Diabetes and Gastrointestinal Quiz
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Questions and Answers

What is the primary reason for absolute insulin deficiency in Type 1 Diabetes Mellitus?

  • Increased insulin breakdown in the liver
  • Reduced insulin production by the pancreas
  • Insulin resistance in target tissues
  • Destruction of pancreatic beta cells (correct)

    • What is the primary metabolic consequence of an inability to utilize glucose as fuel in diabetes mellitus?

  • Increased protein synthesis
  • Usage of fats as an alternative energy source (correct)
  • Elevated blood glucose levels
  • Increased glycogen storage in the liver

    • What is the main reason ketones are produced in Type 1 Diabetes Mellitus?

  • Increased carbohydrate intake
  • Increased glucose uptake by cells
  • Breakdown of fats for energy (correct)
  • Excessive protein breakdown

    • Which of these is a symptom of untreated ketoacidosis in Type 1 Diabetes Mellitus?

    <p>Hyperpnea (B)</p> Signup and view all the answers

    What physiological process is impaired in Type 2 Diabetes Mellitus?

    <p>Insulin binding to target tissues (A)</p> Signup and view all the answers

    Which symptom is characteristic of hyperinsulinism?

    <p>Hypoglycemia (C)</p> Signup and view all the answers

    What is a common treatment for hypoglycemia due to hyperinsulinism?

    <p>Sugar ingestion (B)</p> Signup and view all the answers

    Which of these is NOT a risk factor for Type 2 Diabetes Mellitus?

    <p>Hypothyroidism (A)</p> Signup and view all the answers

    What is the first part of the large intestine?

    <p>Cecum (A)</p> Signup and view all the answers

    What condition is characterized by acute inflammation of the appendix?

    <p>Appendicitis (A)</p> Signup and view all the answers

    What is the role of the rectal valves?

    <p>Stop feces from being passed with gas (A)</p> Signup and view all the answers

    Which part of the large intestine travels upward on the right side of the abdomen?

    <p>Ascending colon (C)</p> Signup and view all the answers

    Which section of the colon is S-shaped and travels through the pelvis?

    <p>Sigmoid colon (A)</p> Signup and view all the answers

    What is the primary alkaline component of pancreatic juice that helps neutralize acidic chyme?

    <p>Bicarbonate (HCO3−) (D)</p> Signup and view all the answers

    What activates trypsinogen in the duodenum?

    <p>Enteropeptidase (B)</p> Signup and view all the answers

    Which enzyme is responsible for digesting carbohydrates in pancreatic juice?

    <p>Amylase (D)</p> Signup and view all the answers

    What is a key characteristic of proteases secreted by the pancreas?

    <p>They are secreted in inactive forms and require activation. (A)</p> Signup and view all the answers

    How much pancreatic juice does the pancreas typically produce daily?

    <p>1200–1500 ml (A)</p> Signup and view all the answers

    What is the primary function of enzymes in the digestive process?

    <p>To break down macromolecules into smaller absorbable units (A)</p> Signup and view all the answers

    Where does the digestion of carbohydrates begin?

    <p>In the mouth with salivary amylase (C)</p> Signup and view all the answers

    Which type of transport is primarily used for the absorption of polar molecules?

    <p>Active transport (A)</p> Signup and view all the answers

    What happens to salivary amylase when it reaches the acidic environment of the stomach?

    <p>It is denatured and inactivated (A)</p> Signup and view all the answers

    Which macromolecule is primarily broken down by brush border enzymes?

    <p>Carbohydrates (D)</p> Signup and view all the answers

    Which of the following substances is absorbed via lacteals?

    <p>Fatty acids (C)</p> Signup and view all the answers

    What is the principal polysaccharide found in the human body?

    <p>Glycogen (A)</p> Signup and view all the answers

    What is the role of tight junctions in the intestinal epithelium?

    <p>They control the passage of molecules between the lumen and blood. (B)</p> Signup and view all the answers

    What is the primary function of the mucosa in the alimentary canal?

    <p>Secretion, absorption, and protection (C)</p> Signup and view all the answers

    Which layer of the alimentary canal wall contains blood and lymphatic vessels?

    <p>Submucosa (B)</p> Signup and view all the answers

    Which of the following organs is classified as retroperitoneal?

    <p>Pancreas (C)</p> Signup and view all the answers

    What is a characteristic feature of the epithelial layer of the mucosa?

    <p>Simple columnar epithelium with Goblet cells (D)</p> Signup and view all the answers

    The muscularis externa is primarily responsible for which function?

    <p>Segmentation and peristalsis (A)</p> Signup and view all the answers

    What tissue type makes up the lamina propria of the mucosa?

    <p>Loose areolar connective tissue (C)</p> Signup and view all the answers

    Which component is NOT part of the four basic layers of the alimentary canal?

    <p>Peritoneum (B)</p> Signup and view all the answers

    What is the primary role of the muscularis mucosae?

    <p>Producing local movements of the mucosa (B)</p> Signup and view all the answers

    What is the primary form of thyroid hormone that consists of two tyrosine molecules with four bound iodine atoms?

    <p>T4 (D)</p> Signup and view all the answers

    What is the predominant effect of thyroid hormone on the basal metabolic rate?

    <p>Increases it (C)</p> Signup and view all the answers

    How is T4 converted to T3 in the body?

    <p>It loses one iodine atom (D)</p> Signup and view all the answers

    Which hormone triggers the release of T3 and T4 from storage in the thyroid follicles?

    <p>Thyroid-stimulating hormone (TSH) (C)</p> Signup and view all the answers

    What is the role of iodine in thyroid hormone synthesis?

    <p>It is necessary for the formation of T3 and T4 (B)</p> Signup and view all the answers

    What happens to thyroid hormone (TH) levels when they fall below a certain threshold?

    <p>Thyroid-stimulating hormone (TSH) is stimulated (C)</p> Signup and view all the answers

    Which substance has the most significant role in increasing adrenergic receptors in blood vessels?

    <p>Thyroid hormone (A)</p> Signup and view all the answers

    Which of the following hormones can inhibit the release of thyroid-stimulating hormone (TSH)?

    <p>Thyroid hormone (TH) (B)</p> Signup and view all the answers

    Flashcards

    Cecum

    The first part of the large intestine.

    Appendix

    A mass of lymphoid tissue attached to the cecum.

    Appendicitis

    Acute inflammation of the appendix, often due to fecal blockage.

    Colon

    The large intestine, divided into four regions: ascending, transverse, descending, and sigmoid.

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    Rectum

    The final section of the large intestine with three transverse folds (rectal valves).

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    Alimentary Canal

    A continuous tube from mouth to anus where digestion occurs.

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    Mucosa

    The innermost layer of the alimentary canal; involved in secretion and absorption.

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    Submucosa

    The layer outside the mucosa containing blood vessels, lymphatics, and a nerve plexus.

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    Muscularis Externa

    The layer that allows for segmentation and peristalsis in the digestive tract.

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    Intraperitoneal

    Refers to organs located within the peritoneum.

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    Retroperitoneal

    Refers to organs located behind the peritoneum, like the pancreas and parts of the large intestine.

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    Mucosal Function: Secretion

    Mucosa secretes mucus, digestive enzymes, and hormones for digestion.

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    Muscularis Mucosae

    Smooth muscle layer of the mucosa that creates local movements.

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    Type 1 Diabetes Mellitus

    An autoimmune condition causing destruction of pancreatic beta cells, leading to absolute insulin deficiency.

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    Type 2 Diabetes Mellitus

    Characterized by insulin resistance, causing relative insulin deficiency and interference with glucose uptake.

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    Insulin Mechanism of Action

    Insulin facilitates glucose uptake by cells and regulates glucose production and release by the liver.

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    Ketogenesis

    The metabolic process where fatty acids are converted into ketone bodies, especially during insulin deficiency.

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    Ketoacidosis

    A condition resulting from the buildup of ketones in the blood, leading to acidosis and potential coma.

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    Hyperinsulinism

    A condition characterized by excessive insulin secretion, leading to low blood glucose levels (hypoglycemia).

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    Ketonuria

    Presence of ketones in urine, often a result of ketoacidosis in diabetes.

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    Diabetes Risk Factors

    Factors that increase the risk of developing type 2 diabetes include age, obesity, and inactivity.

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    Digestion

    Catabolic process that breaks down macromolecules into monomers for absorption.

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    Enzymatic Hydrolysis

    Process where enzymes add water to break chemical bonds in polymers.

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    Enzymes

    Proteins that catalyze biochemical reactions, including digestion.

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    Absorption

    Movement of substances from the gut lumen into the body.

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    Tight Junctions

    Structures that allow molecules to pass through cells, not between them.

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    Lipid Absorption

    Lipid molecules are absorbed passively through cell membranes.

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    Carbohydrate Types

    Carbohydrates exist as mono-, di-, and polysaccharides, only monosaccharides are absorbed.

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    Salivary Amylase

    Enzyme in saliva that begins carbohydrate digestion in the mouth.

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    Pancreas Location

    The pancreas is mostly retroperitoneal, with its head encircled by the duodenum and the tail abutting the spleen.

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    Endocrine Function

    The endocrine portion of the pancreas secretes insulin and glucagon from pancreatic islet cells.

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    Exocrine Function

    The exocrine pancreas produces pancreatic juice with zymogen granules and secretes it into the duodenum.

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    Composition of Pancreatic Juice

    Pancreatic juice contains a watery, alkaline solution (pH 8), electrolytes (mainly HCO3−), and digestive enzymes.

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    Activation of Proteases

    Proteases are secreted inactive and activated in the duodenum by enteropeptidase, starting a cascade of activations.

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    Thyroid Hormone (TH)

    The body's major metabolic hormone, influencing numerous bodily functions.

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    Forms of Thyroid Hormone

    TH exists as T4 (thyroxine) and T3 (triiodothyronine), both derived from tyrosine.

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    Calorigenic Effect

    The increase in basal metabolic rate and heat production due to TH.

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    Role of Iodine

    Iodine is essential for synthesizing T3 and T4 hormones.

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    Thyroid Hormone Synthesis

    T3 and T4 are synthesized and stored in thyroid follicles until released by TSH.

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    Transport of T3 and T4

    Thyroid hormones are transported in the blood by thyroxine-binding globulins.

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    TSH Regulation

    Thyroid-stimulating hormone (TSH) regulates TH release; low TH increases TSH, high TH inhibits it.

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    Impact on Blood Pressure

    TH helps maintain blood pressure by increasing adrenergic receptors in vessels.

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    Study Notes

    The Digestive System Part II

    • The digestive system consists of the oral cavity, salivary glands, esophagus, pancreas, gallbladder, stomach, large intestine, and small intestine.
    • The digestive system structures work together to process food for absorption into the body.

    Accessory Digestive Organs of the Small Intestines

    • The liver's primary function is bile production.
    • The gallbladder stores bile.
    • The pancreas supplies most of the enzymes needed to digest chyme, alongside bicarbonate to neutralize stomach acid.

    Gross Anatomy of the Liver

    • The largest gland in the body, roughly 3 pounds.
    • Consists of four primary lobes: right and left, quadrate, and caudate.
    • The gallbladder sits in a recess on the inferior surface of the right lobe.
    • Falciform ligament separates the larger right lobe from the smaller left lobe.
    • It is suspended from the diaphragm and the anterior abdominal wall.
    • The round ligament is a remnant of the fetal umbilical vein, aligned along the free edge of the falciform ligament.
    • Lesser omentum anchors the liver to the stomach.
    • The hepatic artery proper and hepatic portal vein enter the liver at the porta hepatis.
    • Bile leaves the liver through left and right hepatic ducts, which fuse to form the common hepatic duct.
    • The cystic duct fills/drains the gallbladder.
    • The bile duct is formed by the union of the common hepatic and cystic ducts.

    Microscopic Anatomy of the Liver

    • Liver lobules are hexagonal, sesame-sized structural and functional units.
    • Plates of hepatocytes (liver cells) filter and process nutrient-rich blood.
    • Central veins are located along the longitudinal axis.
    • Liver sinusoids are leaky capillaries between hepatic plates, lined with stellate (hepatic) macrophages that remove debris and old red blood cells.
    • Portal triads in each corner of a lobule contain a branch of the hepatic artery (supplies O2), a branch of the hepatic portal vein (delivers nutrient-rich blood from the intestine), and a bile duct (receives bile from bile canaliculi).

    The Liver

    • Hepatocytes contain rough and smooth ER, Golgi apparatus, peroxisomes, and mitochondria.
    • They produce approximately 900 ml of bile per day.
    • Hepatocytes process bloodborne nutrients, storing glucose as glycogen and producing plasma proteins.
    • They store fat-soluble vitamins and perform detoxification functions (e.g., converting ammonia to urea).
    • Hepatocytes excrete bilirubin into the bile, phagocytize old red blood cells, leukocytes, and some bacteria, and synthesize most clotting factors and lipoproteins.
    • The only digestive function of the liver is bile production.

    Bile: Composition and enterohepatic circulation

    • Bile is a yellow-green, alkaline solution containing bile salts , cholesterol derivatives and phospholipids that function in fat emulsification and absorption.
    • Bilirubin, the main bile pigment from heme of hemoglobin, is broken down by bacteria in the intestine to stercobilin, which gives the brown color to feces.
    • Bile also contains cholesterol, triglycerides, phospholipids, and electrolytes.
    • Enterohepatic circulation is a recycling mechanism that conserves bile salts.
    • Reabsorbed in the ileum, they are returned to the liver.
    • 95% of secreted bile salts are recycled.

    The Gallbladder

    • A thin-walled muscular sac on the inferior surface of the liver.
    • Stores and concentrates bile by absorbing its water and ions.
    • Contains honeycomb folds that allow it to expand as it fills.
    • Muscular contraction releases bile via the cystic duct into the common bile duct.

    The Pancreas

    • Mostly retroperitoneal, with its head encircled by the duodenum and its tail abutting the spleen.
    • Contains endocrine (insulin and glucagon) and exocrine (pancreatic juice) parts.
    • Acinar cells produce zymogen granules containing proenzymes.
    • Ducts secrete to the duodenum via the main pancreatic duct, with smaller ducts producing water and bicarbonate (HCO3—).
    • Pancreatic juice is 1200-1500ml/day and contains watery alkaline solution (pH 8) to neutralize acidic chyme from the stomach, electrolytes (primarily HCO3−), and digestive enzymes (e.g. proteases, amylase, lipases, and nucleases).
    • Proteases are produced in inactive form (proenzymes) and require activation in the duodenum by enterokinase.

    The Small Intestine

    • The major organ of digestion and absorption.
    • Includes duodenum, jejunum, and ileum.
    • Extends from pyloric sphincter to ileocecal valve; ~7-13 ft during life and ~20ft in a cadaver.
    • Has a small diameter of 2.5-4 cm (1.0 - 1.6 inches).
    • Modifications (circular folds, villi, and microvilli) increase surface area ~ 600x to ~ 200 m2, aiding absorption.
    • Blood supply from superior mesenteric artery; venous return via veins to superior mesenteric veins, then hepatic portal vein, and finally the liver.
    • Nerve supply from parasympathetic innervation via the vagus nerve and sympathetic innervation from thoracic splanchnic nerves.
    • The mucosa has absorptive cells synthesizing digestive enzymes (brush border enzymes), producing intestinal juice (a watery mixture of mucus that aids in chyme transport), and five main cell types (enterocytes, goblet cells, enteroendocrine cells, and paneth cells).

    The Large Intestine

    • Frames the small intestine on three sides, extending from the ileocecal valve to the anus.
    • Much shorter than the small intestine (~1.5 vs. 6 m), but about twice its diameter (~7 cm).
    • Major functions include absorbing most of the remaining water from indigestible food residues, and absorbing metabolites produced by resident bacteria.
    • It also stores residues temporarily and eliminates them as semisolid feces.
    • Subdivisions include: cecum, appendix, ascending colon, transverse colon, descending colon, and sigmoid colon.
    • The anal canal terminates at the anus and includes the internal and external anal sphincters; they close the anus except during defecation.
    • Mucus from glands in the mucosa coats the large intestine and reduces friction.
    • The muscularis externa has 3 bands, called teniae coli, that run the length of the colon and form pouches called haustra, which facilitate movement of digested material.

    The Liver, Gallbladder, and Pancreas

    • The liver, gallbladder and pancreas function in digestion and absorption of nutrients.

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    Digestive System Part II PDF

    Description

    Test your knowledge on critical concepts related to Type 1 and Type 2 Diabetes Mellitus, including insulin deficiency, metabolic consequences, and symptoms of ketoacidosis. Additionally, explore questions related to the anatomy and functions of the large intestine. This quiz combines essential aspects of endocrinology and gastrointestinal physiology.

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