Cedrick
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A healthy 25 year old woman who is at 24 week's gestattion develops heartburn within an hour after eating
Which of the following is the most likely cause?
a.-decreased competency of the lower esophageal sphincetr
b.-decreased esophageal motility
c.-increased gastric acid production
d.-increased garstic emptying
e.-increased gastric motility
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| Cedrick
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?
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| Cedrick
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| Cedrick
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?
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| study_ing
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a
PROgesterone, i think relaxes muscle. perhaps also a reason for constipation. what do the rest think??
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| robin082006
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C
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| study_ing
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and ur reasoning/ reference is....??
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| muzammil
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i think it may be a or b as these two are the mechnism underlying for reflux decrease competency of LES cause reflux and dec motility of esophagus causes delayed removal of reflux material
for my guess work i wud go for a
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| drpkaur
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According to me what i have read the answer is A -because progesterone causes incompetence of LES which explains why in pregnancy heart burn is so common..
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| study_ing
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thanx a lot. was unsure abt it
but if u read it sumwhere, and i read it somewhere then it probably is true
was it blueprints gynae??
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| robin082006
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Kaplan has a similar question.
Pregnancy causes stress, resulting in increased acid secretion--> gastric peptic disease.
This patient has symptoms of gastric ulcer disease (postprandial pain)
In GERD: substernal pain, increase when lying,
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| Cedrick
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Yeah I know the system was down
yes C
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| study_ing
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i wudnt favor c
http://www.emedicine.com/med/topic3265.htm#sectio...
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| vanshita
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A
heart burn present in gastrooesophageal disease not peptic ulcer disease
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| muzammil
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explannation of rboin has weight can some one settle the matter once and for all
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| Cedrick
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wow good articule
Decreased LES
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| Cedrick
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Hey what is going on ?
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| muzammil
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cedrick have a look at this
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd...
it says
In general, peptic ulcer disease during pregnancy is relatively rare. Certainly, gastroesophageal reflux symptomatology and hyperemesis gravidarum are the primary pregnancy-associated upper gastrointestinal tract illnesses.
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| muzammil
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i think the answer is a as peptic ulcer disease is not common in preganncy but reflux is and the phenomenon is progestrone leads to dec LES tone
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| Cedrick
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ok thanks
moving along to next question
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| shumaker
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A
progestrone has a smooth muscle relaxing effect resulting in lower LES tone
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| mjl1717
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According to the first article answers a and e should be correct.
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| yasmeen
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IT,S A FOR SURE PROGESTERONE CAUSES INCOMPETENCE OF LES CAUSING REFLUX OF ACIDIC GASTRIC CONTENTS CAUSING HEART BURN .THERE IS DECREASE GASTRIC EMPTYING IN PREGNANCY AND ACTIUALLY PEPTIC ULCER IMPROVES IN PREGNANCY
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| docswapna
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AND ACTIUALLY PEPTIC ULCER IMPROVES IN PREGNANCY
dint know this before..
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| dr.mum
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I would say, C.
Because when I was pregnant, I read a book about pregnacy. It says pregnancy can cause gastric ulcer disease due to high gastric acid secretion. 
Not from Kaplan, it's from a mom's experience.
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