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Tutorial
Topic
Groups
1 -12 & WJC
Digestive
Physiology Case
13-15
Digestive Pathology
Cases
16-18
Digestive Pathology
Cases
19-21
Digestive Pathology
Cases
22-24
Digestive Pathology
Cases
Digestive Pathology:
Venues
MMLT
Physiology Lab.
Level 4 FMSTRC
Pathology Teaching Lab.
Level 0 Conference Room
FMSTRC
Level 1 Conference Room
FMSTRC
MMLT
Level 0 Conference Room
FMSTRC
Level 1 Conference Room
FMSTRC
Pathology Teaching Lab.
Lecture Theatre 3
Level 0 FMRSTRC
LEARNING OBJECTIVES
This tutorial is supplementary to the lectures on diseases of the gastrointestinal tract and
is designed to consolidate factual knowledge about common gastrointestinal disorders
through case discussions.
By the end of the tutorial students should be able to:
CASE 2
A 37-year-old man presented to his private doctor with a history of weight loss and
exertional dyspnea. On systematic enquiry he admitted to episodic diarrhoea and a
family history of gastrointestinal disease. A fecal occult blood test done was positive.
Colonoscopy was performed and multiple lesions were identified, the largest of which
was biopsied.
1.
2.
3.
4.
Digestive Physiology:
The following case will be discussed
A 35-year-old woman presents with severe abdominal pains, bloody stools and
chronic diarrhoea. She has been taking antacids for the last month with little pain
relief. She indicates that she has had symptoms of heartburn in the past.
Radiological studies reveal multiple ulcers involving the duodenum and jejunum.
Analysis of the basal gastric acid secretory rate is high and radioimmunoassay of
serum gastrin is elevated.
a)
Describe the functional organization of the stomach.
b)
Describe the mechanism of gastric acid secretion?
c)
Describe the regulation of gastric acid secretion?
d)
State the different types of gastrin.
e)
What are the functions of gastrin?
f)
How is gastrin secretion regulated?
g)
Is the gastrin level high or normal?
h)
Is the basal gastric secretory rate high or normal?
i)
How do antacids work?
j)
Describe the pathophysiology associated with heartburn?
k)
Describe the physiology of the duodenum.
l) Name the hormones released and the functions of each.
m)
What is the most likely cause of the presenting symptoms?
n)
How can provocative tests using calcium, secretin or a test meal be used to
differentiate antral G-cell hyperplasia from the Zollinger-Ellison syndrome?
o)
Suggest another drug treatment for this patient.
p)
Would you recommend surgery?