Brainscape's Knowledge GenomeTM

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


See full index

The Patient 2 > Dyspepsia, GORD & PUD > Flashcards

Dyspepsia, GORD & PUD Flashcards

1
Q

What is Dyspepsia?

A

Basically indigestion which causes abdominal pain

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

What are some symptoms of dyspepsia?

A

Persistent or recurrent pain or discomfort in upper abdomen, nausea and vomiting, heartburn etc

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

What are some causes of dyspepsia?

A

lifestyle factors, medication and diseases

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

What is GORD?

A

Gastro-oesophageal reflux disease occurs when gastric contents move up into the oesophagus

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

What are some causes of GORD?

A

obesity, lifestyle, genetics, medication and age

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

What are some symptoms/ complications of GORD?

A

chronic cough or laryngitis, linked to asthma, can lead to stricture, Barrett’s oesophagus etc

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

What happens during gastro-oesophageal reflux?

A

Lower oesophageal sphincter relaxation causing reflux of gastric contents into oesophagus

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

What is a peptic ulcer?

A

open sores / ulceration that occurs on the inner lining of the oesophagus, stomach upper portion of SI

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

What causes peptic ulcers?

A

H pylori, NSAIDs, lifestyle factors & genetic factors

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

What are some complications of peptic ulcers?

A

upper GI bleed

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

What are the initial symptoms of peptic ulcers?

A

upper abdominal pain, heartburn/reflux, bloating, early satiety, nausea and vomiting

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

What is the difference in symptoms of a gastric ulcer and a duodenal ulcer?

A

With gastric ulcer the pain radiates to the back, occurs mainly at night, is aggravated by food and causes weight loss but with duodenal ulcers you’ll experience epigastric pain anytime even on an empty stomach, the pain is relieved by food/antacids and you’ll gain weight

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

How do you assess for a peptic ulcer?

A

take a detailed medical and social history, review medication, blood tests, H pylori testing, X ray and endoscopy

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

What are some peptic ulcer warning signs?

A

ALARMS: Anaemia, loss of weight, anorexia, recurrent problems, melaena (blood in stools), swallowing problems

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are some lifestyle measures used to manage dyspepsia, GORD and PUD?

A

smoking cessation, healthy eating, avoiding known precipitants that cause dyspepsia such as fatty, acidic or fried foods, reducing or exclusion of chocolate and caffeine, avoid eating late, reduce stress, raising the head of the bed (GORD)

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

What medication is used to manage these conditions?

A

Antacids (+alginates), PPIs, H2 receptor antagonists, Misoprostol

17
Q

What are some side effects of antacids?

A

often contain magnesium or aluminium compounds and those that are magnesium containing cause a laxative effect and aluminium containing cause constipation

18
Q

Why should you be aware of the sodium content of some antacids?

A

patient may be on a salt restricted diet, undesirable in those with: liver/renal/cardiac conditions, those with hypertension and in pregnancy

19
Q

What is the definition of low sodium?

A

less than 1mmol per tablet or 10ml dose

20
Q

What are some problems caused by interaction with antacids?

A

may impair absorption of other drugs, may damage enteric coating by raising pH

21
Q

What drug is used in combination with antacids and what is its purpose?

A

alginates, increases viscosity of stomach contents

22
Q

What do histamine receptor antagonists do?

A

Reduce gastric acid output by blocking histamine H2 receptor

23
Q

What are H2 receptor antagonists licensed for?

A

GORD, NSAID prophylaxis, functional dyspepsia, stress ulcers, peri-operatively for those who are nil to mouth

24
Q

Give 4 drugs that Cimetidine interacts with

A

warfarin (inhibits metabolism, increases INR), phenytoin (inhibits metabolism, increases plasma conc) , theophylline (inhibits metabolism, increases plasma conc), sildenafil (increases plasma conc)

25
Q

What do PPIs do?

A

block final pathway in production of gastric acid so block gastric H,K-ATPase, inhibiting gastric acid secretion

26
Q

What are some indications of PPIs?

A

dyspepsia, GORD, treatment of gastric and duodenal ulcers, maintenance treatment, NSAID prophylaxis, excessive gastric excretion, stress ulcer prophylaxis

27
Q

Long term PPI therapy can cause achlorhydria and this is associated with increased risk of what conditions?

A

gastric cancer, H pylori, pneumonia. C difficile infection, bacterial overgrowth and reduced calcium absorption leading to hip fracture

28
Q

What drugs to PPIs interact with?

A

antiretrovirals, methotrexate, citalopram, omeprazole

29
Q

What is H. Pylori?

A

a gram negative bacteria which causes persistent infection in the gastro duodenal mucosa. A common cause of PUD

30
Q

How is H. Pylori detected?

A

It produces an antibody response detectable in serum, saliva or urine and an antigen response which is detected in stool

31
Q

What methods are used to test for H. Pylori?

A

urea breath test kits, stool test, mucosal biopsies, lab based serology, careful drug history

32
Q

What are the characteristics of H. Pylori treatment?

A

simple, well tolerated, cost effective, easy to comply with

33
Q

Describe H. Pylori treatment

A

First line is triple therapy which consists of a twice daily course of a PPI and 2 ABs. for example: PPI full dose BD, Amoxicillin BD, Clarithromycin BD or Metronidazole

34
Q

What are the risk factors for an NSAID bleed?

A

60 years old, multiple NSAIDs, smoker, H pylori infection, concurrent medication including steroids & anticoagulants, higher dose/ longer duration

35
Q

Describe the mechanism for NSAID induced ulcers

A

synthesis of prostaglandin is inhibited which impairs the mucosal defenses and causes an erosive breach of the protective layer of the GIT, the epithelial barrier.

36
Q

How is NSAID induced PUD managed?

A

– stop NSAID if possible, test for H pylori, give full dose PPI or H2 receptor antagonist for 8 week, if H pylori present give eradication therapy, if you can’t stop NSAID then discuss potential harm and review regularly or reduce dose or select an alternative treatment.

37
Q

What is Misoprostol and what is it used for?

A

a prostaglandin analogue with antisecretory and cytoprotective effects, good at preventing NSAID induced PUD

The Patient 2 (8 decks)

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