Brainscape's Knowledge GenomeTM

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


See full index

Applied Pathophysiology > GERD > Flashcards

GERD Flashcards

1
Q

What are the 4 steps the body uses to prevent damage to esophagus from acid reflux?

A

1) Acid and food reflux into esophagus due to relaxed lower esophageal sphincter
2) Peristalsis returns most acid reflux back to stomach
3) After peristalsis, a small amount of acid remains in esophagus
4) Saliva containing HCO3- neutralizes remaining acid in esophagus

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

What is the function of the lower esophageal sphincter (LES)?

A

protects the esophagus from noxious stomach contents

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

What maintains the tone for the LES?

A

Ach

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

What is the pressure of the LES? When is it the highest?

A

15-30mmHg higher than intragastric pressure

Highest at night, lowest in the day

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

What is the function of the pyloric sphincter?

A

controls emptying of stomach contents into duodenum

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

What is the function of the duodenum?

A

Continual digestion of chyme from stomach

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

What is chyme?

A

food mixed with stomach contents

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

What is the pH of the stomach? Why?

A

pH 1-2 due to HCl in stomach

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

What else can be found in the stomach besides HCl?

A 
Electrolytes
Water
Pepsin
Mucus
Proteins
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What protects the stomach walls from acid?

A

Lipoprotein rich membrane

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

What 2 thing influence the ability of the mucosa to withstand injury?

A

age

nutritional status

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

What is the function of parietal cells?

A

Secrete HCl and Intrinsic factor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the function of the G cells?

A

Produce gastrin

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

what is the function of the ECL cells?

A

produce histamine

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

What is the function of Chief cells?

A

produce pepsinogen

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

How is HCl in the stomach produced?

A

H+/K+ ATPase pumps on parietal cells
passive movement of K+ in and Cl- ions out into canaliculus
H+ transported out actively (against gradient) and binds to Cl-, making HCl

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

What is GERD?

A

gastroesophageal reflux disease
chronic disorder related to the retrograde flow of gastro-duodenal contents into the esophagus/adjacent organs, resulting in various symptoms with or without tissue damage

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

What are the 2 main reason GERD occurs?

A

dysfunction in lower esophageal sphincter pressure (LESP)

impaired acid clearance

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

what are 3 causes of dysfunction in LESP? which is the most common?

A

transient LES relaxation (TLESR) - most common
increase in intra-abdominal pressure
hormones, meds, or food that decrease LES tone

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

what is TLESR?

A

spontaneous LES relaxation not associated with swallowing

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

What molecule would increase LESP?

A

protein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what are some foods that lower LESP? (6pts)

A 
chocolate
fat
ethanol
peppermint
garlic
onions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what hormones decrease LESP?

A

glucagon
progesterone
estrogen

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

what could cause impaired acid clearance?

A

decreased peristalsis
decreased salivation
increased frequency of reflux

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

what is barrett’s esophagus?

A

long term assault of reflux on esophagus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

what are 5 consequences of long term GERD?

A 
barrett's esophagus
adenocarcinoma of esophagus
esophagitis
bleeding
esophageal erosions and ulcerations
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What are 6 classes of drugs that could be used in GERD treatment? Which is the first choice to use?

A 
antacids
alginic acid
H2 receptor antagonists
P+ pump inhibitors - first choice
prokinetics
mucosal protectants
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

how do antacids help with GERD?

A

neutralize stomach acid by increasing pH over 4, meaning pepsinogen can’t convert to pepsin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

how does alginic acid help with GERD?

A

creates a viscous barrier at top of stomach contents to reduce reflux episodes

30
Q

What are some H2 receptor antagonists?

A 
-dine
cimetidine
nizatidine
famotidine
ranitidine
31
Q

what are some side effects to using H2 receptor antagonists?

A 
diarrhea
headache
dizziness
rash
tiredness
32
Q

how do H2 receptor antagonists help with GERD?

A

block H2 receptors on parietal cells to reduce acid production

33
Q

What are some P+ pump inhibitors? Which ones are better to use?

A 
-prazole
esomeprazole (better)
lansoprazole
omeprazole
pantoprazole (better)
raberprazole
34
Q

How do P+ pump inhibitors help with GERD?

A

inhibit proton pump on parietal cells to decrease acid production
maintains pH above 4 for a longer period of time to allow healing

35
Q

When is the best time to take P+ pump inhibitors? why?

A

30min before breakfast

only work on actively secreting pumps

36
Q

what are some side effects to using p+ pump inhibitors?

A 
headache
diarrhea
nausea
abdominal pain
constipation
dizziness
rash
37
Q

How do prokinetics help with GERD?

A

help move contents of stomach through faster

38
Q

why aren’t prokinetics used very often?

A

significant drug interactions

39
Q

what are some examples of prokinetics?

A

cisapride
metoclopramide
domeperidone

40
Q

what is the main side effect for prokinetics?

A

diarrhea

41
Q

how do mucosal protectants help with GERD?

A

put coating on mucus layer of stomach

42
Q

what is an example of a mucosal protectant?

A

sucrafate (old school, not used often)

43
Q

name 5 unique therapy options for GERD treatment?

A 
baclofen
trazodone/SSRIs
surgical laparoscopic sphincter augmentation
cholestyramine
acupuncture
44
Q

how does baclofen help with GERD?

A

reduces TLESRs and increases gastric emptying

45
Q

how do trazodone/SSRIs help with GERD?

A

reduce esophageal pain

46
Q

how does acupuncture help with GERD?

A

controls regurgitation and heartburn

47
Q

what are some things to avoid when trying to treat GERD?

A 
foods that trigger GERD
lying down right after meals
smoking
excessive bending
tight fitting clothing
48
Q

what are some lifestyle modifications that could help with GERD?

A 
exercise
maintain healthy body wt
reduce alcohol/caffeine intake
eat smaller, frequent meals
reduce stress
sleep with head elevated higher than pelvis
49
Q

What is VBAD? what is it used for?

A 
to know when to refer someone
V- persistent vomiting
B - bleeding
A - abdominal wt loss
D - dysphagia
50
Q

What are some red flags indicating to refer a patient? (10pts)

A 
chest pain typical of a cardiac event
recurring vomitting
blood loss in vomit or stool
dysphagia (esp. with solids)
odynophagia
unexplained wt loss > 5%
family history of gastric cancer
unexplained cough, hoarseness, or dyspnea
50 yrs
drug induced GERD
51
Q

what are 6 risk factors for GERD?

A 
food
obesity
pregnancy
meds
smoking
hiatrial hernia
52
Q

how is food a risk factor for GERD?

A

meals within 2-3hrs of bedime or with alcohol increase acid production and nocturnal GERD

53
Q

how is obesity a risk factor for GERD?

A

increases symptoms

54
Q

how is smoking a risk factor for GERD?

A

decreases LESP

55
Q

what is a hiatrial hernia?

A

the proximal stomach is dislocated though the hiatus of the diaphragm into the chest and the crural diaphragm becomes separated from the LES
GERD: LES before diaphragm (usually after diaphragm)

56
Q

what are some chest symptoms for GERD? (6pts)

A 
heartburn 
angina
regurgitation (sour taste in mouth)
belching
dysphagia
odynophagia
57
Q

what is dysphagia?

A

hard to swallow

58
Q

what is odynophagia?

A

pain upon swallowing

59
Q

what are some pulmonary symptoms of GERD? (4pts)

A

non-allergic asthma
cough
aspiration
hoarseness

60
Q

what are 2 oral symptoms of GERD?

A

tooth decay

gingivitis

61
Q

what are 3 throat symptoms of GERD?

A

globus sensation
hoarseness
laryngitis

62
Q

What are 3 components involved in impaired acid clearance that contribute to GERD?

A

duration of acid exposure
composition of reflux
delayed gastric emptying

63
Q

how is duration of acid exposure involved in GERD?

A

primary cause of symptoms and tissue damage

64
Q

what are important components of stomach reflux that contribute to GERD?

A

pH 2
pepsin
acid

65
Q

what is heartburn?

A

burning pain that can move up from the stomach to the middle of the chest and possibly throat

66
Q

what is regurgitation?

A

a symptom of acid reflux

contents of the stomach move into the esophagus and and maybe into throat (sour taste in mouth)

67
Q

what is dyspepsia?

A

indigestion

mostly stomach discomfort that could include burping, nausea, bloating, and upper abdominal pain

68
Q

what is the most common symptom of GERD?

A

heartburn usually after a meal

>2x a week suggest GERD (esp with regurgitation)

69
Q

what age category is more susceptible to GERD?

A

adults over 40

70
Q

is there a gender preference for GERD?

A

no (except pregnancy)

Applied Pathophysiology (11 decks)

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