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Questions and Answers
What are the two components of the normal anti-reflux barrier?
What are the two components of the normal anti-reflux barrier?
- Liver and pancreas
- Diaphragm and lower esophageal sphincter (correct)
- Stomach and esophagus
- Small intestine and large intestine
What does GERD stand for?
What does GERD stand for?
Gastroesophageal reflux disease
Which of the following is NOT a symptom of GERD?
Which of the following is NOT a symptom of GERD?
- Postprandial
- Aggravated by change in position
- Increased appetite (correct)
- Burning/regurgitation
What is a potential complication of GERD?
What is a potential complication of GERD?
What is the primary function of antacids?
What is the primary function of antacids?
Which of the following is NOT a common antacid ingredient?
Which of the following is NOT a common antacid ingredient?
Antacids provide long-lasting relief from GERD symptoms.
Antacids provide long-lasting relief from GERD symptoms.
Anti-secretory therapies for GERD focus on increasing the production of stomach acid.
Anti-secretory therapies for GERD focus on increasing the production of stomach acid.
Which type of receptor do H2-receptor antagonists block?
Which type of receptor do H2-receptor antagonists block?
Which of the following is NOT an example of an H2-receptor antagonist??
Which of the following is NOT an example of an H2-receptor antagonist??
H2-receptor antagonists work by permanently inhibiting the H2 receptor.
H2-receptor antagonists work by permanently inhibiting the H2 receptor.
Cimetidine can cause drug-drug interactions due to its ability to inhibit CYP450 enzymes.
Cimetidine can cause drug-drug interactions due to its ability to inhibit CYP450 enzymes.
Ranitidine is effective in healing erosive esophagitis.
Ranitidine is effective in healing erosive esophagitis.
What is the mechanism of action of proton pump inhibitors (PPIs)?
What is the mechanism of action of proton pump inhibitors (PPIs)?
Which of the following is NOT an example of a PPI?
Which of the following is NOT an example of a PPI?
PPIs form a temporary bond with the proton pump.
PPIs form a temporary bond with the proton pump.
PPIs can completely inhibit stomach acid production.
PPIs can completely inhibit stomach acid production.
PPIs should be taken on-demand, as needed.
PPIs should be taken on-demand, as needed.
PPIs are known for their common and severe adverse effects.
PPIs are known for their common and severe adverse effects.
Peptic ulcer disease (PUD) is primarily caused by the overuse of antibiotics.
Peptic ulcer disease (PUD) is primarily caused by the overuse of antibiotics.
What is the hallmark symptom of PUD?
What is the hallmark symptom of PUD?
Which of the following is NOT a possible symptom of PUD?
Which of the following is NOT a possible symptom of PUD?
H. pylori is a gram-positive bacteria.
H. pylori is a gram-positive bacteria.
NSAID use is a major cause of PUD.
NSAID use is a major cause of PUD.
Which of the following treatment strategies is recommended for H. pylori-related PUD?
Which of the following treatment strategies is recommended for H. pylori-related PUD?
Triple therapy is generally successful in curing H. pylori infection.
Triple therapy is generally successful in curing H. pylori infection.
PPIs are more effective than H2-receptor antagonists in treating NSAID-induced PUD.
PPIs are more effective than H2-receptor antagonists in treating NSAID-induced PUD.
Which of the following is NOT a cytoprotective therapy?
Which of the following is NOT a cytoprotective therapy?
Misoprostol is contraindicated in pregnant women.
Misoprostol is contraindicated in pregnant women.
What is the mechanism of action of sucralfate?
What is the mechanism of action of sucralfate?
Bismuth can neutralize stomach acid.
Bismuth can neutralize stomach acid.
Bismuth is safe to use with aspirin.
Bismuth is safe to use with aspirin.
Long-term use of bismuth is associated with a low risk of toxicity.
Long-term use of bismuth is associated with a low risk of toxicity.
Flashcards
What is Gastroesophageal Reflux Disease (GERD)?
What is Gastroesophageal Reflux Disease (GERD)?
The inability of the lower esophageal sphincter to prevent stomach acid from backing up into the esophagus
What is erosive esophagitis?
What is erosive esophagitis?
A condition where stomach acid damages the lining of the esophagus, leading to inflammation and pain
What is Barrett's esophagus?
What is Barrett's esophagus?
A precancerous condition where the lining of the esophagus changes from a protective squamous epithelium to a more intestinal-like columnar epithelium
What is a peptic stricture?
What is a peptic stricture?
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What are antacids?
What are antacids?
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How do H2-receptor antagonists work?
How do H2-receptor antagonists work?
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What is a CYP450 inhibitor?
What is a CYP450 inhibitor?
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What is tachyphylaxis?
What is tachyphylaxis?
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How do proton pump inhibitors (PPIs) work?
How do proton pump inhibitors (PPIs) work?
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What is Peptic Ulcer Disease (PUD)?
What is Peptic Ulcer Disease (PUD)?
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What is H. pylori?
What is H. pylori?
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How do NSAIDs affect PUD?
How do NSAIDs affect PUD?
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What is triple therapy for H. pylori PUD?
What is triple therapy for H. pylori PUD?
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How do you treat NSAID-induced PUD?
How do you treat NSAID-induced PUD?
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What is misoprostol?
What is misoprostol?
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How does sucralfate work?
How does sucralfate work?
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How does bismuth (Pepto-Bismol) work?
How does bismuth (Pepto-Bismol) work?
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What are some lifestyle changes for GERD?
What are some lifestyle changes for GERD?
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Why are lifestyle modifications important for GERD?
Why are lifestyle modifications important for GERD?
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What causes GERD?
What causes GERD?
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What is medical therapy for GERD?
What is medical therapy for GERD?
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What are the consequences of GERD?
What are the consequences of GERD?
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What are anti-secretory therapies for GERD?
What are anti-secretory therapies for GERD?
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What are proton pump inhibitors (PPIs)?
What are proton pump inhibitors (PPIs)?
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What are H2-receptor antagonists (H2RAs)?
What are H2-receptor antagonists (H2RAs)?
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What are cytoprotective therapies?
What are cytoprotective therapies?
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What is sucralfate?
What is sucralfate?
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What is misoprostol?
What is misoprostol?
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Study Notes
Gastroesophageal Reflux Disease (GERD)
- Esophagus structure and gastroesophageal junction discussed
- Normal anti-reflux barrier: diaphragm and lower esophageal sphincter
- GERD: symptoms and/or esophageal damage from refluxing stomach contents
- Symptoms include heartburn, regurgitation, postprandial symptoms, and position-related discomfort
- Antacids provide relief by neutralizing stomach acid
GERD Complications
- Erosive esophagitis: damage to the esophageal lining
- Peptic stricture: scar tissue narrows the esophagus
- Barrett's esophagus: tissue changes increasing risk of esophageal cancer
- Esophageal cancer: a serious complication of chronic GERD
Antacids
- Weak bases neutralizing stomach acid
- Quick onset (5-10 minutes) but short duration (30-60 minutes)
- Magnesium hydroxide, aluminum hydroxide, sodium bicarbonate, or calcium carbonate can be combined
- Suitable for intermittent, mild symptoms that occur less frequently
Anti-Secretory Therapies
- Focus on blocking the parietal cells within the stomach lining from producing acid
- Targeting the ability of parietal cells to produce stomach acid
H2-receptor Antagonists (H2-RAs)
- Block histamine 2 receptors, decreasing gastric acid secretion by competitive inhibition
- Examples: Ranitidine (Zantac), Famotidine (Pepcid), Cimetidine (Tagamet)
- 30-45 minutes for onset of action, lasts for 4-10 hours
- Fewer side effects than PPIs, but less effective in healing erosive esophagitis
- Should not be used long term due to potential for reduced efficacy
- Cimetidine inhibits CYP450 enzymes
Proton Pump Inhibitors (PPIs)
- Most potent acid-secretion inhibitors
- Create a stable, irreversible bond with the proton pump, leading to long-lasting effects
- Reduce gastric acid by 90%
- Useful for healing erosive esophagitis
- Take 30 minutes before the first meal daily
- Examples: Omeprazole (Prilosec), Lansoprazole (Prevacid)
Lifestyle Modifications for GERD
- Elevate the head of the bed to reduce acid reflux during sleep
- Avoid large meals/snacks close to bedtime
- Avoid foods and drinks that trigger GERD symptoms (e.g., caffeine, chocolate, alcohol)
- Maintain a healthy weight
- Avoid smoking
Peptic Ulcer Disease (PUD)
- Defects in gastric mucosa due to gastric secretions
- Associated symptoms: pain, nausea, vomiting, dyspepsia, heartburn, weight loss, and hematemesis
- Common cause: H. pylori infection or NSAID overuse
- NSAID use weakens the stomach lining by blocking production of cytoprotective prostaglandins
- Treatment often includes a triple therapy of PPI combined with multiple antibiotics and ongoing acid control
Cytoprotective Therapies
- Misoprostol: blocks parietal cell cAMP production response to histamine
- Sucralfate (Carafate): binds to injured tissue, reducing pepsin and acid exposure
- Bismuth (Pepto-Bismol): inhibits pepsin activity, coats the ulcer and suppresses H. pylori infection
- Contraindications to use in pregnant women or in patients that use aspirin (salicylates).
- Potential side effects can occur with long-term use
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Description
This quiz covers the essentials of Gastroesophageal Reflux Disease (GERD), including its symptoms, complications, and treatments. Explore the anatomy involved, the role of antacids, and anti-secretory therapies. Test your knowledge on how GERD affects the esophagus and the associated risks.
