At what concentration is the

transport mechanism for 300 mg/dL

glucose saturated?

Define effective renal plasma ERPF = U (PAH) x V/P (PAH) =

flow. C (PAH)

Define filtration fraction. FF = GFR/ RPF

Define free water clearance. C(H2O) = V- C(osm)

 GFR = U(inulin) x V/P (inulin) =
C (inulin) GFR also equals the
difference in (osmotic pressure
Define GFR. of the glomerular capillary
minus Bowman's space) and
(hydrostatic pressure of the
glomerular capsule minus
Bowman's space).

Define renal blood flow. RBF = RPF/1 - Hct

Cx = UxV/Px The volume of

plasma from which the
Define renal clearance.
substance is cleared
completely per unit time.

V = urine flow rate C (osm) =

Define urine flow rate.
U(osm)V/P(osm)
 Reabsorption occurs by at
How are amino acids cleared least 3 distinct carrier
in the kidney? systems, with competitive
inhibition within each group.

By inhibiting the production

of prostaglandins which
How do NSAIDs cause renal
normally keep the afferent
failure?
arterioles vasodilated to
maintain GFR

How high can the osmolarity

1200-1400 mOsm
of the medulla reach?

How is ICF measured? ICF = TBW - ECF

How is interstitial volume
Interstitial volume = ECF - PV
measured?

How is PAH secreted? Via secondary active transport

How is PAH transport Mediated by a carrier system

mediated? for organic acids

How much of the ECF is

Three-fourths
interstitial fluid?
 How much of the ECF is
One-fourth
plasma?

How much of the total body

water is part of intracellular Two-thirds
fluid?

How much of the total body

water is part of the One-third
extracellular fluid?

If clearance of substance X is There is no net secretion or

equal to GFR, what occurs? reabsorption
If clearance of substance X is
greater than GFR, what
occurs?
If clearance of substance X is
less than GFR, what occurs?
T/F. Secondary active
transport of amino acids is
saturable.
What 3 layers form the
glomerular filtration barrier?
Net tubular secretion of X
Net tubular reabsorption of X
TRUE
1. Fenestrated capillary
endothelium 2. Fused
basement membrane with
heparan sulfate 3. Epithelial
layer consisting of podocyte
foot processes
 -Increase water permeability
of principle cells in collecting
What actions does ADH have ducts -Increase urea
on the kidney? absorption in CD -Increase
Na/K/2Cl transporter in the
thick ascending limb

-Contraction of efferent
arteriole increasing GFR -
What actions does AII have on
Increased Na and HCO3
the kidney?
reabsorption in proximal
tubule

-Increased Na reabsorption in
What actions does aldo have distal tubule -Increased K
on the kidneys? secretion in DT -Increased H
ion secretion in DT

What actions does ANP have -Decreased Na reabsorption -

on the kidney? Increased GFR
 -Increased Ca reabsorption -
What actions does PTH have Decreased phosphate
on the kideny? reabsorption -Increase 1,25-
(OH)2 Vit D production

What activates 1 alpha-

PTH
hydroxylase?

1. Vasoconstriction 2. Release
of aldo from adrenal cortex 3.
What are the 4 actions of Release of ADH from
angiotensin II? posterior pituitary 4.
Stimulates hypothalamus to
increase thirst

1. EPO release 2. Vitamin D

What are the 4 endocrine
conversion 3. Renin release 4.
functions of the kidney?
Prostaglandins release
 -Albuminuria -
What are the consequences of Hypoproteinemia -
a loss in the charge barrier? Generalized edema -
Hyperlipidemia

What competitively inhibits

Probenecid
the carrier system for PAH?

What constricts the efferent

Angiotensin II
arteriole?

What dilates the renal afferent

Prostaglandins
arteriole?
 What do the collecting ducts
reabsorb in exchange for K or Na ions
H?

Cleave angiotensinogen into

What does renin do?
angiotensin I

What does the anterior -FSH and LH -ACTH -GH -

pituitary secrete? TSH -MSH -Prolactin

What does the beta subunit The beta subunit determines

do? hormone specificity
What does the early distal
convoluted tubule actively -Na ions -Cl ions
reabsorb?

What does the posterior

ADH and oxytocin
pituitary secrete?

What does the secretion of

Vasodilates the afferent
prostaglandins from the
arterioles to increase GFR
kidney do?

What does the thick

ascending loop of Henle -Na ions -K ions -Cl ions
actively reabsorb?
 What does the thick
descending loop of Henle -Mg ion -Ca ions
indirectly reabsorb?

What effect does constriction -Decreased RPF -Increased

of the efferent arteriole have? GFR -FF increases

What effect does dilation of -Increased RPF -Increased

the afferent arteriole have? GFR - FF remains constant

What enzyme converts 25-OH

1alpha-hydroxylase
Vit D to 1,25-(OH)2 Vit D?
What happens to glucose in Glucose is completely
the kidneys when glucose is reabsorbed in the proximal
at a normal level? tubule.

1. ADH 2. Aldosterone 3.
What hormones act on the
Angiotensin II 4. Atrial
kidney?
natriurtic Peptide 5. PTH

What inhibits constriction of

ACE inhibitors
the efferent arteriole by AII?

What inhibits dilation of the

afferent arteriole by NSAIDS
prostaglandins?
What is an important clinical
Glucosuria
clue to diabetes?

To increase intravascular
What is angiotensin II's
volume and increase blood
overall function?
pressure

What is passively reabsorbed Water via medullary

in the thin descending loop of hypertonicity (impermeable to
Henle? sodium)

What is reabsorbed in the

early distal tubule under the Ca ions
control of PTH?
 Reabsorbs all of the glucose
What is the function of the
and amino acids and most of
early proximal convoluted
the bicarbonate, sodium, and
tubule?
water

What is the oncotic pressure

Zero
of Bowman's space?

What is the thick ascending

loop of Henle impermeable Water
to?

What is the threshold for

glucose reabsorption in the 200 mg/dL
proximal tubule?
 What may act as a 'check' on
the renin-angiotensin system ANP
in heart failure?

What part of the nephron Early proximal convoluted

secretes ammonia? tubule

What part of the pituitary is

Posterior pituitary
derived from neuroectoderm?

What percentage of the body

0.6
is water?
 What regulates the
reabsorption of water in the ADH
collecting ducts?

What secretes renin? JG cells

-Increased plasma osmolarity

What stimulates ADH
-Greatly decreased blood
secretion?
volume

-Decreased blood volume (via

What stimulates aldosterone
AII) -Increased plasma K
secretion?
concentration
What stimulates angiotensin Decreased blood volume (via
secretion? renin)

What stimulates ANP

Increased atrial pressure
secretion?

What stimulates EPO release? Hypoxia

What stimulates PTH Decreased plasma ca

secretion? concentration
 1. Decreased renal arterial
What stimulates renin pressure 2. Increased renal
release? nerve discharge (Beta 1
effect)

What subunit do TSH, LH, FSH

Alpha subunit
and hCG have in common?

What symptom is present

Glucosuria
once threshold is reached?

What type of tissue is the

anterior pituitary derived Oral ectoderm
from?
What value is used clinically
Creatinine clearance
to represent GFR?

What variables are needed to -Urine flow rate -Urine

calculate free water osmolarity -Plasma
clearance? Osmolarity

Where does ACE convert AI to

Primarily the lung capillaries
AII?

Where does secondary active

transport of amino acids In the proximal tubule
occur?
 Endothelial cells of the
Where is EPO secreted? peritubular capillaries
(kidney)

Where is paraaminohippuric
Proximal tubule
acid secreted?

Which barrier is lost in

Charge barrier
nephrotic syndrome?

Which layer filters by negative

Fused basement membrane
charge?
 Fenestrated capillary
Which layer filters by size?
endothelium

Why does the nephron Acts As a buffer for secreted

secrete ammonia? H ions

Because it is freely filtered

Why is inulin sued to measure
and is neither absorbed or
GFR?
secreted

Why is PAH used to calculate

PAH is secreted and filtered.
RPF?
 Decreased cortisol and
A 21-Beta-hydroxylase
mineralocorticoids
deficiency will result in what
(hypotension, hyperkalemia)
hormone deficiencies/
Increased sex hormones
excesses?
(masculinization)

A deficiency of 17-alpha
Decreased sex hormones and
hydroxylase will result in an
cortisol
decrease in what hormone(s)?

A deficiency of 17-alpha
Aldosterone Produces
hydroxylase will result in an
hypertension, hypokalemia
increase in what hormone(s)?

A dopaminergic antagonist
would be expected to have
Stimulates prolactin secretion
what effect prolactin
secretion?
 A maturing graafian follicule
During the proliferative phase
can be found at what stage of
(Around Day 7)
the menstrual cycle?

Stimulates aldosterone
Angiotensin II has what effect production by enhancing the
on the adrenal cortex? activity of aldosterone
synthase

Calcitonin's actions Oppose. Calcitonin acts faster

(synergize/oppose) the than PTH to decrease serum
actions of PTH. Ca2+ levels.

Decreased cortisol levels as in

ACTH levels will be increased
any of the congenital adrenal
contributing to increased skin
hyperplasias will have what
pigmentation
effect on ACTH?
 Decreased phosphate will
Increased activated Vit D.
have what effect on Vit D?

Degenerated. Shortly after

During the 2nd and 3rd
the first trimester, the
trimester, one would expect
placenta makes estriol and
the corpus luteum to be?
progesterone.

Estradiol is converted from

Aromatase converts
what precursor by what
Testosterone to Estradiol.
enzyme?

Estrogen is produced in what Corpus luteum, placenta,

4 locations in the body? adrenal cortex, and testes
Estrogen levels are low/med/ High. Estrogen switches to
high during the just before positive feedback of LH from
the peak of the LH surge? negative so both increase.

Complex effects. Early on

Estrogens have what effect of estrogen has a negative effect
LH secretion? that switches to positve just
before the LH surge.

Estrogens have what effect of Estrogens stimulate growth of

the follicle? the follicle

Failure of brain maturation

due to lack of thyroid Cretinism
hormone is known as?
Finasteride inhibits what step Converstion of testosterone
in testosterone metabolism? to DHT by 5-alpha reductase

Follicular growth is fastest During the second week od

during what part of the the proliferative phase (Days
menstrual cycle? 7-14)

FSH stimulates what cells in Sertoli cells

the male? (spermatogenesis)

Decreased Ca2+ will increase

Hypocalcemia will have what PTH which will stimulate the
effect on Vit D metabolism? kidney to produce more
activated Vit D.
 In addition to peripheral
conversion, DHT is also Prostate
produced in the?

In what organ is Vitamin D3 The skin. Vit D requires sun

produced? exposure (UV light and heat)

Is testosterone considered to
be anabolic or catabolic Anabolic
overall?

LH levels would be low/med/

Low. The LH surge has
high at the time of ovulation
already declined
(Day 14)
 LH stimulates what cells in Leydig cells (testosterone
the male? synthesis)

Brain and RBC's take up

Name the two primary insulin
glucose independent of
independent organs?
insulin

Order the following with the

most potent first: DHT > testosterone >
testosterone, androstenedione
androstenedione. DHT

Order the following with the

Estradiol > estrone >
most potent first: estrone,
estriol
estradiol, estriol.
Phosphate reabsortion in the
kidneys is inhibited by what PTH
hormone?

Progesterone has what effect

Increases body temperature
on body temperature?

To decrease the risk of

Progestorone is used in
endometrial cancer
combination with estrogen
associated with unopposed
for what reason?
estrogen therapy

Prolactin inhibits ovulation by

Prolactin has what effect on inhibiting the release/
ovulation? synthess of GnRH from the
hypothalamus
PTH causes increased calcium
reabsorption in what part of DCT
the kidney?

PTH is produced by what cell Chief cells of the parathyroid

type? glands

Androgen-binding protein
Sertoli cells stimulate (ABP) - concentrates
spermatogenesis by testosterone in the
producing what 2 factors in seminiferous tubules Inhibin
response to FSH? - inhibits FSH secretion fro
the ant pit

False. Thyroid hormones

T/F - Glycolisis is promoted increase blood glucose levels
by the thyroid hormones by stimulating glycolgenolysis
and gluconeogenesis.
 T/F - PTH stimulates both
True
osteoclasts and osteoblasts?

False. 5-alpha reductase

T/F - Testosterone is the
activates testosterone to DHT
most active androgen in
which is the most active
males and females?
androgen.

Testosterone acts as a
negative inhibitor on what GnRH
hormone from the brain?

Testosterone is synthesized
Testis Adrenal Cortex
in what two locations?
The hormone with the highest
concentration during the Progesterone
secretory phase is?

Dopamine secreted from the

The key inhibitor of prolactin hypothalamus Bromocriptine
release is? (Dopamine agonist has the
same effect)

The parathyroid glands come

The 3rd and 4th pharyngeal
from what embryonic
pouches
structures?

The primary estrogen

Estradiol
produced by the ovary is?
 The primary estrogen
Estriol
produced by the placenta is?

Thick mucous production is

Progesterone Decreases
the result of what sex
sperm entry into the uterus
hormone?

Throid Stimulating
Graves Disease
Immunoglobulin results in
(hyperthroidism)
what disease?

Thyroid hormones acts

synergistically with what
GH
hormone with respect to bone
growth?
 TRH is produced in what
Hypothalamus
region of the brain?

TSH levels in a hypothroid Elevated TSH Decreased free

patient would be? Free T4? T4

Progesterone decreases
Unlike estrogen, what effect
myometrial excitability to
does progesterone have on
help maintain the pregnancy/
the myometrium?
facilitate fertilization

Vit D deficiency in kids cause Rickets in kids Osteomalacia

what disease? Adults? in adults
What 2 conditions other than Hydatidiform moles in women
pregnancy increase hCG? or choriocarcinoma

What adrenergic effects do

Beta-adrenergic effects
the thyroid hormones have?

HAVOC H = Hot flashes A V =

What are the symptoms of Atrophy of the Vagina O =
menopause? Osteoporosis C = Coronary
Artery Disease

Parafollicular cells (C cells) of

What cells produce calcitonin?
the thyroid
 What does an elevated
Ovulation
progesterone level indicate?

During puberty, testosterone

What effect do androgens
stimulates bone growth but
have on growth of long
eventually causes closure of
bones.
the ephyseal plates

What effect do estrogens have Stimulate endometrial

on the endometrium? proliferation Increase
Myometrium? myometrial excitability

What effect do estrogens have Increase hepatic synthesis of

on the liver? transport proteins
 What effect do the thyroid
hormones have on cardiac Thyroid hormones increase:
output? Heart rate? CO HR SV contractility and RR
Contractility? Stroke Volume?
Respiratory Rate?

What effect does Ca2+ have Stimulates bone resorption of

on bone? calcium.

What effect does

Progesterone is inhibitory to
progesterone have on FSH?
both gonadotrophins
On LH?

Progesterone stimulates the

What effect does endometrial glands to
progesterone have on the become secretory and
endometrium? increases spiral artery
development
What effect does PTH have on Increases bone resorption of
bone? Ca2+ and phosphate

What effect does thyroid

Lipolysis is stimulated
hormone have on lipolysis?

The kidney will produce more

1-25-OH2 Vit D which will
What effect will low serum increase phosphate release
phosphate have the kidney? from bone matrix and
increase Ca2+ and phosphate
absorption in the GIT

What enzyme deficiency will 11-Beta hydroxylase

produce BOTH hypertension deficiency 11-
and masculinization of deoxycorticosterone will act
females? as a mineralocorticoid
 PTH stimulates 1-alpha-
What enzyme in the kidney is
hydroxylase cause increased
stimulated that affects
production of 1,25-(OH)2
vitamin D metabolism?
vitamin D.

What happens to the corpus

The corpus luteum regresses
lutem if progesterone levels
and menstration occurs
fall without fertilization?

The corpus luteum is

What happens to the corpus maintained by hCG acting like
lutem if progesterone levels LH which maintains both
with fertilization? estrogen and progesterone
levels.

What hormonal changes are

Decreased estrogen Increased
seen with untreated
FSH (Greatly) Increased LH
menopause with respect to
(No surge) Increased GnRH
estrogen, FSH, LH, GnRH?
What hormone predominates
during the secretory phase of Progesterone
the menstrual cycle?

Decrease in free serum Ca2+

What is the key regulator of increases PTH secretion.
PTH secretion? Increased Ca2+ feedback
inhibits PTH secretion.

What is the key regulator that

increases Calcitonin Increased serum Ca2+
secretion?

What is the most common

21-Beta hydroxylase
cause of congenital adrenal
deficiency
hyperplasia?
 What is the physiologic The syncytiotrophoblasts of
source of hCG? the placenta

What is the primary organ

that converts Vit D to 25-OH Liver
Vit D?

What is the primary source of

Adrenal glands
androstenedione?

What is the role of calcitonin Probably not important as

in normal calcium PTH is the primary regulator
homeostasis? of calcium homeostasis.
 What is the VERY first
molecule in the pathway for
Cholesterol
the synthesis of Aldosterone?
Cortisol? Adrenal androgens?

Cessation of estrogen
What is thought to be the
production due to decline in
cause of menopause?
the number of follicles

PTH increases serum Ca 2+,

What overall effects does PTH
decreases serum phosphates,
have on body electolytes?
increases urine phosphates

What signal from the body

Thyroid hormones, T3
decreases TRH secretion?
What substance is used by
the brain for energy during Ketone bodies
starvation?

What will the levels of Ca2+,

Increased Ca2+, decreased
phosphate, and alkaline
phosphate, increased alkaline
phosphatase be in
phosphatase
hyperparathyroidism?

What will the levels of Ca2+,

No changes in Ca2+,
phosphate, and alkaline
phosphate, or alkaline
phosphatase be in
phosphatase
osteoporosis?

What will the levels of Ca2+,

Alkaline phosphatase
phosphate, and alkaline
increased with normal Ca2+
phosphatase be in Paget's
and phosphate
disease of bone?
What will the levels of Ca2+,
Decreased Ca2+, increased
phosphate, and alkaline
phosphate, and alkaline
phosphatase be in renal
phosphates WNL
insufficiency?

What will the levels of Ca2+,

Increased Ca2+ and
phosphate, and alkaline
phosphate with alkaline
phosphatase be in Vit D
phosphatase WNL
intoxication?

Which ducts (Mullerian or Wolfian ducts are

Wolfian) are promoted by differentiated into the internal
androgens? gonadal structures.

It is detectable in the blood

Why is hCG so useful for
and urine 8 days after
detecting pregnancy?
successful fertilization.
 Decrease hot flashes and
decrease bone loss.
Why is hormone replacement
Decreased risk of heart
therapy used in
disease could be on the
postmenopausal women?
boards but is no longer true
(2001).

Bound to specific binding

Will most steroids in the
globulins Steroids are
blood be bound or unbound?
lipophilic

Elevated Thyroid hormone

You would expect the body increases Na/K ATPase
temperature of a patient with activity => increased
hyperthroidism to be? consumption of O2 =>
increased temp

Causes hypoxic
A decrease in PA O2 will have
vasoconstriction that shifts
what effect on the pulmonary
blood awayfrom poorly
vasculature?
ventilated regions
 A value of infinity for V/Q
Blood flow obstruction
indicates?

A ZERO value for V/Q

Airway obstruction
indicates?

Bicarbonate in the RBC is

transported out of the cell in Cl- by a HCO3-/Cl- antiport
exchange for what ion?

Cor pulmonale is the result

Pulmonary hypertension
of?
 Right ventricular failure
Cor pulmonale will lead to
(jugular venous distention,
what condition of the heart?
edema, hepatomegaly)

Dissociation of CO2 from Hb

upon oxygenation in the The Haldane effect
lungs is known as?

Exercise (increased cardiac The V/Q will approach 1

output) will have what effect (from 3) as a result of dilation
on V/Q to the apex? of vessels in the apex.

In the apex of the lung, V/Q V/Q > 1. NL = 3 which

should be >1, =1, or <1? indicates wasted ventilation.
 In the base of the lung, V/Q V/Q < 1. NL = 0.6 which
should be >1, =1, or <1? indicates wasted perfusion.

In the perpheral tissue what

factor helps unload oxygen Increased H+ (decreased pH)
by shifting the curve to the a.k.a. the Bohr effect
right?

Increased 2,3-DPG will cause

The curve will shift RIGHT.
a shift in what direction of
This allows Hb to release
the oxygen-Hb dissociation
more oxygen
curve?

Increased erythropoietin
levels as a response to high
Increase hematocrit and Hb
altitudes will have what affect
on the blood?
Neonatal respiratory distress
Surfactant (dipalmitoyl
syndrome is due to a
phosphatidylcholine, lecithin)
deficiency of what?

Both ventilation and perfusion

Perfusion is greatest in what
are greater at the base than
part of the lung?
at the apex.

Recurrent TB grows best in

Apex because of high O2.
what part of the lung? Why?

Surfactant role in the lungs is Decrease alceolar surface

to do what? tension
 T/F - The pulmorary
circulation is a high F. It has low resistance and
resistance, low compliance high compliance.
system.

The conversion of CO2 to

H2CO3 (Carbonic acid) is
Carbonic Anhydrase
catalyzed by what RBC
enzyme?

The kidneys would do what to

compensate for respiratory
Excrete bicarbonate
alkalosis as a response to
high altitude?

HCO3- (bicarbonate)
The predominant form of
accounts for 90%, followed by
CO2 transport from the
Hb bound CO2 (5%) and
tissues to the lungs is?
dissolved CO2 (5%)
 TV+IRV+ERV = ? TV = tidal
Vital capacity. VC is
volume, IRV = inspirartory
everything but the residual
reserve volume, ERV =
volume.
expiratory reserve volume

Both ventilation and perfusion

Ventilation is greatest in what
are greater at the base than
part of the lung?
at the apex.

Decrease metabolic needs,

What 6 factors decrease O2
dcr PCO2, dcr temperature,
affinity to Hb/decrease P50?
increased pH, dcr 2,3-DPG,
What direction does the O2-
and Fetal Hb The curve shifts
Hb dissociation curve shift?
LEFT.

What are some potential side Cough and angioedema due

effects of ACE inhibitors? to decreased bradykinin
 What cellular change could
you expect as a response to Increased mitochondria
high altitude?

What enzyme in the lungs is a Angiotensin-converting

key enzyme in the renin- enzyme (ACE) which converts
angiotensin system? Ang I to Ang II

What is expiratory reserve Air that can still be breathed

volume? out after normal expiration

FRC is the flume in the lungs

What is FRC? How is it
after normal respiration and
calculated?
is the sum of RV +ERV.
 Air in excess of the tidal
What is inspiratory reserve volume that moves into the
volume? lungs with maximum
inspiration

Air in the lung at maximal

What is residual volume?
expiration

What is the bodies acute

reponse to a change from low Increase in ventilation
to high altitude?

What is the difference

Capacities are the sum of
between capacites and
>= 2 volumes.
volumes in the lung?
 What is the Total Lung IRV + TV + ERV + RV or VC +
Capacity? Normal Value? RV Normal would be ~ 6.0 L

Air that moves into the lung

What is tidal volume? What is
with each quiet expiration.
a normal TV value?
500 mL is normal

What would be the effect on

the heart due to chronic
hypoxic pulmonary Right ventricular hypertrophy
vasoconstriction (High
altitude)?

Would you expect acidosis or

alkalosis due as a response to
Respiratory alakalosis
high altitude? Metabolic or
Respiratory?
 Exocrine secretion of
zymogens by secretory acini -Acetylcholine -CCK
is stimulated by what?

1. Increase production of
saliva 2. Increase gastric H+
Five effects of secretion 3. Increases
Parasympathetic GI pancreatic enzyme and
Innervation: HCO3- secretion 4. Stimulates
evteric nervous system to
creat intestinal peristalsis 5.
Relaxes sphincters

-Mucus (Mucous cell) -

Five main components of Intrinsic factor (Parietal cell) -
gastric secretions and their H+ (Parietal cell) -Pepsinogen
sources? (Chief cell) -Gastrin (G cell in
antrum and duodenum)

1. Proton pump inhibitors

(omeprazole) 2. H2 receptor
Four categories of drugs that antagonists (Rantidine,
inhibit/decrease secretion of Cimetidine, Famotidine) 3.
gastric acid: Anticholinergics 4.
Prostaglandin receptor
antagonists (Misoprostol)

Four effects of Sympathetic GI
Innervation:
1. Increase production of
saliva 2. Decreases
splanchnic blood flow in
fight-or-flight response 3.
Decreases motility 4.
Constricts Sphincters

-Kills bacteria -Breaks down

food -Lowers pH to optimal
Four functions of H+ secreted
range for pepsin function
in the stomach?
(conversion of pepsinoget) -
Sterilizes chyme

1. Inhibits Gastric acid and

pepsinogen secretion 2.
Four functions of Inhibits pancreatic and small
Samatostatin? intestine fluid secretion 3.
Gallbladder contraction 4.
Release of both insulin and
glucagon

From what cells is bile

hepatocytes
secreted?
 Stimulates secretion of HCl,
Function of Gastrin secreted
IF, and pepsinogen (also
in the stomach?
stimulates gastric motility)

Binding protein required for

Function of Intrinsic factor
vitamin B12 absorption (in
secreted in the stomach?
terminal ileum)

-Limit fat intake -Monitor for

How do you treat Pancreatic
signs of fat-soluble vitamin
Insufficiency?
(A,D,E,K) deficiency

How does jaundice manifest

yellow skin and sclerae
in the body?
How much urobilinogen is
4mg
secreted per day?

In what form is bilirubin

urobilirubin
secreted by the kidney?

In what form is bilirubin

stercobilin
secreted in the feces?

-alpha-amylase -lipase -
phospholipase A -colipase -
Name as many Pancreatic proteases (trypsin,
enzymes as you can: chymotrypsin, elastase,
carboxypeptidases) -
trypsinogen (trypsin)
Name the major product of
heme metabolism that is
Bilirubin
actively taken up ty
hepatocytes:

Name the organ and enzyme

Nonerythroid enzymes in the
family involved in the
liver
production of bilirubin?

Name the three salivary -Parotic -Submandibular -

secretory glands: Sublingual

Name two potent stimulators 1. Phenylalanine 2.

of Gastrin: Tryptophan
 Secretin's nickname? Nature's antacid

SEE PICTURE ON LAST PAGE SEE PICTURE ON LAST PAGE

OF GI PHYSIOLOGY!!! OF GI PHYSIOLOGY!!!

1. Stimulates gallbladder
contraction 2. Stimulates
Three main functions of CCK?
pancreatic enzyme secretion
3. Inhibits gastric emptying

1. Stimulates pancreatic
Two functions of Secretin? HCO3 secretion 2. Inhibits
gastric acid secretion
Two functions of the mucus -Lubricant -protects surface
secreted in the stomach? from H+

What activates all the

trypsin
proteases?

What are the products of

Monosaccharides (glucose,
oligosaccharide hydrolase
galactose, fructose)
action?

What are the products of

Oligosaccharides, maltose
starch hydrolysis by
and maltotriose
pancreatic amylase?
 What are the products of the
hydrolysis of carbohydrate maltose, maltotriose and
alpha-1,4 linkages by salivary alpha-limit dextrans
amylase?

1. Begin starch digestion 2.

What are the three main Neutralize oral bacterial acids
functions of saliva? which maintains dental health
3. Lubricate food

-Hepatic production by
nonerythroid enzymes -
What are the two main
Metabolism of heme from red
sources of bilirubin in the
blood cells (120 day life span)
body?
and incomplete or immature
erythroid cells

What causes pain to worsen Eating fatty foods which

in Cholelithiasis? cause CCK release
 What component of GI
secretion is 'not essetial for Gastric acid
digestion?'

What condition results from

Jaundice
elevated bilirubin levels?

What disease is commonly

associated with pancreatic Cystic Fibrosis
insufficiency?

What do pancreatic ducts

secrete when stimulated by -mucus -alkaline fluid
secretin?
What does inadequate gastric Increased risk of Salmonella
acid cause? infections

What enzyme converts enterokinase (a duodenal

trypsinogen to trypsin? brushborder enzyme)

What enzyme hydrolyzes

Pancreatic amylase
starch?

What enzyme is involved in

the rate-limiting step in Oligosaccaride hydrolases
carbohydrate digestion?
What enzyme starts digestion
and hydrolyzes alpha-1,4 Salivary Amylase
linkages?

What form are the proteases

proenzyme form
secreted in?

What form is Alpha-amylase

active form
secreted in?

What hormone decreases

absorption of substances Somatostatin
needed for growth)
 What inhibits the release of
Somatostatin
gastrin and secretin?

What is pancreatic amylase in

In the duodenal lumen
highest concentration?

What is the composition of -bile salts -phospholipids -

bile? (5) cholesterol -bilirubin -water

What is the fate of Broken down to pepsin (a

pepsinogen? protease) by H+
What is the function (fxn) of Begins protein digestion
Pepsin? (optimal pH = 1.0 - 3.0

What is the function of

starch digestion
Alpha-amylase?

What is the function of

protein digestion
proteases?

-pancreatic HCO3- secretion

What is the function of VIP? - intibition of gastric H+
secretion
 What is the function on Causes smooth muscle
Nitrous Oxide? relaxation

What is the major stimulus

for secretion of enzyme-rich
Cholecystokinin
fluid by pancreatic acinar
cells?

What is the major stimulus

for zymogen release, but a
Acetylcholine
poor stimulus for bicarbonate
secretion?

What is the only types of

carbohydrate that is Monosacharides
absorbed?
What is the primary location
over bacterial conversion or
Colon
conjugated bilirubin to
urobilinogen?

What is Zollinger-Ellison
1. Hypersecretion of Gastrin
syndrome? What is the main
2. Peptic ulcers
manifestation?

What manifestations are seen -malabsorption -stratorrhea

in pancreatic insufficiency? (greasy, malodorous stool)

Stimulated by secretin,
What regulates bicarbonate
potentiated by vagal input
secretion?
and CCK
 What regulates CCK Stimulated by fatty acids and
secretion? amino acids

-Stimulated by stomach
distension, amino acids,
What regulates Gastrin
peptides, and vagus -
secretion?
Inhibited by secretin and
stomach acid pH less than 1.5

What regulates secretion of Stimulated by acid and fatty

secretin? acids in lumen of duodenum

What regulates secretion of -Stimulated by acid -

Somatostatin? Inhibited by vagus
 They are amphipathic
What special characteristic do
(contain both hydrophilic and
bile salts possess?
hydrophobic domains)

What special characteristic

does the conjugated form of It is water soluble.
bilirubin possess?

What substance stimulates

ductal cells to secrete Secretin
bicarbonate-rich fluid?

What three enzymes aid in fat 1. Lipase 2. Phospholipase A

digestion? 3. Colipase
 What trasport is utilized in
Sodium-glucose-coupled
glucose absorption across
transporter
cell membrane?

What two conditions are

-Chronic Gastritis -Pernicious
caused be autoimmune
Anemia
destruction of parietal cells?

What type(s) of innervation BOTH Sympathetic and

stimulate salivary secretion? Parasympathetic

Where are the oligosaccharide At the brush border of the

hydrolase enzymes located? intestine
 Where does bilirubin
Liver
conjugation take place?

Where does glucose Duodenum and proximal

absorption occur? Jejunum

Where does heme catabolism In the Reticuloendothelial

take place? System

-Surface mucosal cells of

stomach and duodenum -
Where is bicarbonate secreted
Neutralizes acid -Present in
and what does it do?
the unstirred layer preventing
autodigestion
 Where is Cholecystokinin I cells of duodenum and
(CCK) secreted? jejunum

Where is Secretin secreted? S cells of duodenum

Where is Somatostatin D cells in pancreatic islets

secreted? and GI mucosa

Where is Vasoactive Intestinal Smooth muscle nerves of the

Peptide (VIP) secreted intestines
 Which component of bile
makes up the greatest Water (97%)
percentage?

Which component of bile

solubilizes lipids in micelles Bile salts
for absorption?

Which component of saliva

Alpha-amylase (ptyalin)
begins starch digestion?

Which component of saliva

Mucins (glycoproteins)
lubricates food?
Why do we need alkaline To neutralize gastric acid,
pancreatic juice in the allowing pancreatic enzymes
duodenum? to function