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28 Cards in this Set
- Front
- Back
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True/False: GERD is a disorder of primary motility.
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FALSE
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What causes GERD?
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tLESR--transient LES relaxation that allows acid to travel into the esophagus
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What contributes to the tone of the lower esophageal ligament?
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The diaphragm
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What are the risk factors for reflux?
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Certain drugs and foods do contribute--obesity
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True/False: Most patients with severe GERD have a hiatal hernia.
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TRUE
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How is GERD diagnosed?
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History, symptomatic response to empirical trial, barium swallow, endoscopy, 24 hour pH monitoring, impedance monitoring
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What are some complications of GERD?
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Esophagitis, Barrett's, esophageal adenocarcinoma
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What is Barrett's?
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Normal mucosa is replaced by intestinal columnar like epithelium that contains goblet cells(used to be strat. squamous epithelium)
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What are the THREE primary risk factors for Barrett's?
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Long standing reflux
White Caucasian MAle |
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Why is the frequency of Barrett's increasing?
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Obesity epidemic
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Is screening viable for Barrett's patients?
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Yes--if the patient has low grade dysplasia then they can be monitored
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Histology of proximal stomach vs. distal stomach.
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Oxyntic glands are found in proximal stomach--pyloric glands are found in the distal stomach
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True/False: Gastrin stimulates ECL cells to secrete histamine
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TRUE--gastrin attaches to the CCK2 receptor to cause histamine secretion
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What is ZE syndrome?
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Increased gastrin secretion from neuroendocrine tumors
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What does H. pylori infection cause?
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Increased acid secretion
Increased response to gastrin Increased response to GRP Decreased effect from inhibitors |
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What are most gastric ulcers related to?
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H. pylori infection or NSAID overuse
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What is the best way to diagnose peptic ulcer?
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Endoscopy or an upper GI series
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How does H. pylori cause infection?
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Infects antrum and causes inflammation
Reduction of somatostatin from D cells Increased gastrin = increased Acid Duodenal bulb gastric metaplasia = H. pylori infection = inflammation = ulcer |
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True/False: Pan gastritis patients usually contract a duodenal ulcer.
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FALSE--they usually get a gastric ulcer
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What are the vast majority of gastric ulcers caused by?
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NASIDS and H. pylori
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What is the main cause of duodenal ulcer?
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HP(NSAIDS ARE SECOND)
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What is the most common complication of duodenal ulcer?
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Bleeding--may be bleeding into organs
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True/False: There is a direct link between stress, alcohol, or diet and getting an ulcer.
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FALSE
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What are some risks of long term PPI treatment?
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Risk of bone fracture, CAP, C. diff, bacterial overgrowth
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People with antral gastritis will be more likely to get what?
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A duodenal ulcer
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What happens in Zollenger Ellison syndrome?
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Pancreas produces tons of gastrin
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What occurs in acute H. pylori infection?
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Increase SST causes decreased gastrin and decreased acid
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What happens during antral gastritis?
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Decrease in SST causes increase in gastrin which causes an increase in acid
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