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Gastro > Peptic ulcer Disease > Flashcards

Peptic ulcer Disease Flashcards

1
Q

MC location of DUs

A

First portion of the duodenum 95%

90 % located within 3 cm of the pylori a

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2
Q

MC location of GUs

A

Distal to the junction between the Antrum and gastric secretory mucosa

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3
Q

Mnemonic types of gastric ulcers

A

BAPC

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4
Q

Chronic disorders shown to have strong association with PUD:

A 
Advanced age
COPD
Chronic renal failure
Cirrhosis
Nephrolithiasis
Anti trypsin deficiency
Systemic mastic gross
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5
Q

Appetite regulating hormone released by Cells in stomach

A

Gherkin

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6
Q

Secretes HcL

A

Parietal cell oxyntic gland

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7
Q

Receptors in parietal cell for stimulants of gastric acid secretion

A

Histamine
Gastrin
Acetylcholine

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8
Q

When to repeat testing H pylori UbT after triple treatment

A

4 weeks

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9
Q

When is recrudescence

A

Within 6 mos after therapy

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10
Q

GU negative for Ca when to repeat endoscopy

A

8-12 weeks

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11
Q

Define refractory ulcers

A

GU 12 weeks
DU 8 weeks
Doesn’t heal

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12
Q

Pathognomonic of ZEs

A

bao> 15 in the presence of hyper gastrinemia

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13
Q

Most sensitive gastric provocative test

A

Secretin study
>120 ph inc in gastric within 15 mins of secretin injection

Other pentagram run bao/Mao ration>0.6

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14
Q

Mucosal defense system 3 layers

A

1) preepithelial
- mucus bicarbonate phospholipid later
2) epithelial
- mucus production
3) subepithelial
- elaborate microvascular system

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15
Q

2 types of gastric acid production

A
  1. Basal- circadian highest at nighyblow st in morning
  2. Stimulated gastric acid secretion (3 phases)
    Cephalon, gastric, last phase
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16
Q

GI hormone released by endocrine cells found in the gastric mucosa (D cells) in response HCl

A

Somatostatin

17
Q

Mechanism of acid production inhibition by somatostatin

A

Direct (parietal)

Indirect (histamine from ECG and gastric from G cells)

18
Q

Mechanism of action Ghrelin

A

Increase gastric acid secretion through stimulation of histamine release from ECL cells

19
Q

First step in eval of px with ZES

A

Obtain fasting gastric level

All gastrinoma px will have fasting gastinlecel >150-200

Next is assess gastric acid pH (should be less than 3)

20
Q

When to Obtain fasting gastrin level

A 
Multiple ulcers 
Ulcers in unusual locations 
Ulcer px awaiting surgery 
Extensive family history for our 
Basal hyperchlorydia unexplained diarrhea or steatorrhea 
Hypercalcemia 
FH of pancreatic islet pituitary of parathyroid tumor 
prominent gastric or duodenal folds
21
Q

MC location of stress related mucosal injury

A

Fundus and body of stomach

Gastro (9 decks)

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