Peptic Ulcer

Question 1

تعریف P U از نظر قطر و عمق؟

Answer 1

بیش از ۵mm

عمقش به ساب موکوز میرسه

Question 2

۳ محرکی که روی پریتال سل برای تحریک ترشح اسید گیرنده دارن؟

Answer 2

Gastrin
Histamine
Ach

Question 3

چه فاکتور هایی برای کارکرد درست فرایند restitusion لازمن؟

Answer 3

uninterrupted blood flow and an alkaline pH in the surrounding environment.

Several growth factors, including epidermal growth factor (EGF), transforming growth factor (TGF) α, and basic fibroblast growth factor (FGF), modulate the process of restitution.

Question 4

مصرف کرونیک کدوم دارو ها سبب ایجاد اولسر پایدار میشه؟

Answer 4

استروئید
NSAIDs

چون سطح PGرو کم میکنن

Question 5

محل cox 1 & 2?

Answer 5

1:
Stomach 
kidney 
platelets
Endothelium

COX2:
macrophage
 leucocytes 
fibroblasts
 endothelium

Question 6

ریتم سیرکادین ترشح اسید basal چطوریه؟

Answer 6

حداکثر در شب
حد اقل در صبح

تنظیم توسط واگ و هیستامین

Question 7

محرک های ترشح اسید stimulated?

Answer 7

۱-مغزی
۲-اتساع جدار معده بعد غذا
۳- ورود غذا به روده

Question 8

مکانیسم اثر مهاری سوماتوستاتین بر اسید معده؟

Answer 8

در فوندوس:
۱- مهار ECL 👈 هیستامین
۲-مهار مستقیم پریتال

در انتروم:
۱- مهار G cell

Question 9

DU

بیشتر مرتبطه با h.pylori یا GU?

Answer 9

DU

Question 10

فرق سنی DU و GU?

Answer 10

GUs tend to occur later in life than duodenal lesions, with a peak incidence reported in the sixth decade.

Question 11

DU و Gu کدم شایع تره؟

Answer 11

More than one-half of GUs occur in males and are less common than DUs, perhaps due to the higher likelihood of GUs being silent and presenting only after a complication develops. Autopsy studies suggest a similar incidence of DUs and GUs.

Malignant DUs are extremely rare.
GASTRIC ULCERS In contrast to DUs, GUs can represent a malignancy and should be biopsied upon discovery. Benign GUs are most often found distal to the junction between the antrum and the acid secretory mucosa. Benign GUs are quite rare in the gastric fundus and are histo- logically similar to DUs. Benign GUs associated with H. pylori are also associated with antral gastritis. In contrast, NSAID-related GUs are not accompanied by chronic active gastritis but may instead have evidence of a chemical gastropathy, typified by foveolar hyperplasia, edema of the lamina propria, and epithelial regeneration in the absence of H. pylori. Extension of smooth-muscle fibers into the upper portions of the mucosa, where they are not typically found, may also occur.
Pathophysiology • DUODENAL ULCERS H. pylori and NSAID- induced injuries account for the majority of DUs. Many acid secretory abnormalities have been described in DU patients. Of these, average

Question 12

DU

در کدوم قسمت بیشتر رخ میده؟

Answer 12

DUs occur most often in the first portion of the duodenum (>95%), with ~90% located within 3 cm of the pylorus.

They are usually ≤1 cm in diameter

Question 13

What is giant ulcer?

Answer 13

When diameter reach 3–6 cm

Question 14

مشخصات DU در پاتولوژی؟

Answer 14

Ulcers are sharply demarcated, with depth at times reaching the muscularis propria. The base of the ulcer often consists of a zone of eosinophilic necrosis with surrounding fibrosis