Lecture 3 - Stomach Flashcards
gastrin:
binds ___ cells via the ____ receptor, causing a release of histamine;
binds ____ cells, causing a release of acid;
which is the more important effect?
ECL, CCKb (more important);
parietal
Gastrin is release in response to _____ and _____
peptides, vagal stimulation
vagal effects:
ACH binds ____ receptors on ____ cells, causing an increase in acid release;
_____ binds G cells, causing gastrin release
M3, parietal;
GRP
Histamine is released from ____ cells. it binds ____ receptors, which are G __ coupled on parietal cells
ECL;
H2, s
what kind of pump releases acid? where are parietal cells located?
H+/K+ ATPase;
fundus and body of stomach
H2 receptor antagonists end in “___”;
dine;
cimeti, raniti, famoti, nizatidine
cimetidine has anti ___ effects and inhibits ____
androgenic (gynecomastia, impotence, galactorrhea)
CYP450
proton pump inhibitors (PPIs) all end in “____”
prazole
ie omeprazole, lanso, esome, panto, dexlanso
____ polymerizes and forms a protective barrier at ulcer sites. it requires a _____ pH
sucralfate, acidic
_____ is a synthetic prostaglandin _ derivative. it causes decreased ____ secretion and increased _____ and ___ secretion
misoprostol, E1;
acid; bicarb, mucus
triple therapy typically used for H pylori:
amoxicillin (or metronidazole) + clarithromycin + PPI (or H2 blocker)
also bismuth salt
in addition to cell regeneration, name 4 protective factors of the gastric mucosa
prostaglandins, blood flow, HCO3, mucus
an ulcer penetrates through the ____, by defintion
muscularis mucosa
gastric vs duodenal ulcer:
pain is greater with meals?
pain is decreased with meals?
H pylori is prevalent in both, but is in 90% of which kind?
gastric;
duodenal;
duodenal
gastric vs duodenal:
NSAIDs especially cause this:
Zollinger ellison causes this:
increased risk of carcinoma with?
gastric,
duodenal;
gastric
gastric ulcers are usually found where? what about duodenal ulcers?
lesser curvature;
anterior duodenum
H pylori:
produces ____ to survive ion the acidic enviornment, which converts ____ into ____;
usually colonizes the ____ of the stomach
urease;
urea, ammonia (alkaline enviornment);
antrum
in the antrum, H pylori causes decreased production of _____ and _____ secretion of acid.
in the body, it damages the ____ glands leading to ____ and gastric ____
somatostatin, increased;
acid producing;
achlorydia, atrophy (and increased cancer risk)
bleeding with ulcers:
rupture of ____ duodenum causes bleeding from the ____;
ruptured gastric ulcer causes bleeding from the ______
posterior, gastroduodenal;
left gastric
the ____ breath test can be used to diagnose ___ h pylori
urea, active
most gastric cancers are what type?
adenocarcinoma
gastric cancer intestinal vs diffuse: associated with H. pylori = signet ring cells = linitis plastica = nitrosamines (esp this country \_\_\_\_\_) =
intestinal (most common overall);
diffuse;
diffuse;
intestinal (japan)
tobacco smoking and achloryhydria are associated with the ____ type of gastric cancer. what blood type has a higher risk?
intestinal;
type A
what is a sister mary joseph nodule?
what about a krukenberg tumor
subcutanoues periumbilical mets (from gastric cancer);
bilateral mets to ovary
