Unit 2 Case 2 Flashcards
What is Unit 2 Case 2 about?
A 15-year-old female has trouble swallowing and is overcome by a deep, painful burning sensation in her throat and chest. She is told she has GERD due to a weak esophageal sphincter.
She is advised to change lifestyle choices but loses control of that which results in nausea, vomiting, and trouble swallowing. She has been prescribed a proton pump inhibitor and is in danger of developing Barrett’s esophagus. She has an endoscopy to reveal the extent of the damage as her family looks at treatment options.
What are the 2 types of peristalsis?
Primary peristalsis
Secondary peristalsis
What is primary peristalsis?
Peristalsis that is swallow induced- the most common form of peristalsis
What is secondary peristalsis?
Activated by oesophageal distension, e.g from food let from primary peristalsis
What normally makes cells resistant to stomach acid?
Mucous cells secrete an alkaline mucus that protects the epithelium against the stomach acid
How does acidic PH effect a cell and its function?
Acidic PH levels denature enzymes and alter virtually all cellular processes within the cell which leads to loss of function
What is Lansoprazole?
A type of drug
A proton pump inhibitor
What does Lansoprazole do and what is it prescribed for?
Lansoprazole reduces the amount of acid your stomach makes
Prescribed for indigestion, heartburn, and acid reflux and GERD
What is the mechanism of action for Lansoprazole?
- selectively inhibits the membrane enzyme H+/K+ ATPase in gastric parietal cells
- Therefore reduces the amount of acid your stomach makes
What are parietal cells?
Cells that secrete hydrochloric acid
What are antacids?
Antacids are a combination of compounds containing salts of calcium, magnesium, and aluminum-an alkaline
-neutralise stomach acid
What is the mechanism of action for antacids?
- H+ ions fullys dissociated in HCL
- Antacids containing bicarbonate ions combine with the H+ ions to form an unstable complex which dissociates into H2O AND CO2
- Decrease H+ conc (neutralises the acid)
What are the pros and cons of antacids?
Pros: Do not have to be prescribed such as gaviscon
Cons: Not a long term solution, the long term solution is a proton pump inhibitor
What are displasic cells?
Precancerous cells - has potential to become cancerous
What does GERD stand for?
Gastro-Oesophageal Reflux Disease
What is a weak esophageal sphincter and what does it allow?
A weak esophageal sphincter is when the sphincter doesnt close tightly enough
-allows stomach acid to flow back up into the esophagus
Can acid reflux reach the lungs and what are the consequences of this?
It can reach the lungs when you are in a supine position (sleeping)
- when acid gets into the lungs it can cause throat irritation and lung inflammation possibly leading to bronchitis/pneumonia
What are the most common ages of people with GERD?
Highest in the 20-29 age group
Lowest in the 70-79 age group
What causes a weak esophageal sphincter?
When a person regulary eats or is overweight, their stomach swells and puts alot of extra pressure on the Lower Esophageal sphincter
-over time it looses its shape and strength making it weak
Why is the rate of mutation increased during constant acid exposure in oesophageal cells?
Oesophageal epithelium don’t have a protective mucus layer like stomach epithelium
-the acid causes DNA damge to the cells leading to point mutations
What is Barrett’s oesophagus?
When the epithelium in the oesophagus changes from simple squamous to simple columnar. Resembling the lining of the small intestine
- more likely to get oesophageal cancer
- often reffered to as a pre cancerous condition
What is heart burn?
When acid reflux travels up your oesophagus from your stomach. Which causes a burning feeling in your chest
What causes heart burn?
The most common cause is food that is acidic or high in fat. As this increases acid reflux