peptic ulcer diseases

Question 1

histological layers of the gastric wall?

Answer 1

epithel
lamina propria
muscularis mucosa
sub mucosa
musculris externa
circular
longditual 
serosa

Question 2

cells that line the stomach’s glands

Answer 2

foveola- surface mucus 
neck mucus 
parietal
endocrine
cheif

Question 3

parietal cells acid production inducing receptors

Answer 3

gastrin (g cells, antrum, endocrine)
achetylcholin (vagus)
histamine (entrochromaffin like cells, paracrine)

Question 4

which cells responsable for the gastric mucin layer?

Answer 4

foveolar cells

Question 5

most potent acid production inducer in parietal cells

Answer 5

histamine

Question 6

what stimulates acid prduction in parietal cells (phase wise)

Answer 6

chephalic- vagus
gastric- amino acids and distention
small intestine- distantion

Question 7

which cell produce pepsin and due to what stimuli?

Answer 7

chief cells
gastrin (g cells, antrum, endocrine)
achetylcholin (vagus)
histamine (entrochromaffin like cells, paracrine)

Question 8

in what PH does pepsin seize to work?

Answer 8

greater than 4

Question 9

which cell produce histamin and due to what stimuli

Answer 9

entero-chromaffin like cells

due to gastrin secreted by G cells (endocrine)

Question 10

by which cell does G cell regulate negatively ?

Answer 10

D cells, somatostatin (paracrine)

Question 11

to which stimuli does G cell regulate possitivly?

Answer 11

food in antrum

achetycholin (vagus)

Question 12

which cell produce secretin and to what stimuli?

Answer 12

s. cells

acidic food in the deodenum

Question 13

what do secretin do?

Answer 13

increase secrition of bicabonate at pancrease
inhibit gastric motility
decrease bile secretion

Question 14

what stimulate CCK release (and from where?)

Answer 14

I-cells

indigested FF+ AA in deodenum

Question 15

what does CCK do?

Answer 15

increase bile secretion

increase pancreatic enzymes flow

Question 16

pre-epithelial mechanism for mucosal integrity?

Answer 16

mucus- bicarbonate

surface active phospholipids layer

Question 17

epithelial cells mechanism for mucosal integrity?

Answer 17

tight junctions
ion pumps
cell renewal

Question 18

post-epithelial cells mechanism for mucosal integrity?

Answer 18

mucosal blood flow (PGE2, PGI2 vasodialition)

Question 19

which system operates the gastric emptying while fasting?

Answer 19

migratory motor complex (every 90min)

Question 20

what does the vaso-vagal reflex do when food enters the stomach?

Answer 20

receptive relaxition and accomodition of fundus

later on, perylstasis

Question 21

what is the differance between erosion and ulceration?

Answer 21

ulcer involves the sub-mucosa

Question 22

favored area of peptic ulcers?

Answer 22

antrum and body of stomach

1st part of deodenum

Question 23

peptic ulcers empidemiology?

Answer 23

g.ulcers represent malignancy whilst d.ulcers do not

bening g.ulcers locate typically distal to antrum

H.pyloric associated g.ulcers associate with chronic gastritis

NSAIDS -dont cause chronic gastritis

Question 24

peptic ulcers epidemiology?

Answer 24

g.ulcers less common than d.ulcers
M>F
60’s

Question 25

location at which H.pylori is found?

Answer 25

deep parts of the mucus layer of the stomach between epithel layer to mucus layer

Question 26

toxins H.pylori produce?

Answer 26

cag A | vaculating cytotoxin a

Question 27

trasmission of H.pylori?

Answer 27

oral-oral facal-oral usually occurs in first decade of life

Question 28

what can antral predominant gastritis caused by H.pylori | deteriorate to?

Answer 28

asymptomatic H.infection or dudenal ulceration (HCL production is up)

Question 29

what can non-atrophic pangastritis cause by H.pylori | deteriorate to?

Answer 29

asymptomatic H.infection | B-cells lymphoma

Question 30

what can corpus (body) predominant atrophic gastritis cause by H.pylori deteriorate to?

Answer 30

asymptomatic H.infection gastric ulcers gastric cancer

Question 31

location at which H.pyloric induced gastritis produce most HCL?

Answer 31

antral > non-atropic > adenocarcinoma

Question 32

clinical outcomes of H.pyloric inflammation response?

Answer 32

d.ulcer B-cell lymphoma non cardia gastric adenocarcinoma

Question 33

non invasive H.pyloric tests?

Answer 33

serology (not for iradication, after first possitive test all shall be positive ever on) urea breath test stool antigen

Question 34

which test wont be used to check for H.pyloric eradication?

Answer 34

serology, after first possitive test all shall be positive ever on

Question 35

H.pylori treatment?

Answer 35

PPI+ amoxicillin+clarithromicin+metronidazole (10-14 days) | PPI+ Bismuth + tetracyclin + metronidazole (10-14 days)