Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Gastro > Dyspepsia and Peptic Ulcer Disease > Flashcards

Dyspepsia and Peptic Ulcer Disease Flashcards

1
Q

Define dyspepsia

A

Indigestion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are some of the symptoms of dyspepsia

A

Epigastric pain or burning
Postprandial fullness
Early satiety
Combination or separate symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the structures of the foregut and where does it start and end

A 
Oesophagus
Stomach
Duodenum
Pancreas
Gallbladder
Starts at the cricopharyngeus to the ampulla of Vater
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Describe the epidemiology of Dyspepsia

A 
Very common (20-40% global)
No consistence association with sex/age/ socioeconomic status/ smoking or alcohol
More common if H pylori infected
More common if using NSAIDs
Overlap with IBS / GORD
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the 2 main classes of causes of Dyspepsia and how common is each one

A

Organic (25%) and Functional (75%)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are some of the organic causes?

A

Peptic ulcer disease
Drugs (NSAIDs, COX2 inhibitors)
Gastric cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are some of the functional causes?

A

Idiopathic
Associated with other functional gut disorder such as IBS
No evidence of culprit structural disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is it really important to differentiate between in diagnosing dyspepsia

A

Heartburn, reflux or dyspepsia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the only examination finding in dyspepsia

A

Epigastric tenderness only

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

If the dyspepsia is complicated, what else can it cause

A

Cachexia
Mass
Evidence of gastric outflow obstruction
Peritonism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How do we manage a patient with no alarm symptoms

A

Non invasive test and treat strategy

Test for H pylori

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

If a patient is H pylori positive what course of action should be taken?

A

Prescribe course of antibiotics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

If H pylori negative what course of action should be taken?

A

Use PPI and other acid suppression and monitor the patient symptomatically if under 55
If the patient is over 55, we use ore active treatment and consider a referral to specialist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What other factors can affect functional dyspepsia?

A 
Visceral hypersensitivity (MAIN CONTRIBUTOR)
Disrupted gut-immune interactions
Abnormal upper GI motor and reflex functions 
Psychosocial factors (gut changes with stress)
Genetic factors
Altered brain-gut interactions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is peptic ulcer disease

A

Peptic ulcer disease refers to painful sores or ulcers in the lining of the stomach or first part of the small intestine, called the duodenum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the common syptoms of peptic ulcer disease?

A 
Pain radiating to the back 
Nocturnal pain 
Aggrevated or relieved by eating 
Relapsing and remitting chronic illness
More common in lower socio-economic groups 
Past family history
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the 2 main causes of peptic ulcers

A

H pylori and NSAIDs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is happening to the ratio of NSAID: H pylori?

A

It is rising

19
Q

Describe H pylori

A

Acquired in infancy
Gram negative microaerophilic flagellated bacillus
Oral-oral/ faecal oral spread
Consequences of infection do not arise until later in life

20
Q

What are the 2 main consequences of H Pylori

A

Peptic Ulcer disease

Gastric cancer

21
Q

Describe the prevalence of H Pylori around the world

A

In the developing world, the prevelance is very high at an early age
In the Western world, there is a greater prevalence as the age increases. Older generations were brought up in a less clean and more poorly sanitised environments.
There is a higher prevalence of H pylori in lower social economic areas

22
Q

What are the 2 different outcomes of an H Pylori infection

A

An increase in acid secretion of a decrease in acid secretion.
An increase causes an increased risk of duodenal ulcer
A decrease causes atrophy which results in Gastric Cancer

23
Q

What is a typical endoscopic finding of a duodenal NSAID induced ulcer

A

Multiple white erosions all on one side of the tube

24
Q

What do we need to worry about if an ulcer is irregular in shape and deep with raw edges?

A

Cancer - biopsy is required!

25
Q

What is a typical sign of a gastric ulcer?

A

Raw edges on an ulcer

26
Q

What 4 ways can we diagnose H pylori infection?

A

Gastric Biopsy
Urease Breath Test
Faecal Antigen test
Serology (IgA antibodies)

27
Q

What might give you a false reading of H pylori?

A

If the patient is taking PPIs

28
Q

What does H pylori do?

A

Increases the pH of its microenvironment

29
Q

What would H pylori look like in terms of histology?

A

Black dots in the crypt area of the stomach

30
Q

How can we treat Peptic Ulcer Disease (PUD)

A

Antisecretory Therapy (PPI)
Test for presence of H pylori
Withdraw NSAIDs
Surgery

31
Q

Is the peptide ulcer likely to be organic or functional if symptoms persist in the young?

A

Functional

32
Q

What do we do if symptoms persist in a patient over 55

A

Refer for an endoscope

33
Q

What are the 2 main groups of drugs used to treat ulcers? and give examples of both

A

H2RAs - Ranitidine or nizatidine

PPIs - Omeprazole or lansoprazole

34
Q

Why is omerprazole better than H2RAs in Duodenal ulcers?

A

It heals duodenal ulcers faster

35
Q

Why are H2RAs better than omeprazole in Duodenal Ulcers?

A

Therapy after four weeks is higher

36
Q

What is the disadvantage of antacids such as Gaviscon ?

A

They take much longer and the patient is more likely to lose compliancy

37
Q

What is the first line treatment of H Pylori

A

Triple therapy - 1 week of:
PPI + amoxycillin 1g bd + clarithromycin 500mg bd
PPI + metronidaxole 400mg bd + clarithromycin 250mg bd

38
Q

What happens if the treatment of H pylori has not improved the symptoms

A

Biopsy may be required

39
Q

What are the main side effects that occur during the treatment of H Pylori

A

Nausea, diarrhoea

40
Q

Name 4 complications of peptic ulcer disease?

A

Anaemia
Bleeding
Perforation
Gastric outlet / duodenal obstruction

41
Q

What follow up treatment is required for duodenal ulcers?

A

No follow up
Confirmation of helicobacter free
Rarely forms malignancy

42
Q

What follow up treatment is required for Gastric Ulcers

A

Follow up endoscopy in 6-8 weeks

Ensure healing and no malignancy has formed which is common

43
Q

What are some of the symptoms /risks of gastric cancer?

A

Dyspepsia and alarm symptoms such as weight loss, anaemia, mass, recurrent vomiting
Family history of gastric cancer
Achlorhydria (production of gastric acid in the stomach is absent or low, respectively)

44
Q

What is the overall end result of H pylori infection regardless of the increase or decrease in acid

A

An increase in Gastrin

Gastro (67 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions