Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

GI > Disorders of Gastric Secreation > Flashcards

Disorders of Gastric Secreation Flashcards

1
Q

What the stomach secreates

A
  • Acid
  • Intrinsic Factor
  • Pepsinogens
  • Lipase
  • Bicarbonate/Mucous
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Causes of Elevated Acid Secretion

A 
• Elevated gastrin
• Elevated vagal tone
• Elevated histamine (mastocytosis,
basophilic granulocytic leukemia)
• Elevated parietal cell mass/idiopathic
• Paraneoplastic (non-gastrin: rare)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

• Expected response to reduced delivery
of acid to antrum
– Antral pH elevated

A

increased gastrin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What does it mean when we see elevated gastrin levels when pH is <2?

A

Elevation independent of antral

acidification; naughty, naughty!!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

• Syndrome resulting from clinical consequences of hypersecretion of gastric acid due gastrin secreting neuroendocrine tumor

A

Zollinger-Ellison Syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Zollinger-Ellison Syndrome causes

A

– Isolated gastrinoma (75%)

– As component of Multiple Endocrine Neoplasia I (MEN I [25%])

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Diagnostic features of Zollinger-Ellison Syndrome in regards to:
Basal acid secreation
Gastrin levels

A

• Elevated basal acid secretion (15
mEq/hr)
• Gastrin > 150 pg/ml (Nl < 100)
– > 1000 pg/ml diagnostic with low pH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What’s weird about secretin in Zollinger-Ellison syndrome>

A

• Secretin stimulation: Gastrin

increases > 120 pg/ml (usually secretin inhibits gastrin!)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Pts on this type of medication can get a false negative test for ZE syndrome

A

PPI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

ZE syndrome in this presents as a single gastrinoma, – Localize and remove for cure
– Typically in duodenum/pancreas

A

Sporadic type

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

ZE syndrome; multifocal, not curable
– Associated hyperparathyroidism,
other islet cell tumors, pituitary
tumors

A

MEN1 type

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

In more severe ZE syndrome, ulcers are in what area?

What can we do for treatement?

A

– Extends to distal duodenum/jejunum

– Relapsing ulcer, high PPI dose to cure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is diarrhea like in severe ZE syndrome?

A

Large acidic fluid volume
– Inactivation of pancreatic enzymes
– Hypokalemia, steatorrhea, weight loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Random causes of elevated Gastrin secreation

A
  • H. pylori (via reduced somatostatin)
  • Antral G-cell hyperplasia
  • Gastric outlet obstruction
  • Retained antrum (gastric surgery)
  • Cysteamine treatment
  • Short bowel syndrome
  • Renal failure (rare)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Conditions Causing Low

Acid Secretion

A 
• Medications
– PPI, H2RA, anti-cholinergic
• Inflammatory destruction of parietal cells (gastritis)
• Acute H. pylori infection
• Vagal injury/transection
• VIP producing tumors
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Consequences of low acid secraetion

A 
• Overall well tolerated with modern
diet; impaired protein digestion
• Impaired absorption of Fe, Ca, B12
• Gastric bacterial overgrowth
• Enteric infections/tuberculosis
• Small bowel bacterial overgrowth
• Impaired delivery of certain drugs
17
Q

Carrier glycoprotein that binds to
Vitamin B12 to permit active
transport in ileum
• Produced by parietal cell

A

IF

18
Q

Conditions affecting____ secretion

affect IF secretion

A

acid

19
Q

What test do we use to test for Vit B 12 deficieny

A

Schilling test

20
Q

Give pt radiolabelled Vitamin B12 orally and measure it; if its low, give it along with IF, if it corrects, what does this tell us?

A

issue with IF

21
Q

Give pt radiolabelled Vitamin B12 orally and measure it; if its low, give it along with IF; it if doesn’t correct, what is the next step?

A

repeat after empiric antibiotic treatment for SBBO; if corrects we know its bacterial issue

22
Q

if pt does schilling test and was tx for SBBO but still has low vit B12, what is our diagnosis?

A

pancreatic insufficiency

or terminal ileal disease

23
Q

Cause of reduced pepsin or lipase secreation

A

the same things that lower acid secreation

24
Q

Affect of low pepsin and lipase on inidivual

A

• Perhaps less important for
digestion with modern diet
• Play a role in killing ingested
infectious agents

25
Q

Cause of decreased bicarb/mucous secreations

A

same as those that cause low acid secreation AND from NSAID/aspirin use

26
Q

consequence of low bicarb, mucous?

A

mucosal injury

GI (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions