13: Dyspepsia and peptic ulcer disease

Question 1

What is dyspepsia?

Answer 1

Burning epigastric pain

Question 2

Pathology in which section of the gut produces epigastric pain?

Answer 2

Foregut

Question 3

Infection with which bacteria can cause dyspepsia?

Answer 3

H. pylori

Question 4

Which class of drugs can cause peptic ulcers associated with dyspepsia?

Answer 4

NSAIDs (aspirin, ibuprofen)

Question 5

What are some organic causes of dyspepsia?

Answer 5

Peptic ulcers

Drugs (NSAIDs)

Gastric cancer

Question 6

75% of dyspepsia cases are ___.

Answer 6

idiopathic

no clear cause

Question 7

Which functional gut disorder can cause dyspepsia?

Answer 7

IBS

Irritable bowel syndrome

Question 8

What is a common disease causing organic dyspepsia?

Answer 8

Peptic ulcer disease

Question 9

Where is pain associated with peptic ulcers felt?

Answer 9

Epigastrium

Question 10

Where can pain associated with peptic ulcers radiate?

Answer 10

Back

Question 11

What can aggravate dyspepsia caused by peptic ulcers?

Answer 11

Eating

Question 12

Which bacteria causes peptic ulcer disease?

Answer 12

H. pylori

Question 13

What drugs cause peptic ulcer disease?

Answer 13

NSAIDs

Question 14

When do people tend to acquire H. pylori?

Answer 14

Childhood

Question 15

H. pylori is a Gram (positive / negative) (cocci / bacillus).

Answer 15

Gram -ve bacilli

Question 16

Where do peptic ulcers arise?

Answer 16

Stomach

Duodenum

Question 17

1% of those infected with H. pylori go on to develop gastric ___.

Answer 17

cancer

Question 18

Which hormones stimulates the release of hydrochloric acid from parietal cells?

Answer 18

Gastrin

Histamine

Question 19

Which cells release gastrin?

Answer 19

G cells

Question 20

When food enters the stomach, the pH ___.

Answer 20

increases

Question 21

Increasing pH causes an (increase / decrease) in the amount of gastrin secreted by G cells.

Answer 21

increase

Question 22

H. pylori related gastritis causes an increase in the secretion of ___ by _ cells.

What is a consequence of this?

Answer 22

gastrin , G cells

Increased HCl secretion leading to gastric / duodenal ulcers

Question 23

Ulcers which burrow into arterioles are at a high risk of ___.

Answer 23

bleeding

Question 24

Gastric ulcers can be ___ or ___.

Answer 24

acute , chronic

Question 25

Large, irregular looking gastric ulcers are indicative of ___.

Answer 25

cancer

Question 26

Which enzyme is used to test for H. pylori infection?

Answer 26

Urease

Question 27

What material can be tested for H. pylori antigens?

Answer 27

Faeces

Question 28

Which enzyme, expressed by H. pylori, can be used to test for its presence?

Answer 28

Urease

Question 29

What sort of test is commonly used to detect H. pylori in the stomach?

Answer 29

Urease BREATH test

Question 30

All patients with peptic ulcer disease are given which class of drug?

Answer 30

PPIs (e.g omeprazole)

anti-secretory

Question 31

All patients with peptic ulcer disease are tested for the presence of which bacteria?

Answer 31

H. pylori

Question 32

Which drugs should be withdrawn if a patient has peptic ulcer disease?

Answer 32

NSAIDs

Question 33

Which triple therapy is used to eradicate H. pylori?

Answer 33

PPI + 1g Amoxicillin BD + Clarithromycin 500mg BD

or

PPI + 400mg Metronidazole BD + Clarithromycin 250mg BD

Question 34

H. pylori eradication therapy tends to cause ___ and ___.

Answer 34

nausea

diarrhoea

Question 35

Why may a peptic ulcer patient develop anaemia?

Answer 35

Bleeding

Question 36

What may happen to the wall of the stomach / duodenum if a peptic ulcer penetrates it deeply?

Answer 36

Perforation

Question 37

Patients with untreated peptic ulcers may develop GI tract ___ due to fibrosis.

Answer 37

obstruction