BLD 402, EXAM 2 QUESTIONS AND ANSWERS WITH
COMPLETE SOLUTIONS GRADED A++
True or False:
Amylase hydrolyzes starch and glycogen, and the product is all glucose.
False
How soon will AMY activity in serum peak during acute pancreatitis?
half-day later
What is associated with increased S-type amylase?
a viral/bacterial salivary gland infection
If amylase activity in serum is high due to macro-amylase, what would you expect
in urine amylase activity?
low to normal urine amylase activity
macro-amylase
AMY complexed with IgA/G
-too big to be filtered at glom causing accumulation (congenital or autoimmune)
-confirmation: ↑ serum AMY and ↓ urine AMY
Major cause of peptic/duodenal ulcer
H. pylori
How can you test for H. pylori?
-patient takes a tablet of urea
-metabolized by urease of H. pylori into NH3 and CO2
,-detect CO2 from patient's breath
Cause of Zollinger-Ellison syndrome
gastrinoma produces ectopic gastrin, increasing stomach acid secretion
-lab test: gastric basal and peak acid output testing
gastric basal and peak acid output testing
pentagastrin stimulation test
-detects problems with acid secretion (peak issue) and gastrinomas (basal issue)
stomach carcinoma
tumor identified as food causing ↑ stomach acid
-late phase: achlorhydria (no HCl bc functioning cells are gone 🍴)
A patient with fat malabsorption often has a bleeding problem. Why?
Lack of vitamin K, interferes with coagulation factors
What is commonly measured instead of serotonin?
metabolite: 5HIAA in urine
colon cancer early detection
early detection: colonoscopy, stool occult blood, DNA mutation detected in stool
occult blood detection
-Guaiac-peroxide rxn: detection of heme, requires diet restriction to prevent false
positives
-immunochemical test: detection via anti-human Hgb Ab
absorption of dietary lipids
1. emulsified by bile salts in the small intestine
2. pancreatic enzymes convert lipids into amphiphilic form
, 3. micelle formation
4. absorption into intestine
5. secondary uptake by ileum via enterohepatic circulation
What is the mechanism behind pernicious anemia?
Autoimmune to gastric mucosa → ↓ intrinsic factor → B12 can't bind to intrinsic factor →
no absorption at ileum → ↓ B12 → ↓ nucleic acid and myelin synthesis
What is the Schilling test used for in pernicious anemia?
B12 absorption:
Oral admin of radioactive vitamin B12, measure radioactivity of feces/urine/serum or
externally scan liver
Useful as a laboratory testing for celiac disease
anti-tTG Ab, anti-DGP Ab, and fecal calprotectin
steatorrhea
malabsorption of fat
-caused by pancreatitis or bile obstruction
-bad smelling stool
lactose intolerance
-intestinal lactase activity deficiency
-no change in blood glucose
-symptom: osmotic diarrhea (unabsorbed lactose affects osmotic pressure, water pulled
into intestine)
-lab test: unabsorbed lactose is metabolized by GI bacteria that produce H2, breath test
😀
COMPLETE SOLUTIONS GRADED A++
True or False:
Amylase hydrolyzes starch and glycogen, and the product is all glucose.
False
How soon will AMY activity in serum peak during acute pancreatitis?
half-day later
What is associated with increased S-type amylase?
a viral/bacterial salivary gland infection
If amylase activity in serum is high due to macro-amylase, what would you expect
in urine amylase activity?
low to normal urine amylase activity
macro-amylase
AMY complexed with IgA/G
-too big to be filtered at glom causing accumulation (congenital or autoimmune)
-confirmation: ↑ serum AMY and ↓ urine AMY
Major cause of peptic/duodenal ulcer
H. pylori
How can you test for H. pylori?
-patient takes a tablet of urea
-metabolized by urease of H. pylori into NH3 and CO2
,-detect CO2 from patient's breath
Cause of Zollinger-Ellison syndrome
gastrinoma produces ectopic gastrin, increasing stomach acid secretion
-lab test: gastric basal and peak acid output testing
gastric basal and peak acid output testing
pentagastrin stimulation test
-detects problems with acid secretion (peak issue) and gastrinomas (basal issue)
stomach carcinoma
tumor identified as food causing ↑ stomach acid
-late phase: achlorhydria (no HCl bc functioning cells are gone 🍴)
A patient with fat malabsorption often has a bleeding problem. Why?
Lack of vitamin K, interferes with coagulation factors
What is commonly measured instead of serotonin?
metabolite: 5HIAA in urine
colon cancer early detection
early detection: colonoscopy, stool occult blood, DNA mutation detected in stool
occult blood detection
-Guaiac-peroxide rxn: detection of heme, requires diet restriction to prevent false
positives
-immunochemical test: detection via anti-human Hgb Ab
absorption of dietary lipids
1. emulsified by bile salts in the small intestine
2. pancreatic enzymes convert lipids into amphiphilic form
, 3. micelle formation
4. absorption into intestine
5. secondary uptake by ileum via enterohepatic circulation
What is the mechanism behind pernicious anemia?
Autoimmune to gastric mucosa → ↓ intrinsic factor → B12 can't bind to intrinsic factor →
no absorption at ileum → ↓ B12 → ↓ nucleic acid and myelin synthesis
What is the Schilling test used for in pernicious anemia?
B12 absorption:
Oral admin of radioactive vitamin B12, measure radioactivity of feces/urine/serum or
externally scan liver
Useful as a laboratory testing for celiac disease
anti-tTG Ab, anti-DGP Ab, and fecal calprotectin
steatorrhea
malabsorption of fat
-caused by pancreatitis or bile obstruction
-bad smelling stool
lactose intolerance
-intestinal lactase activity deficiency
-no change in blood glucose
-symptom: osmotic diarrhea (unabsorbed lactose affects osmotic pressure, water pulled
into intestine)
-lab test: unabsorbed lactose is metabolized by GI bacteria that produce H2, breath test
😀
