Complications of peptic ulcer

Question 1

3 locations of ulcers

Answer 1

eosphogeal,gastric, duodenal

Question 2

t or F, pregnancy is a risk factor for complicated PUD

Answer 2

TRUE

Question 3

risk of complication in NSAIDs is dependent on

Answer 3

3Ds, drug specific, dose speicifc, duration

Question 4

which patients should receive prophylactic antacids

Answer 4

patients with multi-organ failure

Question 5

name 4 physiological stautus at the time of pt presentation that predispose the pt to poor outcome (4)

Answer 5

1. hypotension at time of admission 2. metabolic acidosis 3. acute renal failure 4. hypoalbuminermia

Question 6

older age and comorbid disease are associated with

Answer 6

poor outcomes of PUD

Question 7

List the 4 complications of ulcers

Answer 7

Bleeding, perfortation, penetration, stenosis

Question 8

o Can present as Fresh blood vomiting

o OR Melina (black stool) = Digested blood/ oxidized by the acid

Answer 8

upper GI bleeding

Question 9

what separates upper and lower GI bleeding?

Answer 9

ligament of treitz

Question 10

diagnosis of bleeding is typically made via

Answer 10

endoscopy

Question 11

in the management of bleeding, which drugs are discontinued

Answer 11

NSAIDs, warfarin, heparin

Question 12

treatment of bleeding is done via

Answer 12

endoscopy (first) or surgery

Question 13

when do you do surgery instead of endoscopy for pts w/ bleeding

Answer 13

1. failed endoscpy 2. hemodynamic instability 3. recurrent hamorrhage 4. continued slow bleeding w/ tran exceeding 3 units/day, 5. big ulcer and wide area needs ligation

Question 14

2/10 of of peptic ulcers are complicated by

Answer 14

perforations

Question 15

quantify and name the area where perforations often take place

Answer 15

duodenal 60%

Question 16

· Sudden epigastric pain and quickly becomes generalized.

· Pain may radiate to the top of the right shoulder or to both shoulders.which phase of perforation is the following:

Answer 16

initial- within 2 hours of onset

Question 17

in which phase does abdominal rigidity take place?

Answer 17

initial

Question 18

WHEN does the second phase of perforation occur

Answer 18

2-12 hours after onset

Question 19

abdominal pain MAY lessen, marked board like rididity

Answer 19

2nd phase

Question 20

increased abdominal distention, temperation elevation and hypovolemia are all characteristic of ___phase of perforation

Answer 20

3rd

Question 21

when does the 3rd phase of perforation occur?

Answer 21

> 12 h

Question 22

management of perforation

Answer 22

intravenous proton pump inhibitor, antibiotic, surgery.

Question 23

most common organ that is penetrated

Answer 23

pancreas > lesser omentum > biliary tract (from duodenum) > liver (duodenum), the least would be vascular structures

Question 24

antral and duodenal ulcers suggest which type of organ perforation

Answer 24

pancreas

Question 25

pyloric or prepyloric ulcers suggest which type of organ perforation

Answer 25

duodenum > gastroduodenal fistula (corrected surgically)

Question 26

what is the least frequent complication of peptic ulcer

Answer 26

gastric outlet ostruction

Question 27

t or f, 95% of gastric outlet obstruction is caused by pUD

Answer 27

false, only 5%

Question 28

which symptom is suggestive of gastric outlet obstruction

Answer 28

weight loss, vomitting, anorexia