21653619
Descripción
Fichas por Evian Chai, actualizado hace más de 1 año
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Creado por Evian Chai
hace más de 4 años
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| Pregunta | Respuesta |
| What is an ulcer? | A chronic lesion/sore in the GI tract |
| What are the symptoms of ulcers? | 1. Abdominal pain Relieved by eating if in duodenum 2. Heartburn 3. Bloating |
| What are 2 complications of ulcers? | 1. Penetration when ulcer burrows in pancreas/liver 2. Perforation when ulcer opens 3. Upper GI bleeding when ulcer erodes artery |
| What causes ulcers to develop? | 1. Smoking 2. H. pylori (main cause) 3. Aspirin/non steroidal anti-inflammatory drugs |
| Does acid hypersecretion cause ulcers? | Very rarely |
| In a gastric ulcer, which area is infected with H pylori? What is the main disruption to the balance between mucosal defence and acid/pepsin? | The gastric corpus Normal levels of gastric acid, defect in gastric mucosal resistance |
| In a duodenal ulcer, which area is infected with H pylori? What is the main disruption to the balance between mucosal defence and acid/pepsin? | The gastric antrum Increased secretion of acid/pepsin creates an environment like the gastric mucosa that H pylori can infect |
| Where does H pylori grow and what does it cause? | Grows beneath surface of epithelial cells Causes increased secretion of gastrin/pepsin to damage mucosa |
| What does H pylori secrete to protect itself from gastric acid? | Urease that converts urea to bicarbonate/CO2 |
| How can H Pylori be detected? | Antigen test in stool samples Antibody test in blood |
| How does Ach from PNS fibres directly impact the parietal cell? | Binds to M3 receptor Increases Ca2+ Increases activity of H+/K+ pump to increase HCl secretion |
| How does histamine impact the parietal cell? | Binds to H2 receptor Increases cyclic AMP Increases activity of H+/K+ pump to increase HCl secretion |
| How does gastrin from the G cell impact the parietal cell? (It also stimulates ECl cell) | Binds to CCKb receptor Increases Ca2+ Increases activity of H+/K+ pump to increase HCl secretion |
| How do prostaglandins promote secretion of mucus/HCO3-? How does it inhibit HCl secretion? | Binds to EP3 receptor on cells Binds to EP3 receptor on parietal cell to inhibit HCl secretion |
| How do proton pump inhibitors work? Give an example | Irreversibly block parietal cell H+/K+ ATPase Are inactive, converted to sulfenamides at pH<3 Omeprazole |
| How do H2 receptor blockers work? Give an example | Selectively block parietal cell H2 receptors Famotidine, ranitidine, cimetidine |
| How does bismuth chelate/sucralfate work? What is sucralfate used to treat mainly? | Coats the ulcer to protect it from gastric juices and promote healing Can also kill H pylori Stress ulcers |
| What is taken with NSAIDS to prevent ulcers? | Misoprostil |
| What are the 5 main ways to treat ulcers? | 1. Proton pump inhibitors (Omeprazole) 2. H2 receptor blockers (Famotidine) 3. Improve mucosal protection (bismuth chelate/sucralfate) 4. Misoprostil for NSAIDS caused ones 5. Antimicrobial therapy combined with 1/2 |
| What is gastro-oesophageal reflux disease (GORD)? | Reflux of stomach back into oesophagus causes inflammation, heartburn, tooth erosion |
| How to treat GORD? | 1. Lifestyle changes 2. Proton pump inhibitors to reduce gastric acidity 3. Antacids/alginic acid neutrallses gastric pH, forms foam raft on top of stomach 4. Gastric motility stimulating agents (eg. Metoclopromide/domperidone) 5. Fluorides etc. to protect teeth |
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