gastrointestinal patho

Question 1

what anatomical structure is the reason for many GI issues and heartburn

Answer 1

lower esophageal sphincter

Question 2

explain each of the following gastric gland cells
- parietal
- chief
- mucoid

Answer 2

parietal: in stomach; houses the proton pump = what makes HCl

chief: in stomach; release pepsin, activated by HCl and can break down proteins of stomach lining

mucoid: surface lining of GI tract; secrete mucus to protect lining from HCl

Question 3

what cell is the primary site for stomach acid controlling drugs

Answer 3

parietal cells

Question 4

what enzyme breaks down stomach lining and can lead to an ulcer

Answer 4

pepsin

Question 5

what cells secrete HCl

Answer 5

parietal cells

Question 6

normal pH of HCl
- what if too low (acidic)

Answer 6

pH = 1-4
- too low = stomach pain

Question 7

what factors can increase stomach acid

Answer 7

coffee, obesity, smoking, alcohol, spices, large fatty meals, stress

Question 8

what 3 substances bind to receptors on parietal cell to stimulate acid secretion through the H+/K+/ATPase pump

Answer 8

Ach, gastrin, histamine 2 (H2)

Question 9

best drug class to fully inhibit the proton pump

Answer 9

proton pump inhibitors lmao

Question 10

what are acid related diseases caused by

Answer 10

imbalance of gastric gland cells and their secretions

Question 11

most common acid related disease and the most harmful

Answer 11

most common: hyperacidity
most harmful: peptic ulcer diseases

Question 12

why is PUD the most harmful acid related disease

Answer 12

massive bleeding = hemorrhage
- erode through stomach lining = contents released in abdominal region = sick and infections (bc non sterile env)

Question 13

3 complications of hyperacidity

Answer 13

• gastric and intestinal irritation
• dev of ulcerations
• potential for perforation

Question 14

what is GERD (gastroesophageal reflux disease)
- can lead to ________ and then _______

Answer 14

reflux of acid from stomach back into esophagus
- can lead to Barret’s esophagus and then esophageal cancer

Question 15

factors that contribute to GERD

Answer 15

• pregnancy (baby push up on stomach and pressure on LES)
• overeating, fast eating, eating late at night, alcohol
• cigarettes (nicotine relaxes LES = back up)
• acidic foods: fatty, spicy, caffeine, citrus

Question 16

s/s of GERD

Answer 16

heartburn, regurgitation, dysphagia, waterbrash, chronic cough, noncardiac chest pain

Question 17

lifestyle mods for GERD

Answer 17

• stay upright for at least 1hr after eating
• avoid straining, lifting, bending
• avoid irritant foods: caffeine, citrus, tomatoes

Question 18

what bacteria is known for being an aggressive factor towards PUD
- tx?

Answer 18

helicobacter pylori
Tx: triple meds (PPI and 2 antibix), usually amoxicillin and clindamycin

Question 19

what drug classes are known to be an aggressive factor towards PUD

Answer 19

ASA and NSAIDs

Question 20

4 MOAs of ASA and NSAIDs that make PUD worse

Answer 20

• dec blood flow to mucosal layer
• suppress secretion of mucus
• suppress secretion of bicarb
• promote HCl

Question 21

why is smoking and aggressive factor towards PUD

Answer 21

delays ulcer healing

Question 22

s/s of PUD

Answer 22

pain, worse when stomach empty, flairs at night, relieved by eating, hematemesis, melena, chest pain, weight loss, n/v

Question 23

what is melena

Answer 23

dark, tarry stools

Question 24

laxative effect vs catharsis

Answer 24

laxative: soft, formed stool for 1+ days, mild

catharsis: fast and intense evacuation of non formed stool, accel defecation, bowel prep, fluid evacuation

Question 25

function of the colon

Answer 25

absorbs water and electrolytes

Question 26

best source of dietary fiber
- benefits of fiber

Answer 26

bran
- absorbs water, digested by colon bacteria

Question 27

population at risk for laxative abuse

Answer 27

elderly pts