CIS Flashcards
testing for H. Pylori
histologic exam: EGD with biopsy or rapid CLO
serology: H. pylori Abs, IgA (takes 6-24 months for Abs to decrease)
Stool H. pylori antigen
Carbon 13 or 14 urea breath test
Peptic Ulcer Disease
associated with H pylori 75% of time
typically in lesser curvature of the antrum of stomach
burning epigastric pain
worsens within 30 min after eating
Dx: EGD
Tx: H2 blocker, proton pump inhibitor, eradicate H. Pylori
Duodenal ulcer
95% secondary to H. Pylori gnawing pain 1-3 hours after eating Relieved by food/eating RUQ or epigastric pain causes chronic gastritis, duodenal ulcers, and MALT
gastic ulcer
within 1/2 hour of eating pain worse epigastric or RUQ pain typically sharp burning pain NSAID, alcohol, smoking 75% H. pylori
H. pylori
curved gram negative rods that produce urease (microaerophilic spiral bacili with flagella)
arcus senilis
may be present at birth
typically over age 50
may indicate familial hyperlipidemia
it is lipid deposits in the cornea
treatment for gallstones
start antibiotics
intravenous fluids
consult Gi for ERCP
consult surgery for cholecystectomy
gallbladder disease/gallstone risk factors
female
fat
fertile
forty
melena
black tary stools
hematochzia
bright red stools
coffee-ground emesis
digestive blood
hematemesis
bright red stools
Risk for ulcers
H pylori infection
NSAID use
Steroid use
smoking
NSAIDs and ulcer formation
decreases the secretion of mucin and bicarbonate
gastric ulcer a. affected
splenic a.
