Diarrhoea & GORD Flashcards
Is this secretory or osmotic diarrhoea: Mod stool volume, drha stops in response to fasting, stool osmolality may be increase.
Osmotic
Is this secretory or osmotic diarrhoea: V large volume, drha continues in response to fasting, stool osmolality normal.
Secretory
45 yo man with pain in abdomen, through to back, worse when hungry. Symptoms persist for few weeks then settle for months.
Peptic ulcer possible
These cells in the antrum of the stomach produce gastrin
G cells (G & D cells = “get down” ie in antrum of stomach)
These cells in the antrum of the stomach produce somatostatin
D cells (G & D cells = “get down” ie in antrum of stomach)
What should not be prescribed to a woman of child bearing age
Misoprostol (prostaglandin)
Increased risk of C. difficile infection, osteoporosis fractures and community aquired pneumonia are assoc with long term use of what medication
PPIs e.g. omeprazole
H2 receptor antagonists (Ranitidine, Cimetidine, Nizatidine etc.) are required in High dose for what syndrome
Zollinger Ellison
Domperidone and metclopramide are what type of drugs
Gastric stimulanst - incr peristalsis in sm intestine
Cimetidine (H2 receptor antagonist) INHIBITS what enzyme
CYP450
What would you add to antibiotic regime to eradicate H pylori
Omeprazole (PPI)
Ranitidine is MOSTLY excreted via kidneys or liver?
Kidneys
Omeprazole is MOSTLY excreted by kidneys or liver?
Liver
Omeprazole can increase the effects of what drug?
Warfarin
These cells in the body/ fundus of the stomach secrete gastric acid, which converts pepsinogen to pepsin
Parietal cells (think, high in stomach - fundus)
Crypts of lieberkuhn in sm. intestine - what type of cells are produced
Stem cells - replace epithelial cells
Goblet cells - produce what mainly
Mucus
Three tests for H pylori infection (non endoscopic)
- Serology - H pylori IgG antibodies
- Urea Breath Test - (only perform 2 wks after stopping PPIs)
- Stool antigen test (Paeds)
What cell changes (metaplasia) occur in Barrett’s oesophagus (possible after prolonged GORD)
Oesophageal squamous cells become columnar epipthelium similar to stomach.
Chief cells located where and produce what
Body / fundus of stomach - produce pepsinogen (which is converted to pepsin by gastric acid)
Which cells in the duodenum produce secretin in response to incr. acidity when stomach chyme enters gut.
S cells
4 fat soluble vitamins
A D E K
Where is Vit B12 absorbed
Distal ileum (needs Intrinsic Factor prod by stomach)
Where are Iron, Calcium, Mg and Zn absorbed
Duodenum
