SECRETS GI - Stomach Flashcards
duodenal vs gastric ulcers
gastric = pain with meals –> weight loss due to food avoidance
duodenal = pain 1-3 h after meals
PUD causes
h. pylori
NSAIDs
NSAIDs –> PUD
NSAIDs inhibit PGs that normally protect gastric mucosa by increasing mucus and bicarb production & stimulating local vasodilation (adequate perfusion)
Misoprostal
PGE1 analog
decrease gastric acid secretion
increase mucus and bicarb secretion
COX-2 inhibitors ADR
prothrombotic
exacerbate HTN
upper vs lower GI bleed
upper = melena or hematemesis
ligament of treitz
lower = hematochezia
PUD hemorrhage locations & blood supply
posterior duodenum - gastroduodenal artery
lesser curvature - gastric artery
gastric carcinoma risk factors
chronic gastritis
h. pylori
gastric carcinoma mets
left supraclavicular node (Virchow)
bilateral to ovaries (krukenberg) - signet ring cells
h pylori dx
urease breath test
multiple duodenal ulcers or ulcers in jejunum
zollinger-ellison syndrome
zollinger-ellison syndrome
due to gastrin-secreting tumor or gastrinoma –> excessive secretion of acid
markedly elevated gastrin level
triple therapy
2 antibioties + PPI/H2 blocker
PUD tx
PPI H2 blocker anticholinergic (atropine) mucosal protective agent (misoprostol) antacids
acute gastritis risk factors
alcohol, NSAIDs
acute gastritis pathology
punctate erosions in antrum
diffuse inflammation of gastric mucosa
autoimmune gastritis
affects parietal cells
inhibit production of IF (pernicious anemia) and HCl (achlorhydria)
