Dyspepsia + Peptic Ulcers Flashcards

1
Q

What is Dyspepsia?

A

Epigastric pain or burning.

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2
Q

What are the two categories of causes of Dyspepsia?

A

Organic - 25%
(e.g. Peptic ulcer disease, Drugs (NSAIDs, COX2 inhibitors), gastric cancer)
Functional - 75%
(e.g. idiopathic, associated with IBS etc.)

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3
Q

On examination what would you find in uncomplicated and in complicated Dyspepsia?

A

Uncomplicated - Tenderness only.

Complicated - Cachexia, mass, evidence of gastric outflow obstruction, peritonism

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4
Q

For treatment of Dyspepsia what are the Alarm features that would cause you to send the patient to a specialist?

A
Dysphagia
Evidence of GI blood loss
Recurrent vomiting
Unexplained weight loss
Upper abdominal mass
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5
Q

What should you consider in uncomplicated dyspepsia?

A

Lifestyle changes

Antacids

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6
Q

If symptoms persist after lifestyle consideration and antacid use what is the next move?

A

H. pylori test.

If positive then eradicate

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7
Q

After H. pylori is negative or eradicated then consider the patients age, what would happen now?

A

> 54 see a specialist

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8
Q

How would you diagnose an infection of H.pylori?

A

Urease breath test
Biopsy - histology, culture/sensitivity
Faecal antigen test

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9
Q

What is the treatment of Peptic ulcer Disease?

A
PPI
Test for H.pylori
 - (if +ve - Eradicate and confirm)
 - (if -ve - Antisecretory therapy)
Withdraw NSAIDs
lifestyle change

For non-Hp/NSAID ulcers - Nutrition and optimise comorbidities

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10
Q

In the treatment of H.pylori infection what would be the commonest drugs used in week 1?

A

PPI + Amoxycillin + Clarithromycin
(or)
PPI + Metronidazole + Clarithromycin

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11
Q

What are the complications of peptic ulcer disease?

A

Anaemia
bleeding
perforation
gastric outlet/duodenal obstruction - fibrotic scar

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12
Q

What would you do to follow up treatment for a Gastric Ulcer?

A

Endoscopy at 6-8 weeks to ensure healing and no malignancy.

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