PTG 105 - Exam 3 - Lecture 15-4

  1. Intestinal Metaplasia caused by Helicobacter pylori predisposes the patient to what diseases?
    • Dysplasia
    • Carcinoma
  2. The normal stomach lining has what features?
    • Deep gastric pits
    • Numerous mucus-secreting glands
  3. A stomach biopsy shows deep gastric pits and numerous mucus-secreting glands. What is the diagnosis?
    Normal, no disease
  4. Define PUD:
    Peptic ulcer disease
  5. What is the pathogenesis of PUD?
    Mucosa is exposed to pepsin and gastric acid
  6. What is the major cause/risk factor for Peptic ulcer formation?
    Helicobacter pylori (80%)
  7. What percent of patients presenting with PUD have a Helicobacter pylori infection?
  8. What are the six major causes of PUD?
    • Helicobacter pylori
    • Drugs- NSAIDs/Corticosteroids
    • Stress
    • Alcohol
    • Smoking
    • Excessive acid production in the stomach
  9. What is the major cause of PUD in patients not found to have H. pylori?
  10. What is the name for a disease where the patient has intractable peptic ulcers?
    Zollinger Ellison syndrome
  11. What does ZE stand for?
    Zollinger Ellison syndrome
  12. What causes Zollinger Ellison syndrome?
    • Gastrin secreting tumor of the pancreas
    • Gastrin then stimulates acid production in the stomach
  13. What is the effect of gastrin secretion?
    Stimulates acid production in the stomach
  14. Helicobacter pylori has what effect on the greater GI tract?
    Impairs the protective mechanisms of GI against acid and proteolytic enzymes
  15. What is known to impair the protective mechanisms of GI against acid and proteolytic enzymes?
    Helicobacter pylori
  16. The definition of Intractable is:
    • Hard to deal with
    • Difficult
    • Or Stubborn
  17. What is the mechanism of NSAID related ulcers?
    Answer yet unknown
  18. Which are more common duodenal ulcers or gastric ulcers?
    Duodenal ulcers (7 times more common)
  19. How much more common are duodenal ulcers than gastric ulcers?
    7 times
  20. What is the most frequent site of peptic ulcers?
  21. Where can peptic ulcers form?
    • Duodenum
    • Stomach
  22. What are the symptoms of peptic ulcers?
    Abdominal pain
  23. What are the potential complications of Peptic ulcer?
    • Massive occult hemorrhage
    • Obstruction
    • Perforation
    • Failure to heal (chronicity)
  24. What is the most common complication of peptic ulcers?
    Massive occult hemorrhage
  25. What serious disease can present as an ulcer?
  26. How is a malignant ulcer different from PU on gross examination?
    Answer unknown
  27. What actions can be taken to reduce the symptoms of a peptic ulcer?
    • Remove cause (i.e. smoking)
    • H2 receptor antagonists
    • Antibiotics for H pylori
    • Antacids
    • PPI
    • Surgery
  28. What type of surgery can correct Peptic ulcers?
    • Remove the gastric antrum (area of acid secretion)
    • Vagotomy
  29. What portion of the stomach controls acid production?
  30. Surgical adjustment of nervous control of acid product ion in the stomach is termed:
  31. Removing the gastric antrum helps relieve what disease?
    Peptic ulcers
  32. Vagotomy helps relieve what disease?
    Peptic ulcers
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PTG 105 - Exam 3 - Lecture 15-4
PTG 105 - Exam 3 - Lecture 15-4