Lesson 3 Flashcards

1
Q

List the diagnostic methods for peptic ulcer diseases

A
  • Barium swallow
  • Endoscopy
  • Endoscopic biopsy
  • Haemoglobin in blood
  • Fecal occult blood test
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2
Q

Barium swallow

A

The patient will drink barium.

  • Coats the upper GIT and provides contrast
  • Allows us to better visualise the stomach and small intestine on X-rays
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3
Q

Endoscopy

A

A thin, lighted tube is introduced to the stomach and first part of the small intestine through the mouth

It is used to visualise ulcers, bleeding and any other tissue abnormalities

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4
Q

Endoscopic biopsy

A

Basically a guided biopsy allowing us to obtain a tissue sample to be analysed in the lab

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5
Q

Haemoglobin analysis

A

We analyse the presence of blood haemoglobin in the cases of anaemia which may be faced due to atrophic gastritis

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6
Q

Peptic ulcer protective factors

A

Mucous: has water, electrolytes and glycoproteins that cover and protect the mucosa from gastric acid secretions

Bicarbonate: Is able to penetrate the mucous, preventing the contact of the gastric mucosa with corrosive substances

Prostaglandins: promote the secretion of mucous and bicarbonate

High cell turnover: refers to the ability of gastric stem cells to repair and regenerate damaged tissue

High localised blood supply

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7
Q

Aggressive factors:

A

Helicobacter pylori and NSAIDs

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8
Q

Helicobacter pylori intro

A
  • G(-), flagellated bacterium w/ a special tropism for gastric mucosa
  • Person-person transmission: oral-oral or oral-fecal
  • Able to survive in harsh surroundings (low pH)
  • Produce ureases: generate NH3 that neutralise the HCl and damage epithelial cells
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9
Q

Helicobacter pylori significance in peptic ulcer disease

A
  • Promotes chronic gastritis, and
  • Up to 15% of infected individuals develop peptic ulcer
  • Present in over 50 % of patients with peptic ulcer, and is considered the primary risk factor for its development
  • Generates chemotactic factors for neutrophils and monocytes
    that contribute to gastric mucosal lesion and ulcer development,
  • Can alter mucus and bicarbonate production and
    increase hydrochloric acid levels.
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10
Q

H. Pylori eradication treatments, triple

A
  • Clarithromycin + amoxicillin + PPI
  • Clarithromycin + metronidazole + PPI
  • Levofloxacin + amoxicillin + PPI
  • Rifabutin + amoxicillin + PPI
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11
Q

H. Pylori eradication treatments, quadruple

A

Bismuth + metronidazole + tetracycline + PPI

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12
Q

H. Pylori eradication treatments, sequential

A

Amoxicillin + PPI for 5 days

followed by

Clarithromycin + metronidazole + PPI for 5 days

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13
Q

Diagnostic tests for H.pylori

A

Detection of antibodies in the blood to show that there has been an infection

Urea breath test

Detection of antigens in the stool supports diagnosis before and after treatment

Endoscopic biopsy of the gastric and duodenal lining for further analysis.

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14
Q

Aggressive factors, NSAIDs

A
  • Widespread medication

It’s side effects involve gastric disturbances:
- Minor symptoms: Nausea and dyspepsia

  • Serious complications: complicated or not
    peptic ulcer

Can also produce mucosal damage directly due to their local
effects through their inhibition of prostaglandin production

Consequences:
- Decrease in epithelial secretion of mucus and bicarbonate

  • Decreased mucosal blood flow, mucosal proliferation and impaired resistance to peptic
    damage
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