Gastrointestinal Physiology SEQ

(1).
A 40 year old male was seen in the hospital OPD with a history of episodes of colicky epigastric pain over the last 6 months and moderate steatorrhoea.Upper GI endoscopy showed a duodenal ulcer.

a).The following were observed in him:
Serum gastrin level: 1150 pg/mL (Normal: 50 – 150 pg/mL)
Basal rate of secretion of HCl: 11 mmol/hr (Normal: 1 – 5 mmol/hr)
His steatorrhoea was corrected when gastric juice was removed via a naso gastric tube.
Explain the physiological basis of the above observations.




b). He was treated with a histamine receptor antagonist. But as his symptoms still persisted, he was given a proton pump inhibitor.


Explain the physiological basis of the use of above treatment in this patient.


(2). Explain the physiological basis of the below observations.

The Cl- concentration in venous plasma is less than that in arterial plasma.
During gastric acid secretion the CO2 content of the gastric venous blood is less than that of arterial blood.
Following a meal, a normal person may develop alkaline urine.
Administration of an acetylcholine esterase inhibiting drug would cause an increase in the rate of secretion of gastric juice and saliva.
Surgical removal of the terminal ileum may result in malabsorption of vitamin B12 and fat.
Gastric emptying is delayed following ingestion of a fatty meal, but is facilitated following administration of a H2 receptor blocker.


(3) .A patient who presented with a tumor in the head of the pancreas showed the following:
Steatorrhoea
Total serum bilirubin level Elevated
Bleeding time 3 minutes
Clotting time 15 minutes

Explain the physiological basis of the above observations.


(4). Explain the physiological basis of:
Deglutition
Defaecation

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