valve.

As the cecum contracts it puts pressure on the valve that can seal it closed / The ileocecal valve is the point where chyme passes and then is referred to as fecal matter

Peyer’s patches are found in the small intestine and are responsible for an immune response in the intestine. True or false?

True

All of the following are risk factors for developing gastric cancer EXCEPT?

Excessive amounts of vegetables

Pepsinogen is an inactive enzyme responsible for digestion in the stomach. What is needed to activate that enzyme?

HCl

Which hormone produced by the small intestine creates an enhanced contraction of the small intestine?

CCK

All of the following structures are found on the inner surface of the small intestine EXCEPT?

Lacteal, plicae circulares, villi, and microvilli

Lacteal

There is a low amount of protein digestion in the stomach because pepsin which was released by the salivary glands stops working in the stomach

False

In lecture we discussed several features that are present in the small intestine for increased surface area. What is the name of the structure that is primarily composed of the mucosal layer of the small intestine?

Villi

Select the options that can be symptoms of a person diagnosed with Zollinger Ellison-Syndrome as described in lecture

Vomiting blood / Diarrhea

There are several factors which control movements in the small intestine. Which of the following is correct with respect to this activity?

Secretin inhibits intestinal motility

Gastritis may be caused by excessive NSAID use

True

The liver stores in varying quantities vitamins

A/D/E/K/B12

If describing the liver by a structural basis

the smallest unit is a lobule

The common hepatic artery supplies the liver

gallbladder and part of the stomach

An absence of saliva is referred to as achlorydia

False

Scleroderma may cause an absence of peristalsis within the esophagus

True

Zollinger-Ellison syndrome has a characteristic of multiple benign hamartomatous polyps

False

If a large section of the small intestine were diseased by Crohn’s

especially the duodenum

Where would you find the greatest concentration of Peyer’s patches?

Ileum

Explain how hydrochloric acid (HCl) is secreted in the stomach and which transporters are involved.

Parietal cells secrete HCl via H+/K+ ATPase proton pumps

Describe the process and importance of emulsification in fat digestion in the small intestine.

Bile salts surround fat droplets to create micelles

List the consequences of achlorhydria and explain why each occurs.

Poor absorption of iron and calcium due to lack of stomach acid / Increased risk of intestinal infections / Impaired digestion of protein

Differentiate between Peptic Ulcer Disease and Zollinger-Ellison Syndrome.

Peptic Ulcer Disease is typically due to H. pylori or NSAID use

Describe the structural features of the villi in the small intestine and their roles in absorption.

Finger-like projections composed of mucosa with enterocytes and microvilli increase surface area for nutrient absorption

Chief cells secrete HCl and intrinsic factor

False

Brunner’s glands are only found in the submucosa of the ileum

False

Pepsinogen is activated by hydrochloric acid to become pepsin

True

Chronic atrophic gastritis is commonly associated with H. pylori infection and can lead to pernicious anemia

True

The cecum is a part of the small intestine

False

Which enzyme digests starch in the mouth?

Amylase

What percent of protein is digested in the stomach?

10–20%

Which of the following is secreted by the pancreas and breaks down protein in the small intestine?

Trypsin

What structure regulates the release of bile and pancreatic enzymes into the duodenum?

Ampulla of Vater

What type of cells line the villi of the small intestine?

Columnar

Which structure is responsible for absorbing dietary fats?

Lacteals

Which hormone increases motility in the small intestine?

Motilin

What is a hallmark symptom of gastric carcinoma?

Dyspepsia

Which of the following leads to poor calcium absorption due to lack of stomach acid?

Achlorhydria

What is the role of enteropeptidase?

Activates trypsinogen

Which cell type in the small intestine secretes lysozyme for immune defense?

Paneth cells

What component of micelles allows for transport of fats to intestinal epithelium?

Lecithin

Which pathology involves brown/gray spots on the lips and oral mucosa?

Peutz-Jeghers Syndrome

Which valve marks the transition from small intestine to large intestine?

Ileocecal valve

Which is true of amylose?

Has tighter alpha-1

Which of the following is an aggressive stimulus in gastritis?

H. pylori

Which type of cells are responsible for secreting pepsinogen?

Chief cells

What does the gastroileal reflex do?

Moves chyme into the cecum

What is the main structural characteristic of plicae circulares?

Made of submucosa and mucosa

What inhibits intestinal motility?

Secretin

Symptoms of Zollinger-Ellison syndrome

Abdominal pain / Bloating / Nausea / Vomiting / Chronic diarrhea

Zollinger Ellison syndrome is

A condition where gastrin-secreting tumors increase gastric acid secretion

The treatment for peptic ulcers would be

Antibiotics

What is a risk with proton pump inhibitors?

Renal failure

What layer of the alimentary tract is affected by Peutz-Jeghers hamartomatous polyps?

The entire mucosa

S cells secrete

Secretin

Somatostatin effect

Inhibits gastric secretions

K cells secrete

GIP (duodenum)

Action serotonin performs

Stimulates contraction of stomach / Excitatory

Two hormones that have an excitatory effect on motor function and motility

Gastrin / Serotonin

I cells secrete

CCK

CCK function

Digest fat and protein

What is the enterogastric reflex?

Inhibitory action in the duodenum that slows down stomach secretion via sympathetic/enteric nervous system modulation

What is a reflex?

Rapid change involuntary response to stimulus

How much digestion of carbs occurs in the stomach?

30–40%

What enzyme is digesting carbs in the stomach?

Salivary amylase (ptyalin)

How much digestion of protein occurs in the stomach?

10–20%

What enzyme digests protein in the stomach?

Pepsinogen converted to pepsin in acidic environment

Negative effect of NSAIDs

Decrease mucosal lining of the stomach and increase risk of gastritis

Common symptom of gastritis

Indigestion / Dyspepsia / May be asymptomatic

Pernicious anemia

Lack of intrinsic factor leading to vitamin B12 deficiency and macrocytic anemia

Vitamin B12

Essential for DNA synthesis

What is H. pylori a risk factor for?

Chronic atrophic gastritis / Peptic ulcers

Chronic atrophic gastritis will lead to

Poor absorption of iron and calcium due to higher pH from decreased HCl

Is emulsification digestion?

No

Bile salt surrounding MGs and FAs is known as

Micelle

Bile salts also emulsify

Lipophilic and hydrophobic nutrients like cholesterol and fat-soluble vitamins for absorption

What percent of fats are digested in the stomach?

10% of triglycerides are digested

what enzyme digests fats

lingual lipase from saliva