Dyspepsia and Peptide Ulcer Disease Flashcards

1
Q

dyspepsia

A

epigastric pain or burning

postprandial fullness

early satiety

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2
Q

dyspepsia - causes

A

ORGANIC
peptic ulcer disease, drugs, gastric cancer

FUNCTIONAL
idiopathic
structural disease and functional gut disorders

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3
Q

dyspepsia - examination

A

epigastric tenderness

COMPLICATED
cachexia
mass
evidence gastric outflow obstruction
peritoneum
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4
Q

peptic ulcer disease

A

cause of organic dyspepsia

pain predominant dyspepsia (to back)
often also nocturnal

aggravated or relieved by eating
gastric =pain
duendenal = no pain

relapsing and remitting chronic illness

family history

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5
Q

peptic ulcer disease - causes

A

h.pylori
90% of DU
60% of GU

NSAIDs

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6
Q

h.pylori

A

acquired in infancy
gram -ve microaerophilic flagellated bacillus

oral-oral/faecal oral spread

consequences arrive later in life

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7
Q

h.pylori - consequences

A

no pathology

peptide ulcer disease

gastric cancer

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8
Q

h.pylori - diagnosis

A

gastric biopsy
urease test
histology
culture/sensitivity

urease breath test

FAT (faecal antigen test)

serology (IgA antibiotics) - not accurate with increasing patient age

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9
Q

h.pylori increases pH of its microenvironment

A

produces ammonium bicarbonate

catalysed by urease

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10
Q

treatment of PUD

A

all antisecretory therapy PPI

all tested for presence of H.pylori
+ve = eradicate and confirm
-ve = antisecretory therapy

withdraw NSAIDs

lifestyle

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11
Q

eradication therapy

A

triple therapy for 1 week commonest

PPI + amoxycillin + clarithromycin

2 week regimens
higher eradication rates
poorer compliance

dual therapy

quadruple therapy

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12
Q

complications of PUD

A

anaemia
bleeding
perforation
gastric outlet/duodenal obstruction - fibrotic scar

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