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Pathophysiology - Final Exam > Ch. 36 GI - Book/1 > Flashcards

Ch. 36 GI - Book/1 Flashcards

1
Q

asthma may trigger

A

GERD

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2
Q

GERD impednace/pH monitoring measures

A

the movement of stomach contents upward into the esophagus and the acidity of the refluxate

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3
Q

drugs that relax the LES and can cause GERD

4

A
  1. anticholinergics
  2. nitrates
  3. calcium channel blockers
  4. nicotine
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4
Q

the severity of esophagitis depends on

2

A
  1. composition of gastric contents

2. esophageal mucosa exposure time

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5
Q

ulcers of antral region

A

gastric

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6
Q

gastric ulcers usually develop where

A

antral region

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7
Q

peptic ulcer erosion

A

superficial ulcerations; erode the mucosa but do not penetrate the muscularis mucosa

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8
Q

gastric ulcers

A

ulcers of the stomach

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9
Q

what levels are evaluated to ID ulcers associated with gastric carcniomas

A

radioimmune assays of gastrin levels

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10
Q

decreased mass of parietal cells

A

gastric ulcer

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11
Q

ulcers of the stomach

A

gastric ulcer

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12
Q

zollinger-ellison syndrome

A

rare syndrome that is associated with peptic ulcers caused by gastrin-secreting neuroendocrine tumor of the pancreas of duodenum

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13
Q

txs for GERD

4

A
  1. proton pump inhibitors
  2. H2-receptor antagonists
  3. prokinetics
  4. antacids
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14
Q

agents of choice for controlling and healing esophagitis

A

proton pump inhibitors

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15
Q

gastric secretions may be normal or less than normal

A

gastric ulcer

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16
Q

chronic cough may trigger

A

GERD

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17
Q

duodenal ulcer exacerbation develops when

A

spring and fall

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18
Q

heartburn aka

A

pyrosis

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19
Q

duodenal ulcers - healing

A

often heal spontaneously but recur within months w/o tx

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20
Q

duodenal ulcer perforation occurs with

A

destruction of all layers of the duodenal wall

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21
Q

bleeding from duodenal ulcers causes

2

A
  1. hematemesis

2. melena

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22
Q

cause of esophagitis

A

GERD

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23
Q

when do GERD sx worsen

A
  1. individual lies down

2. intraabdominal pressure increases

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24
Q

superficial ulcerations; erode the mucosa but do not penetrate the muscularis mucosa

A

peptic ulcer erosion

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25
Q

GERD surgery name

A

laparoscopic fungoplication

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26
Q

reflux of acid and pepsin or bile salts from the stomach into the esophagus that causes esophagitis

A

GERD

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27
Q

precancerous lesions of esophagus are called

A

barrett esophagus

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28
Q

most common ulcer

A

duodenal

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29
Q

GERD may be triggered from

2

A
  1. asthma

2. chronic cough

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30
Q

complications of duodenal ulcers include

3

A
  1. bleeding
  2. perforation
  3. obstruction of the duodenum or outlet of stomach
31
Q

ulcers that tend to be chronic

32
Q

GERD is the

A

reflux of acid and pepsin or bile salts from the stomach into the esophagus that causes esophagitis

33
Q

host response to h. pylori infection is

A

activation of B and T cells with infiltration of neutrophils and release of inflammatory cytokines that damages the gastric epithelium

34
Q

pyrosis

35
Q

peptic ulcers develop when

A

mucosal protective factors are overcome by erosive factors commonly caused by NSAIDs and h. pylori infection

36
Q

esophagitis precancerous lesions (barrett) can progress to

A

adenocarcinoma

37
Q

clinical manifestations of GERD

7

A
  1. heartburn (pyrosis)
  2. acid regurgitation
  3. dysphagia
  4. chronic cough
  5. asthma attacks
  6. laryngitis
  7. upper abdominal pain 1 hour after eating
38
Q

duodenal ulcer are commonly caused by

2

A

h. pylori

NSAIDs

39
Q

true ulcers extends

A

through the muscular mucosa and damage blood vessels, causing hemorrhage

40
Q

H. pylori is tx with combo of

2

A
  1. antibiotics

2. proton pump inhibitors

41
Q

gastric ulcers can cause more what than duodenal ulcers

3

A
  1. anorexia
  2. vomiting
  3. weight loss
42
Q

pain of gastric ulcer occurs when

A

almost immediately after eating

43
Q

peptic ulcer locations

3

A
  1. lower esophagus
  2. stomach
  3. duodenal
44
Q

GERD mucosal injury includes

6

A
  1. inflammation
  2. hyperemia
  3. increased capillary permeability
  4. edema
  5. tissue fragility
  6. erosion
45
Q

peptic superficial ulcerations aka

46
Q

causes of gastric ulcers include

5

A
  1. chronic gastritis
  2. decreased mucosal synthesis of prostaglandins
  3. duodenal reflux
  4. use of NSAIDs
  5. h. pylori
47
Q

hiatal hernia is to

48
Q

what two concentration cause duodenal ulcer

A
  1. acid

2. pepsin

49
Q

gastric ulcer prevalence

A

equally common in male and female age 55-65

50
Q

disorders that delay stomach emptying include

3

A
  1. gastroparesis
  2. gastric ulcers
  3. duodenal ulcers
51
Q

chronic intermittent pain in the epigastric area about 2-3 hours after eating, when the stomach is empty

A

duodenal ulcer

52
Q

idiopathic duodenal ulcers are rare and can be associated with
4

A
  1. altered mucosal defenses
  2. rapid gastric emptying
  3. elevated serum gastrin levels
  4. acid production stimulated by smoking
53
Q

what abnormalities can cause GERD

3

A
  1. abnormalities in LES function
  2. abnormalities in esophageal motility
  3. abnormalities in gastric motility or emptying
54
Q

delay or gastric emptying can cause

55
Q

GERD esophageal endoscopy may show

4

A
  1. hyperemia
  2. edema
  3. erosion
  4. strictures
56
Q

rare syndrome that is associated with peptic ulcers caused by gastring-secreting neuroendocrine tumor of the pancreas of duodenum

A

zollinger ellison syndrome

57
Q

risk factors for GERD include

4

A
  1. older age
  2. obesity
  3. hiatal hernia
  4. drugs/chemicals that relax the LES
58
Q

delayed gastric emptying can contribute to reflux esophagitis by
2

A
  1. lengthening the period during which reflux is possible

2. increasing gastric acid content

59
Q

long term consequence of GERD

A

barrett esophagus (precancerous lesions)

60
Q

GERD stands for

A

gastroesophageal reflux disease

61
Q

the characteristics manifestations of duodenal ulcer is

A

chronic intermittent pain in the epigastric area about 2-3 hours after eating, when the stomach is empty

62
Q

peptic ulcer

A

break or ulceration in the protective mucosal lining of the lower esophagus, stomach, or duodenum

63
Q

detected using the urea breath test

64
Q

break or ulceration in the protective mucosal lining of the lower esophagus, stomach, or duodenum

A

peptic ulcer

65
Q

increased secretion of gastrin causes excess secretion of

A

gastric acid

66
Q

risk factors for peptic ulcer

8

A
  1. h. pylori
  2. NSAIDs
  3. alcohol
  4. smoking
  5. advanced age
  6. chronic disease
  7. type O blood
  8. psychological stress
67
Q

gastroesophageal reflux that does not cause sx is known as

A

physiologic reflux

68
Q

GERD dysplastic changes aka

A

barrett esophagus

69
Q

gastric ulcer - a break in the mucosal barrier permits what

A

hydrogen ions to diffuse into the mucosa, where they disrupt permeability and cell structure

70
Q

what is often associated with development of gastric ulcers

A

chronic gastritis

71
Q

gastric ulcer - histamine function

A

stimulates the increase of acid and pepsinogen production, blood flow, and cap permeability (increased disruption)

72
Q

gastric ulcer - primary defect is

A

an abnormality that increases the mucosal barrier’s permeability to hydrogen ions

73
Q

h. pylori is detected using

4

A
  1. urea breath test
  2. IgG Abs
  3. IgA Abs
  4. measure stool Ags levels

Pathophysiology - Final Exam (26 decks)

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