H.plyori and PUD Flashcards
when is H.plyori acquired, when do consequences arise
in infancy, consequences arise later in life
what is H.plyori (microbiological description)
Gram -ve flagellated bacillus
what does H.plyori cause
majority of people = nothing
peptic ulcer (in stomach and duodenum)
gastric adenocarcinomas
chronic gastritis
investigations for H.plyori
urease breath test (1st line)
stool antigen
serology (IgG) - not accurate with increasing age
treatment of H.plyori
PPI + amoxycillin 1g bd + clarithromycin 500mg bd (1st line)
PPI + metronidazole 400mg bd + clarithromycin 250mg bd (2nd line)
side effects of H.plyori treatment
(very common)
nausea
diarrhoea
how is H.plyori spread
oral-oral
faececal -oral
what is a peptic ulcer
a breach in the gastrointestinal mucosa due to acid and pepsin attack
what causes peptic ulcers
H.plyori infection
excess acid due to inappropriate control of secretion
NSAIDs
what is the morphological appearance of a peptic ulcer
2-10cm across with clear cut edges
“punched out” appearance
what is the microscopic appearance of peptic ulcers
layer appearance:
base layer = inflamed granulation tissue
floor = necrotic fibrinopurulent debris
deepest layer = fibrotic scar tissue
symptoms of peptic ulcer in STOMACH
dyspepsia
epigastric pain (nocturnal, worse on eating)
vomiting blood
loss of appetite (due to pain)
diagnosis of peptic ulcer
gastric biopsy
H.pylori test (urease breath test)
treatment of peptic ulcer
reduce acid secretion = PPI, H2 histamine receptor antagonist
eradicate H.pylori
complications of peptic ulcer
perforation anaemia penetration haemorrhage stenosi intractable pain