Hepatitis and Peptic ulcers

Question 1

what are the different cell types in the gastric glands?

Answer 1

Chief cells - found in lower half gastric gland, contains digestive enzymes (e.g. pepsinogen)
Parietal cells - secrete hydrochloric acid, contain numerous mitochondria to provide energy for acid secretion. produces instrinsic factor, which is necessary for intestinal absorption of b12.
Endocrine cells - found in the gastric glands, contains biogenic amines such as serotonin and polypeptide hormones and gastrin-secreting cells.

Question 2

symptoms of H.pylori-induced gastritis

Answer 2

• consistent inflammation to stomach line
• prevalence of infection increases with age
• at 60yrs, 1/2 the pop has serologic evidence of infection
• spreads from person to person

Question 3

symptoms of peptic ulcers

Answer 3

• vomiting, dyspepsia, diarrhoe
• too much of NSAID can cause irritation to mucosa and inhibit prostaglandin synthesis.
• NSAID causes COX1 inhibit, COX2 inhibit and topical irritation. which causes reduced blood flow, epithelial damage and leukocytes adherence resulting in mucosal injury.

Question 4

treatment of H.pylori- induced gastritis

Answer 4

• ending of NSAIDs
• proton pump inhibitors to reduce acid secretion
• antibiotics (e.g. clarithromycin and/or amoxicillin)
• bismuth (eradicates the infection)
• antibiotics cure this gastritis

Follow up is needed
- 4 week post treatment a 2nd ureas breath tests done. results must be less than 50dpm to indicate successful treatment.

Question 5

treatment of peptic ulcers

Answer 5

• antibiotics
• stop using NSAIDs
• nutritional supplements if they have been vomiting, diarrhoea and anerxia.

Question 6

Affects of NSAIDs of gastritis

Question 7

Affects of NSAIDs in Peptic ulcers

Answer 7

• a increased NSAID consumption
• inhibit COX which results in a decrease in gastric mucosa.
• then decreases gastric epithelium protection
• causing gastric epithelium damage

Question 8

mechanism of liver disease

Answer 8

• drugs (eg alcohol)
• toxins (iron, fat, copper)
• autoimmunity
• viruses (HCV, HBV)

these cause liver insult then liver inflammation with cell necrosis or apoptosis then liver scarring or fibrosis.

Question 9

list of liver diseases

Answer 9

NAFLD (non-alcoholic fatty liver disease)
NASH (non-alcoholic steatohepatitis)
AS (alcoholic steatohepatitis)
C Cirrhosis
HC Hepatocellular carcinoma

Question 10

list of morphological changes from liver cirrhosis

Answer 10

• nodules irregular surface
• fibrosis
• nodules surrounded by fibrous tissue

Question 11

list of cellular changes from liver cirrhosis

Answer 11

• reduced liver synthetic and metabolic capacity
• liver cell mass reduced
• increased cell death via necrosis and apoptosis
• net process of scar formation
• liver stem cell proliferation
• carcinogenesis
• post vein hypertension

Question 12

symptoms of liver failure

Answer 12

• fibrosis occurs on liver
• portal vein hypertension
• ascites is the presence of free intra-abdominal fluid.
• jaundice (yellow skin)
• dark urine
• ## abdominal pain

Question 13

Causes of liver disease

Answer 13

• chronic hepatitis B
• hepatitis C
• alcohol
• metabolic disorders (haemochromatosis)
• autoimmune hepatitis
• immune mediated biliary diseases (eg. PBC)