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13 Cards in this Set
- Front
- Back
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Stomach ulcer, 3cm from the pylorus, acts like...
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a duodenal ulcer
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Prostaglandins are the driving forces behind...
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bicarb
mucous blood flow |
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4 major mechanisms leading to increased Duodenal Ulcers...
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1) INC sensitivity to gastrin
2) INC basal gastrin 3) DEC pH inhibition of gastrin release 4) INC gastric emptying |
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Type A gastritis is seen with...
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pernicious anemia
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Type B gastritis is seen with...
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H. pylori present
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Describe the effects of H. pylori presence in terms of Antral D-Cells and Somatostatin....
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-there is a decrease in antral D-cells due to H. pylori presence, leading to
-DEC in somatostatin -INC in gastrin and poss. acid secretion -INC the # of parietal cells -INC the gastric acid secretion NOTE: somatostatin typically INHIBITS G-cell gastrin release typically, pH<3.5 causes D cells to secrete somatostatin which shuts off G-cell release of gastrin, but here that pathway is not as effective |
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Eradicating H. pylori can do what 3 good things?
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1) INC D-cells, which are somatostatin secreters
2) INC somatostatin secretion 3) DEC gastrin release |
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NSAIDs and Ulcers:
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-all NSAIDs produce mucosal damage
-ulcer risk is dose-related -acute mucosal response does not predict subsequent ulcer risk |
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Patients at ABSOLUTE risk for NSAID-induced gastropathy are those that...
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-have a Hx of previous ulcer/GI bleeding
-concomitant glucocorticoid or anticoagulant therapy -high-dose therapy or multiple NSAIDs -advanced age |
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The gastric mucosal barrier depends on a nuber of physiologic and anatomic factors, all of which depend on what family of molecules?
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prostaglandins
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What's in the triad of Zollinger-Ellison Syndrome:
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1) gastric acid hypersecretion
2) severe peptic ulcer disease 3) non-beta islet cell tumors of the pancreas ~1/3 have multiple endocrine neplasia syndrome- MEN I- tumors of parathyroid, pituitary, and pancreatic islets (adenomas of the 3 P's) |
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How do you Dx ZE syndrome?
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inappropriate elevated serum gastrin secretion
-not every elevated serum gastrin is ZE! |
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After a surgical procedure to detach the antrum from the duodenum, it is possible to have a portion of retained antrum. How would you treat this situation?
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Dx/Tx with secretin infusion test
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