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== Study Questions ==
* <spoiler text="What types of factors may predispose to peptic ulcer formation?">Alcoholic cirrhosis, chronic obstructive airway disease, chronic renal disease, and hyperparathyroidism or any condition which leads to hypercalcemia (calcium stimulates gastrin production).</spoiler>
* <spoiler text="Why is infection with ''Helicobacter pylori'' considered to be a significant risk factor for development of peptic ulcers?">''H. pylori'' is found in 90-100% of cases. It is thought that the ''H. pylori'' produce urease, leading to ammonia production and that they also produce a protease that breaks down glycoproteins in the mucus which forms the protective coat on the gastric mucosa.</spoiler>
* <spoiler text="What cells make of the inflammatory reaction at the base of this chronic ulcer?">The base of this chronic ulcer has a granulomatous inflammatory reaction composed of lymphocytes, macrophages, fibroblasts, and endothelial cells. This is in contrast to the acute inflammatory reaction at the surface of the ulcer due to irritation from the acid and gastric contents.</spoiler>
