Gastroesophageal Reflux Disease (GERD) Exam With 100% solved

Gastroesophageal Reflux Disease (GERD) Exam With 100% solved explain the alteration/loss of host defense mechanisms that may predispose to stress ulcer formation 1. ischemia and hypoxia in shock decreases mucusal blood flow 2. decreased rate of turnover and cell proliferation of gastric mucosa 3. back diffusion of bile salts from the duodenum into the stomach 4. lack of PG synthesis and mucus formation ischemia and hypoxia in shock leads to what? -decreased mucosal blood flow -decreased nutrient and oxygen delivery -mucosal inability to remove and neutralize gastric acid -back diffusion from the gastric lumen identify the critically ill patients who require prophylaxis against the development of stress ulcers recommended only for ICU patients who: -mechanical vent > 48 hr -have hx of GI ulceration or bleeding 1 year before admission -have coagulopathy (INR > 1.5, platelet <50,000) describe the clearance mechanisms for protection against GERD -secretion of bicarbonate into saliva -swallowing -esophageal peristalsis certain factors promote GERD by causing 1. relaxation of lower esophageal spincter (LES) 2. intra-abdominal pressure 3. failure of acid clearance processes factors that promote gastroesophageal reflux disease (GERD) by causing: relaxation of the lower esophageal sphincter (LES) -pregnancy -drugs with smooth muscle relaxant properties -various foods and medications drugs with smooth muscle relaxant properties that can promote GERD nitrates CCBs theophylline anticholinergics how does pregnancy lead to relaxation of the lower esophageal sphincter increased levels of progesterone and increased intra-abdominal pressure highest incidence of reflux esophagitis is