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  #1  
Old 08-26-2012
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Question H.pylori

H.pylori damages the gastric mucosa primarily by increasing mucosal levels of which of the following substances??

a) amonium
b) HCO3
c) gastrin
d) pepsin
e) NSAIDs
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Old 08-26-2012
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i hope it's A or D
i would like to go with A) AMMONIA
coz this is the reason for it to survive(neutralise acid) in stomach..and toxic to gastric epithelial cells
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Old 08-26-2012
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Aa...ammonia
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Old 08-26-2012
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Is it C . gastrin ? pylori induced increased gastrin causes the mucosal damage due to excessive gastric acidity leading to ulceration... it does produce ammonia but i doubt if that damages the mucosa...
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Originally Posted by dr.nitowl View Post
Is it C . gastrin ? pylori induced increased gastrin causes the mucosal damage due to excessive gastric acidity leading to ulceration... it does produce ammonia but i doubt if that damages the mucosa...


Q: 72yrs old woman H/O hematemesis,heartburn,abdominal pain. on uper GI endoscopy: inflamation involving gastrc body and antrum as wel as a smal gastric ulcer. tisue biopsy of mucosa shows positivity for H.pylori.H.pylori damages the gastric mucosa primarily by increasing mucosal levels of which of the following substances??

a) amonium
b) HCO3
c) gastrin
d) pepsin
e) NSAIDs
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Old 08-26-2012
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Originally Posted by dr.nitowl View Post
Is it C . gastrin ? pylori induced increased gastrin causes the mucosal damage due to excessive gastric acidity leading to ulceration... it does produce ammonia but i doubt if that damages the mucosa...
It's the other way round buddy.it neutralizes gastrin.
H pylori produce urease and cytokines,the cytokines convert urea to ammonia which is very toxic and burrow through the mucosa layer.
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Old 08-26-2012
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Originally Posted by imgchuchu View Post
It's the other way round buddy.it neutralizes gastrin.
H pylori produce urease and cytokines,the cytokines convert urea to ammonia which is very toxic and burrow through the mucosa layer.
may be am wrong , but I remember reading somewhere that h pylori causes increased gastrin , leading to ulcers .... but it also causes ,atrophic gastritis where it reduces the acid production . two different mechanisms and so different outcomes..
Ne ways thanks ..
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Originally Posted by imgchuchu View Post
It's the other way round buddy.it neutralizes gastrin.
H pylori produce urease and cytokines,the cytokines convert urea to ammonia which is very toxic and burrow through the mucosa layer.
how it neutalizes the gasrin?
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Old 08-26-2012
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Quote:
Originally Posted by riya_rai84 View Post
how it neutalizes the gasrin?
h.pylori produce urease which is converted to ammonia by cytokines....
ammonia which is basic neutralises acid(gastrin ) in stomach with help of mucinase...

but, i guess it's not invasive bacteria..it just colonizes stomach mucosa and blocks its secretions.....i'm not sure about this though...

Last edited by venky2600; 08-26-2012 at 09:04 PM.
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Old 08-26-2012
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Quote:
Originally Posted by riya_rai84 View Post
Q: 72yrs old woman H/O hematemesis,heartburn,abdominal pain. on uper GI endoscopy: inflamation involving gastrc body and antrum as wel as a smal gastric ulcer. tisue biopsy of mucosa shows positivity for H.pylori.H.pylori damages the gastric mucosa primarily by increasing mucosal levels of which of the following substances??

a) amonium
b) HCO3
c) gastrin
d) pepsin
e) NSAIDs

As H.Pylori produce Urease, which generates ammonia from endogenous urea and thereby elevates local gastric pH.......as a result disrupting gastroduodenal mucosal defense consequently mostly presents with predominantly antral gastritis with high acid production despite hypogastrinemia.
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Old 08-29-2012
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Default answer....

Quote:
Originally Posted by riya_rai84 View Post
Q: 72yrs old woman H/O hematemesis,heartburn,abdominal pain. on uper GI endoscopy: inflamation involving gastrc body and antrum as wel as a smal gastric ulcer. tisue biopsy of mucosa shows positivity for H.pylori.H.pylori damages the gastric mucosa primarily by increasing mucosal levels of which of the following substances??

a) amonium
b) HCO3
c) gastrin
d) pepsin
e) NSAIDs
pathophysio QBANK Q:

answer is A) amonium

H.pylori present in 95% of patients with duodenal ulcer,and nearly 100% of patients with gastric ulcer. H.PYLORI has high urease activity which metabolites the urea to amonium allowing the baterium to with stand the acid enviroment of the stomach. the amonium is cytotoxic and directly damages the epi: cells in the stomach,increase permeability of the gastric mucosa which is forerunner to ulcer formation.
although H.PYLORI can increase gastrin level responses to GRP,this alone doesnt damage the gastric mucosa
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The above post was thanked by:
Doc4Step1 (08-29-2012), venky2600 (08-29-2012)



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