Ch. 335 - PUD Flashcards Preview

Nelson - The Digestive System > Ch. 335 - PUD > Flashcards

Flashcards in Ch. 335 - PUD Deck (25):
1

the end result of inflammation caused by an imbalance between cytoprotective and cytotoxic factors in the stomach and duodenum, manifests with varying degrees of gastritis or frank ulceration.

PUD

2

Final common pathway for the development of ulcers

action of acid and pepsin-laden contents of the stomach on the gastric and duodenal mucosa and the inability of mucosal defense mechanisms to allay those effects

3

Peptic ulcers are deep mucosal lesions that disrupt the ___ layer of the gastric or duodenal wall

muscularis mucosa

4

Gastric ulcers are generally located on the ___ of the stomach, and 90% of duodenal ulcers are found in the ___

lesser curvature, duodenal bulb

5

Primary peptic ulcers are more often chronic and ___ in location

Duodenal

6

Secondary peptic ulcers are more often acute and ___ in location

Gastric

7

___ ulcers are most often associated with Helicobacter pylori infection

Primary ulcers

8

By ___ of age, gastric acid secretion approximates adult values

3-4 yr

9

pH of the stomach contents is

1-2

10

Excessive acid secretion is associated with ___ (3)

1) a large parietal cell mass, 2) hypersecretion by antral G cells, and 3) increased vagal tone

11

Results in increased or sustained acid secretion in response to meals and increased secretion during the night

Increased vagal tone

12

Substance released by vagus nerve that promotes acid production

Acetylcholine

13

Substance released by enterochromaffin cells that promotes acid production

Histamine

14

Substance released by G cells of antrum that promotes acid production

gastrin

15

Mucus production and secretion in the stomach are stimulated by

PGE2

16

method of choice to establish the diagnosis of peptic ulcer disease

Esophagogastroduodenoscopy

17

Secretagogues that promote gastric acid production

1) Ach release by vagus 2) Histamine release by enterochromaffin cells 3) Gastrin release by G cells of antrum

18

Mediators that decrease gastric acid secretion and enhance mucin production

Prostaglandins

19

Classic symptom of peptic ulceration present only in a MINORITY of children and presents as

Epigastric pain alleviated by ingestion of food

20

H. pylori: ?urease ?catalase ?oxidase

Yes, yes, yes

21

T/F Chronic colonization with H.pylori can predispose children to a significantly increased risk of developing duodenal ulcer, gastric cancer, or MALT lymphomas

T

22

Recommended eradication therapies for H.pylori-associated disease in children

1) Amox+Clarith+PPI 2) Amox+Metro+PPI 3) Clarith+Metro+PPI

23

First-line drugs for the treatment of gastritis and PUD in children

H2 receptor antagonists and PPIs

24

MOA: H2 receptor antagonist

Inhibit binding of histamine at H2 receptor of gastric parietal cell

25

MOA: PPI

Block gastric parietal cell H+/K+ ATPase pump in dose-dependent fashion, reducing BASAL and STIMULATED gastric acid secretion