Gastric and duodenal ulcers

Question 1

where do peptic ulcers present

Answer 1

stomach or upper part of duodenum (1:4 ratio)
stomach - pain at mealtimes
duodenum - pain relieved by mealtimes (pyloric sphincter closes) but pain 2-3hrs after

Question 2

what is the rough pathogenesis of peptic ulcers

Answer 2

increased acid secretion 
decreased bicarbonate production
decreased thickness of mucosal layer 
decreased mucosal blood flow 
H.pylori

Question 3

what are the risk factors for peptic ulcers

Answer 3

genetic
stress
diet, alcohol, smoking
NSAIDs

Question 4

what drug classes are used to treat peptic ulcers and what do the drugs do

Answer 4

antibiotics (eliminate H.pylori - amoxicillin, clarithromycin, metronidazole)
proton pump inhibitors (irreversible inhibition of H?K ATPase)
histamine type 2 receptor antagonists (inhibit gastric acid secretion from parietal cells by 60%)
cyto-protective drugs (promote healing)

triple combination therapy is best