L23 Upper GIT pathology

Question 1

What is the purpose of the acid produced by the stomach

Answer 1

converts pepsinogen to pepsin
chemical digestion
kill microbes

Question 2

How does the body defend itself against his acid

Answer 2

mucus
bicarbonate
prostaglandins (inhibits acid production and stimulates bicarbonate production)
TJs
rapid epithelial regeneration

Question 3

What role does the acidic environment within the stomach play in the development of a peptic ulcer?

Answer 3

defeats defence mechanisms and allows pepsin and acid to have upper hand

Question 4

How does H. pylori predispose to the development of a peptic ulcer

Answer 4

able to produce substances to buffer gastric acid
bores into mucus layer
motile to swim through mucus
can adhere to gastric epithelial cells

breakdown TJs
increase acid secretion
inflammatory response

Question 5

How does chronic consumption of NSAIDs predispose to the development of a peptic ulcer

Answer 5

damage mucus layer which causes acid to come in contact with mucosa

Question 6

What complications can arise as a consequence of peptic ulceration

Answer 6

epigastric pain, burning, anaemia, vomiting

heal (scar + recovered mucosa)
bleeding
perforation (= transmural damage = pancreatitis or peritonitis = septicaemia)
obstruction

Question 7

What role does the acidic environment within the stomach play in the development of GORD

Answer 7

failure of lower sphincter = acid in oesophagus
or hiatus hernia

damage to mucosa = chronic inflammation

Question 8

What is the role of the oesophagus

Answer 8

food from mouth to stomach

Question 9

What treatment is the most common for GORD management and how does it work?

Answer 9

antacids- neutralize the acid made by the stomach as they are alkali
proton pump inhibitors, changes to lifestyle

Question 10

What complications can arise as a consequence of GORD

Answer 10

strictures (abnormal narrowing of a body passage)

Barrett’s oesophagus (squamous to columnar epithelium)