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NUR112 Peptic Ulcer Disease
Nursing 112 Test 3 - Peptic Ulcer Disease
24
Medical
Undergraduate 2
03/02/2009

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Term
Peptic Ulcer Disease
Definition
occurs when there is an imbalance between mucosal defensive factors and aggressive factors.
Term
The major defensive factors
Definition
mucus , bicarbonate, blood flow and prostaglandins
Term
The major aggressive factors
Definition
H. pylori, NSAIDs, gastric acid, and pepsin
Term
Mucus
Definition
secreted continually by cells of the GI tract, forming a barrier that protects underlying cells from attack by acid and pepsin.
Term
• Bicarbonate
Definition
is secreted by epithelial cells of the stomach and duodenum
Term
• Bicarbonate
Definition
remains trapped in mucus layer where it serves to neutralize any hydrogen ions that penetrate the mucus
Term
• Bicarbonate
Definition
produced by the pancreas is secreted into lumen of duodenum where it neutralizes acid delivered from the stomach
Term
• Blood flow
Definition
Sufficient blood flow to cells of GI mucosa is essential for maintaining mucosal integrity.
Term
• Blood flow
Definition
Reduction in submucosal blood flow causes ischemia which leads to cell injury , thereby increasing vulnerability to attack by acid and pepsin
Term
• Prostaglandins
Definition
These compounds stimulate secretion of mucus and bicarbonate and promote vasodilation which improves blood flow
Term
• Prostaglandins
Definition
suppress secretion of gastric acid.
Term
• Helicobacter pylori
Definition
Gram negative bacillus that can colonize stomach and duodenum
Term
• Helicobacter pylori
Definition
This organism takes up residence in space between epithelial cells and mucus barrier and therefore can escape destruction by acid and pepsin
Term
• Helicobacter pylori
Definition
H. pylori can remain in GI tract for decades.
H. pylori causes PUD by degrading the mucus layer and by injuring mucosal cells
Term
• NSAIDs
Definition
Underlying cause of many gastric ulcers and some duodenal ulcers
Term
• NSAIDs
Definition
inhibit byosynthesis of prostaglandins, which leads to decreased submucosal blood flow, suppression of secretion of mucus and bicarbonate, and increased secretion of gastric acid
Term
• Gastric Acid
Definition
Gastric acid is an absolute requirement for peptic ulcer formation
Term
• Gastric Acid
Definition
acid directly injures cells of GI mucosa
Term
• Gastric Acid
Definition
activates pepsin, a proteolytic enzyme
Term
• Pepsin
Definition
Proteolytic enzyme present in gastric juice.
Term
• Pepsin
Definition
It can injure unprotected cells of gastric and duodenal mucosa
Term
• Smoking
Definition
delays ulcer healing and increases risk of recurrence
Term
• Smoking
Definition
reduces beneficial effects of anti-ulcer medications, reduces secretion of bicarbonate
Term
• Smoking
Definition
accelerates gastric emptying which delivers more acid to duodenum.
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