Ch. 335 - PUD Flashcards

1
Q

the end result of inflammation caused by an imbalance between cytoprotective and cytotoxic factors in the stomach and duodenum, manifests with varying degrees of gastritis or frank ulceration.

A

PUD

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2
Q

Final common pathway for the development of ulcers

A

action of acid and pepsin-laden contents of the stomach on the gastric and duodenal mucosa and the inability of mucosal defense mechanisms to allay those effects

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3
Q

Peptic ulcers are deep mucosal lesions that disrupt the ___ layer of the gastric or duodenal wall

A

muscularis mucosa

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4
Q

Gastric ulcers are generally located on the ___ of the stomach, and 90% of duodenal ulcers are found in the ___

A

lesser curvature, duodenal bulb

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5
Q

Primary peptic ulcers are more often chronic and ___ in location

A

Duodenal

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6
Q

Secondary peptic ulcers are more often acute and ___ in location

A

Gastric

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7
Q

___ ulcers are most often associated with Helicobacter pylori infection

A

Primary ulcers

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8
Q

By ___ of age, gastric acid secretion approximates adult values

A

3-4 yr

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9
Q

pH of the stomach contents is

A

1-2

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10
Q

Excessive acid secretion is associated with ___ (3)

A

1) a large parietal cell mass, 2) hypersecretion by antral G cells, and 3) increased vagal tone

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11
Q

Results in increased or sustained acid secretion in response to meals and increased secretion during the night

A

Increased vagal tone

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12
Q

Substance released by vagus nerve that promotes acid production

A

Acetylcholine

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13
Q

Substance released by enterochromaffin cells that promotes acid production

A

Histamine

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14
Q

Substance released by G cells of antrum that promotes acid production

A

gastrin

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15
Q

Mucus production and secretion in the stomach are stimulated by

A

PGE2

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16
Q

method of choice to establish the diagnosis of peptic ulcer disease

A

Esophagogastroduodenoscopy

17
Q

Secretagogues that promote gastric acid production

A

1) Ach release by vagus 2) Histamine release by enterochromaffin cells 3) Gastrin release by G cells of antrum

18
Q

Mediators that decrease gastric acid secretion and enhance mucin production

A

Prostaglandins

19
Q

Classic symptom of peptic ulceration present only in a MINORITY of children and presents as

A

Epigastric pain alleviated by ingestion of food

20
Q

H. pylori: ?urease ?catalase ?oxidase

A

Yes, yes, yes

21
Q

T/F Chronic colonization with H.pylori can predispose children to a significantly increased risk of developing duodenal ulcer, gastric cancer, or MALT lymphomas

A

T

22
Q

Recommended eradication therapies for H.pylori-associated disease in children

A

1) Amox+Clarith+PPI 2) Amox+Metro+PPI 3) Clarith+Metro+PPI

23
Q

First-line drugs for the treatment of gastritis and PUD in children

A

H2 receptor antagonists and PPIs

24
Q

MOA: H2 receptor antagonist

A

Inhibit binding of histamine at H2 receptor of gastric parietal cell

25
Q

MOA: PPI

A

Block gastric parietal cell H+/K+ ATPase pump in dose-dependent fashion, reducing BASAL and STIMULATED gastric acid secretion