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Flashcards in GI Tutorial 1 Deck (21)
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1
Q

2 aggressive factors for peptic ulcers

A

Pepsin secretion

Acid secretion

2
Q

3 protective factors for peptic ulcers

A

Mucus/bicarbonate secretion
Prostaglandins (mucosal blood flow)
Rapid turnover of gastric mucosa

3
Q

Why do peptic ulcers occur?

A

Due to an imbalance between aggressive factors and mucosal protective mechanisms

4
Q

3 factors that contribute to the gastric mucosal barrier

A

Bicarbonate rich mucus layer
Tight junctions
Luminal membrane of mucosal cells is impermeable for protons

5
Q

Causes of ulcers

A
Hyperacidity
NSAIDs and corticosteroids
Cigarette smoking
Alcohol
Stress
Coffee
Helicobacter pylori infection
6
Q

How can H pylori survive the acidic state?

A

Has urease that neutralizes the gastric acid by turning urea into ammonia
Creates a small atmosphere of neutral pH
Has exotoxins and other products to be able to invade the cells

7
Q

2 ways to treat peptic ulcers

A

Antibiotics (to treat the H pylori)

Proton pump inhibitors (to reduce acid secretion)

8
Q

How do NSAIDs work?

A

Block the COX enzymes
COX1 is constitutive and important for blood flow, platelets, and to protect the stomach
COX2 is responsible for pain and inflammation
Want drugs that are more specific for COX2 instead of COX1

9
Q

Zollinger Ellison syndrome

A

Tumor in pancreas that can cause the release of a lot of gastrin in the stomach, leading to peptic ulcers, diarrhea, and acid hypersecretion

10
Q

Why would too much acid in the duodenum lead to diarrhea?

A

Too acidic, so the pancreatic digestive enzymes do not work

Food is not broken down, and osmotic diarrhea occurs

11
Q

Barrett’s esophagus

A

The replacement of normal esophageal epithelium by stomach like epithelium which is columnar containing goblet cells

12
Q

Symptoms of acute pancreatitis

A

High serum levels of pancreatic lipase and pancreatic amylase
High WBC count

13
Q

Pathophysiology of acute pancreatitis

A
Inflammation from and insult or injury
Causes activation of pancreatic enzymes
Enzymes autodigest and cause fibrosis
Leads to thrombi and necrosis of tissue
Fat necrosis occurs
Fat binds to calcium
Results in hypocalcemia
14
Q

Salivary stimulation

A

All neural

Both parasympathetic and sympathetic stimulation stimulate secretion

15
Q

5 ways to detect H pylori

A
Histology
Breath test (C14-urea)
Urease test
ELISA
Rapid test
16
Q

5 causes of chronic pancreatitis

A
Ethanol abuse
Gallstones
Hyperparathyroidism
Congenital malformation
Idiopathic
17
Q

Exocrine insufficiency manifests as…

A

Steatorrhea and weight loss

18
Q

Endocrine insufficiency

A

May result from islet cell destruction

Leads to diabetes

19
Q

2 agents to treat pancreatitis

A

Somatostatin (decrease pancreatic secretion and motility)

Anticholinergic agents

20
Q

2 beneficial effects of prostaglandins

A

Promote platelet function

Protect the lining of the stomach from the damaging effects of acid

21
Q

3 harmful effects of prostaglandins

A

Inflammation
Pain
Fever