Peptic Disease/Gastritis Flashcards
Ranitidine= H2 antagonist
Note that there is much more H. pylori in eastern europe
What is the Ddx?
What is a peptic ulcer?
A discontinuity that occurs in the Gi epithelium that is exposed to acid and pepsin, most commonly in the stomach or duodenum
T or F. You cannot distinguish a gastric from duodenal peptic ulcer based on the pts. symptoms
T.
What parts of this mans Hx favor peptic ulcer over functional dyspepsia?
- localized pain to the epigastrium
- waking the pt. at night
- helps by eating (pain with functional dyspepsia usually get worse with eating)
- helps with acid suppressing meds. (also true of functional dyspepsia)
- the intermittent nature of the pain (chronic, every-day pain would be highly uncharacteristic of peptic ulcer)
T or F. The pain of peptic ulcer typically waxes and wanes
T. Not constant like in functional dyspepsia
Functional dyspepsia is much more common today!
What is ‘dyspepsia’?
really more of a symptom than a diagnosis- can be interchanged with indigestion, but it is a localized pain/burning in the upper abdomen
T or F. With a diagnosis of functional dyspepsia, the normal anatomy of the GI will be normal and functioning properly
T. It is more idiopathic
Want to know about OTC pain meds
Being from eastern europe (and east asia, south america)= H. pylori risk
Endoscopy too expensive
Barium X-ray pretty hardcore- endoscopy better
Gall bladder might be bad
H. pylori can be checked at the time of endoscopy or via blood draw
Youre not expecting to feel a peptic ulcer on abdominal exam
Pointing sign= can the pt. point to the source of pain with 1 finger. If they can, increased likelihood of peptic ulcer
Note that a positive test for H. pylori means hes been infected at some pt. and he may/may not still have it.
Most H. pylori infections are acquired pediatrically (first 6-7 yrs of life) and highly unlikely to be acquired after. These infections manifest during adulthood, however.
Children can clear the infection on their own and get re-infected but adults cannot clear the infection alone despite the presence of an immune response
How does H. pylori spread?
- fecal-oral spread
- gastric-oral spread
- mother-child via close contact
Note that for Americans, the incidence of H. pylori infection has continually dropped so that most positive pts. will be older
Endoscopy of pt. 1