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ALI > 20. GORD > Flashcards

20. GORD Flashcards

1
Q

superficial zone of stomach mucosa

A

gastric glands and gastric pits

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2
Q

neck zone of stomach mucosa

A

immature stem cells

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3
Q

deep zone of stomach mucosa

A

gastric glands

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4
Q

Glands in Cardia

A

mucus secreting cells

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5
Q

Glands in Fundus and body

A

parietal acid secreting cells

pepsin-secreting chief cells

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6
Q

Glands in Pylorus

A

neuroendocrine gastrin secreting cells

mucus secreting cells

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7
Q

Buccal phase of swallowing

A

voluntary push to hard palate

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8
Q

Pharyngeal phase of swallowing

A

soft palate blocks nasa-pharynx

tongue blocks oral cavity

epiglottis closes larynx

upper oesophageal sphincter relaxes

Involves 5th, 9th and 10th Cranial nerves

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9
Q

Oesophageal phase of swallowing

A

peristaltic wave: primary and secondary

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10
Q

Discuss the normal mechanisms of mucosal and oesophageal protection

A

Mucus production = lubrication
Local HCO3 production in the stomach
Mucosal distension = protect from trauma
Prostaglandins = inhibit acid production and enhance blood flow
Columnar epithelium of the stomach = protecting from low pH
Increased desquamation in the lower oesophagus= transformation from squamous to columnar epithelium

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11
Q

Discuss normal gastric acid secretion and control

A

Secreted by gastric parietal cells, proton pump

Three main factors stimulate secretion: gastrin, histamine and acetylcholine

The terminal proton pump (PP) is a Proton/Potassium – ATPase.

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12
Q

List causes of gastro-oesophageal reflux disease GORD

A 
Pregnancy
obesity
chocolate
coffee
alcohol
large meals
smoking
hiatus hernia
anticholinergic drugs
calcium channel blockers
nitrates
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13
Q

List aetiological factors in peptic ulcer disease (6)

A

1) H.pylor
2) NSAIDS
3) Smoking
4) Hyperacidity
5) Familial aspect
6) Gender

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14
Q

Describe how Helicobacter infection causes PUD

A

H.Pylori provokes an acute inflammatory response

Protease release

Destruction of gastric glands

Atrophy and susceptibility to acidity

Ulceration

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15
Q

Describe the use endoscopic and radiological techniques in the investigation and management of PUD

A

OGD
barium swallow
CT abdomen

H.pylori testing – urease breath test
GORD testing - pH manometers

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16
Q

Discuss the pharmacological basis of treatments for PUD

A

H.pylori eradication therapy
PPI
H2 Receptor antagonist

17
Q

Enterocytes

A

absorptive cell

tall columnar microvilli

18
Q

Goblet cells

A

on villi

mucus producing

19
Q

Paneth cells

A

phagocytic cells

deep in glands

20
Q

Entero-endocrine cells

A 
in the crypts
triangular with microvilli and neuroendocrine granules 
secrete:
1) somatostatin
2)serotonin
3)secretin
4)gastrin
5)motilin
6)VIP

ALI (22 decks)

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