Lecture 3 - Stomach

Question 1

gastrin:
binds ___ cells via the ____ receptor, causing a release of histamine;
binds ____ cells, causing a release of acid;

which is the more important effect?

Answer 1

ECL, CCKb (more important);

parietal

Question 2

Gastrin is release in response to _____ and _____

Answer 2

peptides, vagal stimulation

Question 3

vagal effects:
ACH binds ____ receptors on ____ cells, causing an increase in acid release;
_____ binds G cells, causing gastrin release

Answer 3

M3, parietal;

GRP

Question 4

Histamine is released from ____ cells. it binds ____ receptors, which are G __ coupled on parietal cells

Answer 4

ECL;

H2, s

Question 5

what kind of pump releases acid? where are parietal cells located?

Answer 5

H+/K+ ATPase;

fundus and body of stomach

Question 6

H2 receptor antagonists end in “___”;

Answer 6

dine;

cimeti, raniti, famoti, nizatidine

Question 7

cimetidine has anti ___ effects and inhibits ____

Answer 7

androgenic (gynecomastia, impotence, galactorrhea)

CYP450

Question 8

proton pump inhibitors (PPIs) all end in “____”

Answer 8

prazole

ie omeprazole, lanso, esome, panto, dexlanso

Question 9

____ polymerizes and forms a protective barrier at ulcer sites. it requires a _____ pH

Answer 9

sucralfate, acidic

Question 10

_____ is a synthetic prostaglandin _ derivative. it causes decreased ____ secretion and increased _____ and ___ secretion

Answer 10

misoprostol, E1;

acid; bicarb, mucus

Question 11

triple therapy typically used for H pylori:

Answer 11

amoxicillin (or metronidazole) + clarithromycin + PPI (or H2 blocker)

also bismuth salt

Question 12

in addition to cell regeneration, name 4 protective factors of the gastric mucosa

Answer 12

prostaglandins, blood flow, HCO3, mucus

Question 13

an ulcer penetrates through the ____, by defintion

Answer 13

muscularis mucosa

Question 14

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?

Answer 14

gastric;
duodenal;
duodenal

Question 15

gastric vs duodenal:
NSAIDs especially cause this:
Zollinger ellison causes this:
increased risk of carcinoma with?

Answer 15

gastric,
duodenal;
gastric

Question 16

gastric ulcers are usually found where? what about duodenal ulcers?

Answer 16

lesser curvature;

anterior duodenum

Question 17

H pylori:
produces ____ to survive ion the acidic enviornment, which converts ____ into ____;
usually colonizes the ____ of the stomach

Answer 17

urease;
urea, ammonia (alkaline enviornment);
antrum

Question 18

in the antrum, H pylori causes decreased production of _____ and _____ secretion of acid.

in the body, it damages the ____ glands leading to ____ and gastric ____

Answer 18

somatostatin, increased;
acid producing;
achlorydia, atrophy (and increased cancer risk)

Question 19

bleeding with ulcers:
rupture of ____ duodenum causes bleeding from the ____;
ruptured gastric ulcer causes bleeding from the ______

Answer 19

posterior, gastroduodenal;

left gastric

Question 20

the ____ breath test can be used to diagnose ___ h pylori

Answer 20

urea, active

Question 21

most gastric cancers are what type?

Answer 21

adenocarcinoma

Question 22

gastric cancer intestinal vs diffuse:
associated with H. pylori =
signet ring cells = 
linitis plastica = 
nitrosamines (esp this country \_\_\_\_\_) =

Answer 22

intestinal (most common overall);
diffuse;
diffuse;
intestinal (japan)

Question 23

tobacco smoking and achloryhydria are associated with the ____ type of gastric cancer. what blood type has a higher risk?

Answer 23

intestinal;

type A

Question 24

what is a sister mary joseph nodule?

what about a krukenberg tumor

Answer 24

subcutanoues periumbilical mets (from gastric cancer);

bilateral mets to ovary

Question 25

____ _____ is characterized by acanthosis nigrans and migratory venous thrombi in gastric cancer

Answer 25

trousseau’s syndrome

Question 26

prognosis is directly related to what aspect of the gastric tumor?

Answer 26

depth of invasion

Question 27

besides adenocarcinoma, what cancer does H pylori increase the risk of?

Answer 27

MALT lymphoma