Peptic Ulcer Disease

Question 1

What 3 hormones regulate Acid secretion?

Answer 1

Acetylcholine, gastrin, histamine

Question 2

What releases Acetylcholine?

Answer 2

Enteric neurons

Question 3

What is Histamine and where is it released?

Answer 3

Paracrine, released from ECL cells

Question 4

H pylori associated ulcers are found where?

Answer 4

Duodenum

Question 5

NSAID induced ulcers are found where

Answer 5

Gastric ulcers

Question 6

What do patients of peptic ulcers describe their epigastric pain to be?

Answer 6

Dull, hunger-like pain

Question 7

What is the procedure of choice for diagnosis of duodenal and gastric ulcers?

Answer 7

Upper endoscopy

Question 8

The preferred course of treatment is?

Answer 8

PPIs, Proton pump inhibitors

Question 9

What is H-Pylori?

Answer 9

A spiral, gram negative rod, that resides beneath the gastric mucous layer

Question 10

How do we detect H Plylori?

Answer 10

An ELIZA test

Question 11

What is Zollinger Ellison syndrome caused by?

Answer 11

Gastrin secreting tumors

Question 12

How much % of peptic ulcers are caused by zollinger?

Answer 12

1%

Question 13

Where are Zollinger Ellison most common?

Answer 13

Duodenal wall

Question 14

80% of Zollinger arise in the Gastrinoma triangle, what is it?

Answer 14

Bounded by the Porta hepatis, neck of pancreas, and third portion of duodenum

Question 15

Is Zollinger Ellison malignant or benign?

Answer 15

Mostly malignant, unlike rest of peptic ulcers

Question 16

How do we detect Zollinger Ellison?

Answer 16

Serum Gastrin

Question 17

How do we treat Zollinger Ellison?

Answer 17

Surgical resection if no metastasis