03b-e Stomach path and phys

Question 0

Trituration

Answer 0

Large solids repelled backward for repeatedd grinding

Question 1

Size of particles through pylorus during fed

Answer 1

1-2mm

Question 2

Enegry delivery to small intestine

Answer 2

1-4kCal/min

Question 3

Secretin

Answer 3

• Secreted by duodnum in response to AA, lipids, or HCL

* relaxes stomach, inhibits contractions, increases non propulsive duodenal contractions

Question 4

Somatostatin

Answer 4

Duodenum release in response to peptides and acid

Inhibits FUNDUS MORE

Question 5

CCK

Answer 5

• Duodenal release in response to fat- More with longer lipids
• SLOWS EVERYTHING DOWN (stomach and SI)

Question 6

GIP

Answer 6

Glucose dependant insulinotropic peptide

• small intestine response to glucose
• duoodenal response to glutamine, AA, FA
• colonic response to fermentation

Question 7

Grehlin

Answer 7

Increases rate of gastric emptying and initiates MMC

Question 8

Gastric emptying changes

Answer 8

Weightloss –> slower gastric emptying

Overfeeding—> Quicker empying

Question 9

MMC

Answer 9

fasting motor activity
q1-6 hrrs (usually 90 min) of fasting
3/min at max
MOVES LARGE SOLIDS FROM STOMACH

Question 10

Accommadation failure

Answer 10

• Early satety, pain/bloating, NV, Weight loss, diarrhea, cramps, flatus
• quick gastric emptying of hyper osmotic chyme leads to small bowel distention and hypotension (reverse osmosis from vasculature)
• Poorly timed poor digestion- nutritional deficiency
• Fermentattion of undigested material in colon
• Reactive hypoglycemia from quickk surge and drop in glucose
• acidic duodenum (ulcers and enzyme destruction)

Question 11

MMC failure

Answer 11

Cant clear indigestables
-bezoar and enteric pills remain
small intestinal overgrowth

Question 12

Gastroparesis

Answer 12

Delayed gastric emptying in absence of obstruction

• Early satiety, postprandial fullness, NV, bloating, epigastric pain
• Diagnosis of EXCLUSION

Question 13

Elevated gastrin

Answer 13

Increased gastrin levvels with antrum at pH of 2

Question 14

Zollinger Ellison syndrome

Answer 14

• Neuroendocrine tumor- Isolated gastronoma 75%(sporadic), or MEN1
• elevated basal acid
• > 150pg/ml gastrin (though higher common)
• Paradoxical gastrin secretion with Secretin
• PPI CAN CAUSE FALSE NEGATIVES

Question 15

ZE symptoms

Answer 15

• Severe ulcer disease

- Acidic diarrhea- hypokalemia, steatorrhea, weightloss

Question 16

PPI doesn’t affect secretion of

Answer 16

Gastric lipase

Intrinsic ffactor