Peptic Ulcer

Question 1

What is the pertinent physiology of peptic ulcer?

Answer 1

mucosal injry and thus peptic ulcer occur when the balance between the aggressive factors and the defensive mechanism is disrupted
aggressive factors such as NSAIDS, h pylori, bile salts, acid, pepsin can alter the mucosal defense by allowing back diffusion of hydrogen ions and subsequent epithelial cell injury

Question 2

What is the pathophysiology of pepticc ulcer?

Answer 2

A break in the gastric or duodenal mucosa that arises when the normal mucosal defensive factors are impaired or are overwhelmed by aggressive luminal factors such as acid and pepsin.
By definition ulcers extend through the muscularis mucosae and are usually over 5 mm in diameter
Ulcers occur five times more commoonly in the duodenum than in the stomach ahwere over 95 percent are in the bulb or pyloric channel

Question 3

What are the three major causes of Peptic Ulcer Disease?

Answer 3

NSAIDS
Chronic H Pylori infection
Acid Hypersecretory States

Question 4

What are the symptoms of PUD?

Answer 4

epigastric pain present in 80-90 percent of patients
typically well localized ot the epigastrium and not severe, described as gnawing, dull, aching, or hunger like
approximately fifty percent of patients report relief of pain with food or antacids with recurrence 2-4 hrs later

Question 5

What are some physical findings of Peptic ulcer disease?

Answer 5

Most patients have symptomatic periods lasting up to several weeks with intervals of mothns to years in which they are pain free
nausea and anorexia may occur with gastric ulcers
mild, localized epigastric tenderness to deep palpation may be present