Prescribing Safety Assessment (PSA) Practice Exam

How do oral steroids contribute to the development of ulcers?

1. By increasing gastric acid secretion

2. By inhibiting gastric epithelial renewal

3. By promoting mucosal healing

4. By enhancing blood flow to the stomach lining

The correct answer is: By inhibiting gastric epithelial renewal

Oral steroids contribute to the development of ulcers primarily by inhibiting gastric epithelial renewal. This process involves the reduction of the regeneration and repair of the gastric mucosa, which is crucial for maintaining the integrity of the stomach lining. Normally, the gastric epithelial cells constantly renew themselves to replace damaged cells, maintaining a protective barrier against harmful substances, including gastric acid. When oral steroids are administered, they can impede this regenerative process, leading to a compromised mucosal barrier. As a result, the stomach lining becomes more susceptible to damage from gastric acid and other irritants, which can ultimately result in ulcer formation. In contrast, while increasing gastric acid secretion might seem relevant, it is not the primary mechanism through which steroids induce ulceration. Promoting mucosal healing is clearly contradictory to the adverse effects of steroids, and enhancing blood flow to the stomach lining typically denotes protective mechanisms rather than damage. Therefore, the focus on gastric epithelial renewal provides the most accurate understanding of how oral steroids contribute to ulcer development.