Gastro-Intestinal Physiology

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Across
  1. 2. A mutation preventing activation of this pancreatic zymogen leads to profound protein maldigestion. What enzyme precursor is affected? (1 word)
  2. 5. Severe intestinal distention triggers activation of 5-HT receptors, producing robust peristaltic reflexes. Which natural ligand mediates this response? (1 word)
  3. 9. A patient develops bloating and osmotic diarrhea upon consuming dairy products due to deficiency of a disaccharidase located on enterocyte microvilli. What enzyme is missing? (1 word)
  4. 11. Protein digestion is impaired after the loss of gastric cells that normally secrete the precursor to pepsin. What cells are deficient? (1 word)
  5. 12. A man with progressive dysphagia has impaired peristalsis and failure of LES relaxation due to degeneration of neurons in an ENS plexus. What plexus is affected? (1 word)
  6. 13. Watery diarrhea and hypokalemia occur in VIPoma due to excessive intestinal fluid and electrolyte secretion. Which peptide is responsible? (1 word)
  7. 15. A patient develops biliary colic when opiates cause contraction of a muscular structure controlling bile and pancreatic flow into the duodenum. What structure is this? (3 words)
  8. 16. Mechanical stimulation of the gut lumen releases a hormone from specialized cells that trigger peristaltic reflexes by releasing 5-HT. What cells are these? (1 word)
  9. 18. A patient with chronic pancreatitis presents with greasy, foul-smelling stools due to inadequate hydrolysis of dietary triglycerides. What enzyme is deficient? (1 word)
  10. 20. Duodenal mucosa neutralizes acidic chyme via secretion of which alkaline ion, stimulated primarily by secretin? What ion is this? (1 word)
  11. 23. A child presents with severe protein malabsorption due to failure to activate trypsinogen. What brush-border enzyme is deficient? (1 word)
  12. 24. A pancreatic islet tumor causes profound inhibition of gastric acid production, pancreatic secretion, and GI motility. What inhibitory hormone is being overproduced? (1 word)
  13. 25. A patient with pancreatitis shows elevated levels of a carbohydrate-digesting enzyme in the serum. What enzyme is this? (1 word)
  14. 26. Protein digestion stalls in the small intestine when brush-border enzymes cannot cleave terminal amino acids from peptides. What enzyme family is impaired? (1 word)
  15. 28. A patient with antral G-cell hyperplasia shows excessive stimulation of parietal cell acid secretion and increased gastric mucosal growth. What hormone is responsible for these effects? (1 word)
  16. 29. Vagal stimulation increases gastric motility, acid secretion, and intestinal peristalsis through activation of muscarinic receptors. What neurotransmitter mediates these effects? (1 word)
Down
  1. 1. After small bowel resection, colonic mucosa increases its absorptive capacity in response to a trophic hormone released from the ileum and colon. What hormone mediates this adaptation? (1 word)
  2. 3. A newborn with Hirschsprung disease lacks the ability to coordinate mucosal secretion and submucosal blood flow due to absence of which ENS plexus? (1 word)
  3. 4. A patient consuming table sugar experiences malabsorption because they cannot hydrolyze sucrose into absorbable monosaccharides. What enzyme is deficient? (1 word)
  4. 6. A patient with achalasia lacks a key neurotransmitter responsible for smooth muscle relaxation of the LES. What neurotransmitter is deficient? (2 words)
  5. 7. A patient preparing for surgery has elevated levels of a stomach-derived hormone that stimulates hunger and increases gastric motility. Which hormone is this? (1 word)
  6. 8. After oral glucose ingestion, this incretin enhances insulin release and significantly slows gastric emptying. What hormone performs these actions? (1 word)
  7. 10. Pernicious anemia develops when autoimmune destruction eliminates the stomach cells responsible for intrinsic factor and acid secretion. What cells are lost? (2 words)
  8. 11. A lipid-rich meal triggers gallbladder contraction, pancreatic enzyme release, and relaxation of the sphincter of Oddi. Which hormone coordinates these processes? (1 word)
  9. 14. Pancreatic lipase cannot fully function without a protein cofactor that anchors it to lipid droplets during digestion. What cofactor is this? (1 word)
  10. 17. A fasting patient displays strong, periodic peristaltic waves occurring every 90 minutes. Which hormone generates these migrating motor complexes? (1 word)
  11. 19. NSAID use damages gastric mucosa by inhibiting local mediators that normally promote mucus and bicarbonate secretion. What mediators are reduced? (1 word)
  12. 21. A patient on Hâ‚‚ antagonists exhibits reduced parietal cell activation because a local paracrine mediator cannot bind its receptor. What mediator is normally responsible? (1 word)
  13. 22. After a bolus of acidic chyme enters the duodenum, pancreatic ductal cells release bicarbonate into the small intestine. Which hormone mediates this response? (1 word)
  14. 27. Following a high-calorie meal, ileal enteroendocrine cells release a hormone that slows gastric emptying and signals satiety. What hormone is responsible? (2 words)