Term
| Know which stimulators of acid secretion work via cAMp |
|
Definition
| which work through Ca2+ , |
|
|
Term
| HOw can you determine if a medicine contains Magnesium vs. Aluminum |
|
Definition
| drugs will start with M or A- easy |
|
|
Term
|
Definition
|
|
Term
| What is infection with H.pylori especially important for |
|
Definition
| in regards to ulcers?,Recurrence! If you eradicate H.pylori, recurrence drops |
|
|
Term
| What is the epidemiology of H.pylori infection? |
|
Definition
| Low socioeconomic status, developing countries, crowded living situations, poor sanitation |
|
|
Term
| where is H.pylori seen histologically? |
|
Definition
|
|
Term
| How does H.pylori attach? |
|
Definition
|
|
Term
| HOw does H.pylor disrupt the epithelium? |
|
Definition
|
|
Term
| How does H.Pylori survive through gastric acid? |
|
Definition
|
|
Term
| Where should a biopsy be done for H.pylori? |
|
Definition
| stomach; not in the duodenum where the ulcer is |
|
|
Term
| WHat stain is ok for H.pylori detection? What is best? |
|
Definition
|
|
Term
| How is the Urea Breath test performed? |
|
Definition
| Inject 13C URea into stomach; if urease is present, it will produce 13CO2, which can be detected on exhalation |
|
|
Term
| Is H. Pylori a carcinogen? |
|
Definition
| yes; group 1-definite carcinogen |
|
|
Term
| WHy is Clarithromycin problematic for H.pylori treatment? |
|
Definition
| it must be taken at high doses and causes cramping |
|
|
Term
| What is important about Bisphosphonate administration? |
|
Definition
| if given while the patient is upright, adverse effects of esophageal damage can be prevented |
|
|
Term
| Which types of ulcers are more common due to NSAID damage? |
|
Definition
| gastric ulcers. Duodenal ulcers are not shown to be more common |
|
|
Term
| What 2 risk factors together cause great risk of Peptic Ulcer Dz? |
|
Definition
| H.pylori infection + NSAID use |
|
|
Term
|
Definition
| when taken correctly, for prevention of ulcer?,Misoprostil |
|
|
Term
| How is a Dx of Duodenal Ulcer made? |
|
Definition
| solely based on clinical symptoms |
|
|
Term
| where is pain localized with GERD? |
|
Definition
|
|
Term
| What is another name for heartburn? |
|
Definition
|
|
Term
|
Definition
| salty-reflux that can be tasted in the back of the mouth |
|
|
Term
| What are some esophageal consequences of GERD? |
|
Definition
| Esophagitis, hemorrhage, ulcer, stricture, Barret's |
|
|
Term
| Describe Barrett's histologically |
|
Definition
| Columnar metaplasia; used to be stratified squamous |
|
|
Term
| What does Barrett's Progress to? |
|
Definition
| Adenocarcinoma of distal esophagus and proximal stomach |
|
|
Term
| WHat else besides stomach acid can be causing GERD? |
|
Definition
| bile acid reflux; pancreatic secretion reflux |
|
|
Term
|
Definition
| based on classical symptoms clinically; postprandial or postural heartburn/regurg that is decreaed with antacid |
|
|
Term
| WHy dont Histamine ANtagonists work for GERD |
|
Definition
| if they worked for ulcers?,There is not mucus/bicarb layer in esophagus like there is in the stomach |
|
|
Term
| What are the best drugs for Acid suppression in GERD? |
|
Definition
|
|
Term
| What is the active form of a PPI? |
|
Definition
| After absorption , they are protonated to active sulfonamide form |
|
|
Term
| When is the best time to take PPI's? ** |
|
Definition
| ***in the morning when acid secretion is the lowest; take 30 min before first meal*** |
|
|
Term
| What happens when antisecretory therapy of a GERD patient is discontinued? |
|
Definition
| GERD returns because you are just modulating acid secretion |
|
|
Term
| What is the best Maintenance therapy for GERD patients to remain healed? |
|
Definition
|
|
Term
| What is the diagnosis/treatment approach for Peptic Ulcer Dz? |
|
Definition
| diagnose based on clinical symptoms, treat with acid modulation, test for H.pylori, and address NSAID use |
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