Chapter 55-test 2 Flashcards
Acute gastritis
Exposure to local irritants
NSAIDs steroids
If muscle is damaged, hermmorhage occurs
Chronic gastritis
Chronic exposure
ETOH
Tobacco
Radiation
S/s of chronic gastritis
Patchy diffuse inflammation
Vague epigastric pain
Pernicious anemia-destruction of paritial cells
S/s of acute gastritis
Thick, red mucosa, rugae
Rapid onset
Epigastric pain
May vomit blood
Type A chronic gastritis
Non erosive
Autoimmune
Parietal cell destruction
Fundus
Type B chronic gastritis
Caused by h pylori infection
Antrum
Atrophic chronic gastritis
Elderly Toxic exposure H pylori Related autoimmune Destruction of deep glands
Atrophic gastritis may lead to
Gastric cancer
MALT lymphoma
Treatment of gastritis
Diet No ETOH Caution NSAIDs Avoid caffeine Food and water safe Stress Smoking
Treatment of gastritis medications
Treat h pylori with at least 2 antibiotics and PPI H2 blocker PPI Mucosal barrier fortifiers (karophate) B12 injections to prevent anemia
Most ulcers are caused by
H pylori
Gastric ulcers usually develop in the
Antrum
Peptic ulcer disease hostile factors
H pylori
Gastric acid
NSAIDs
Pepsin
Peptic ulcer disease protective factors
Bicarbonate
Prostaglandins
Blood flow to mucosa
Risk factors for peptic ulcer disease
Heredity
Smoking
Stress
Gastric and duodenal ulcers can perforate
Peritonitis - tender ridged board like abdomen
Paralytic ileum
Emergency
Dyspepsia
Indigestion
Most commonly reported symptoms associated with peptic ulcer disease
S/s of gastric ulcer
GI upset Pain with eating Rare nighttime symptoms Hemmatemisis Nausea vomiting Anemia
S/s of duodenal ulcer
Sharp, burning gnawing pain Pain occurs 90 mins to 3 hours after eating Pain wakes them up at night Melena Anemia
Testing blood
H pylori antibody
H&h
Testing stool
Blood
H pylori
EGD for ulcer
Gold standard
Biopsy for h pylori
And cancer
Medications for treatment
PPIs
H2 blockers
Antacids
H pylori infection treatment
Flagyl (metronidazole Tetracycline or blaxin ( clarithromycin PPI Amoxicillin TRIPLE
Treatment diet
No snacking HS
No ETOH
No smoking
Avoid foods
Treatment UGI bleed
O2 Start 2 large bore IVs Normal saline, LR NPO NG with lavage EGD to stop bleeding Monitor electrolyte
