Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

PBL > Unit 2 Case 2 > Flashcards

Unit 2 Case 2 Flashcards

1
Q

What is Unit 2 Case 2 about?

A

A 15-year-old female has trouble swallowing and is overcome by a deep, painful burning sensation in her throat and chest. She is told she has GERD due to a weak esophageal sphincter.
She is advised to change lifestyle choices but loses control of that which results in nausea, vomiting, and trouble swallowing. She has been prescribed a proton pump inhibitor and is in danger of developing Barrett’s esophagus. She has an endoscopy to reveal the extent of the damage as her family looks at treatment options.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the 2 types of peristalsis?

A

Primary peristalsis

Secondary peristalsis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is primary peristalsis?

A

Peristalsis that is swallow induced- the most common form of peristalsis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is secondary peristalsis?

A

Activated by oesophageal distension, e.g from food let from primary peristalsis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What normally makes cells resistant to stomach acid?

A

Mucous cells secrete an alkaline mucus that protects the epithelium against the stomach acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How does acidic PH effect a cell and its function?

A

Acidic PH levels denature enzymes and alter virtually all cellular processes within the cell which leads to loss of function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is Lansoprazole?

A

A type of drug

A proton pump inhibitor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What does Lansoprazole do and what is it prescribed for?

A

Lansoprazole reduces the amount of acid your stomach makes

Prescribed for indigestion, heartburn, and acid reflux and GERD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the mechanism of action for Lansoprazole?

A
  • selectively inhibits the membrane enzyme H+/K+ ATPase in gastric parietal cells
  • Therefore reduces the amount of acid your stomach makes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are parietal cells?

A

Cells that secrete hydrochloric acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are antacids?

A

Antacids are a combination of compounds containing salts of calcium, magnesium, and aluminum-an alkaline
-neutralise stomach acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the mechanism of action for antacids?

A
  • H+ ions fullys dissociated in HCL
  • Antacids containing bicarbonate ions combine with the H+ ions to form an unstable complex which dissociates into H2O AND CO2
  • Decrease H+ conc (neutralises the acid)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the pros and cons of antacids?

A

Pros: Do not have to be prescribed such as gaviscon

Cons: Not a long term solution, the long term solution is a proton pump inhibitor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are displasic cells?

A

Precancerous cells - has potential to become cancerous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What does GERD stand for?

A

Gastro-Oesophageal Reflux Disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is a weak esophageal sphincter and what does it allow?

A

A weak esophageal sphincter is when the sphincter doesnt close tightly enough
-allows stomach acid to flow back up into the esophagus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Can acid reflux reach the lungs and what are the consequences of this?

A

It can reach the lungs when you are in a supine position (sleeping)
- when acid gets into the lungs it can cause throat irritation and lung inflammation possibly leading to bronchitis/pneumonia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the most common ages of people with GERD?

A

Highest in the 20-29 age group

Lowest in the 70-79 age group

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What causes a weak esophageal sphincter?

A

When a person regulary eats or is overweight, their stomach swells and puts alot of extra pressure on the Lower Esophageal sphincter
-over time it looses its shape and strength making it weak

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Why is the rate of mutation increased during constant acid exposure in oesophageal cells?

A

Oesophageal epithelium don’t have a protective mucus layer like stomach epithelium
-the acid causes DNA damge to the cells leading to point mutations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is Barrett’s oesophagus?

A

When the epithelium in the oesophagus changes from simple squamous to simple columnar. Resembling the lining of the small intestine

  • more likely to get oesophageal cancer
  • often reffered to as a pre cancerous condition
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is heart burn?

A

When acid reflux travels up your oesophagus from your stomach. Which causes a burning feeling in your chest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What causes heart burn?

A

The most common cause is food that is acidic or high in fat. As this increases acid reflux

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

How is peristalsis affected by GERD?

A

Affects secondary peristalsis

Reducing the response to oesophageal distention

25
Q

How is the oesophagus scarred and what does this cause?

A

Scarring can occur when the oesophagus becomes inflammed

-can lead to oesophageal stricture (narrowing of the oesophagus)

26
Q

What is oesophageal stricture?

A

The narrowing of the oesophagus

27
Q

What are symptoms of oesophageal stricture?

A

Main symptom is dysphagia (difficulty swallowing)

  • regurgitation of foods/liquids
  • sensation of something stuck in the chest after eating
28
Q

What is dysphagia?

A

Difficulty swallowing

29
Q

What is dyspepsia?

A

Indigestion

30
Q

How do you take a patients history?

A
  • Introduce yourself
  • Presenting complaint
  • History of presenting complaint
  • Past medical history
  • Drug, family and social history
  • Summary of history and questions
31
Q

What is BMI?

A

BMI (body mass index) is a measure using a patient’s height and weight to assess whether their body weight is healthy.

32
Q

How do you calculate BMI?

A

Mass (kg) divided by Height^2 (M^2)

33
Q

What are the ideal ranges for BMI?

A

The ideal range in adults is 18.5-24.9

34
Q

What are the cons to using BMI to determine if the body is healthy?

A

Dosen’t take into account certain factors, such as muscle density (which will increase BMI), gender or frame size

35
Q

What are the clinical use of BMI?

A

Used as a good gauge of body fat

To determine if the too much or too little body fat presents a risk to health

36
Q

What are the risk factors of obesity?

A

Lack of excersize, unhealthy eating patterns, not enough sleep and stress

37
Q

How can an unhealthy lifetsyle lead to GERD?

A

Poor eating habits and eating alot of acidic or fatty food can increase acid reflux.

38
Q

What diseases are obese people more susceptible to?

A

Type 2 diabetes
Coronary heart disease
Some types of cancers- bowel or breast cancer
Stroke

39
Q

What are the treatment options for GERD?

A

Antacids, Histamine blockers, Proton pump inhibtors which all work to reduce acid reflux

40
Q

What are the treatments for dysphagia?

A

Surgery to treat GERD
Dietary changes-softer foods
Speech therapy-teach how to swallow

41
Q

What is esophagitis?

A

Inflammation that may damage tissues of the oesophagus

42
Q

What is gaviscon?

A

An over the counter antacid that reduces acid reflux

43
Q

What are the side effects of over the counter medicine such as gaviscon?

A

Constipation
Diarrhea
Nausea
Stomach cramps

44
Q

What is an endoscopy?

A

A procedure to look inside the body (medical imaging)

Uses an endoscope to examine the interior of a hollow organ or cavity of the body

45
Q

What type of endoscopy is used to image the oesophagus and what is it looking for?

A

Upper GI endoscopy

-Looking for any narrowing or blockages in the oesophagus

46
Q

What is an oesophageal manometry?

A

A test to show if the oesophagus sphincter and muscles of the oesophagus are working properly
- measures the contractions of the oesophagus and the sphincter

47
Q

What is oesophageal pH monitoring?

A

Oesophageal ph monitoring is the current gold standard for diagnosis of GERD

48
Q

What are normal ranges of oesophageal pH monitoring?

A

Normal oesophageal pH considered to be close to pH 7

- People with GERD have an oesophageal pH of below pH 4

49
Q

Is there a cure for Barrett’s oesophagus?

A

No cure for Barrett’s oesophagus

- but a care plan canbe put in place to stop any more damage due to acid reflux

50
Q

What is Gillick competence?

A

A term used in medical law to decide whether a child is able to consent to their own medical treatment, without the need for parental permission or knowledge

51
Q

How can having GERD have a mental and social impact on people?

A

GERD impacts daily life, such as affecting sleep or physcial activity
Or due to the lifestyle changes involved in managing GERD people may have social anxiety

52
Q

How does the health belief model influence patients with GERD?

A

GERD is common but it is often unrecognised

  • Symptoms are misunderstood- reduced percieved threat and severity lower therefore people dont go to the GP about it
  • more likely to develop into Barrett’s oesophagus
53
Q

What are the main mechanisms of DNA reapir?

A

Base excision
Nucleotide excision
Mismatch repair

54
Q

What is trans differentiation?

A

A process where one mature somatic cell is transformed into another mature somatic cell without undergoing an intermediate pluripotent state

55
Q

What is meant by oesophageal strictures?

A

Narrow spots on the oesophagus which narrow the oesophagus making it harder to swallow
Caused by a build up of scar tissue

56
Q

What is manometry?

A

Putting a tube up the nose into stomach

Tests how well the oesophagus preforms peristalsis and the strength of the lower oesophageal sphincter

57
Q

What is the process of 24 hour pH monitoring?

A

This is when you swallow a Bluetooth capsule which then measures the amount of acid reflux over 24 hours to establish if symptoms are due to acid reflux

58
Q

What makes cells resistant to acid?

A

Presence of mucus barrier

Presence of bicarbonate barrier

59
Q

What are the 2 surgical treatments of Barrett’s oesophagus?

A

Oesophagectomy- remove affected area

Nissan fundoplication- wrapping the fundus around the lower oesophageal sphincter to strengthen it

PBL (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions