Peptic ulcer Flashcards
What is the pathophysiology of peptic ulcers?
The stomach mucosa is prone to ulceration from:
Breakdown of protective layer of stomach or duodenum
Increase in stomach acid
There is protective layer compromised by mucus + bicarbonate which is broken down by:
Medications (steroids, NSAIDS)
Bacteria called Helicobacter pylori
Increase acid can be caused by:
Stress
Alcohol
Caffine
Smoking
Spicy food
Presentations of peptic ulcers?
Epigastric discomfort or pain
Nausea and vomiting
Dyspepsia
Iron deficiency anaemia
Bleeding causing haematemesis
Management + diagnosis of peptic ulcers?
Peptic ulcers diagnosed by endoscopy + during it a rapid urease test is done to see if H.pylori is present.
Medical treatment is just high dose of proton pump inhibitor.
Complications of peptic ulcers?
Bleeding from Ulcer
Perforation leading to acute abdomen + peritonitis
Scaring + strictures.
What is difference between gastric and duodenal ulcers?
Gastric:
Less common
Pain is worse on eating
Relieved by antiacids
Duodenal:
More common
Pain is before a meal and at night
Relieved by eating or drinking milk
What is appendicitis?
Inflammation of appendix
Most common cause is obstruction by:
Fecalith ( poop rock)
Undigested seeds
Pinworm infection
Mucus in appendix gets trapped and makes appendix grow and hit visceral nerve fibres causing abdominal pain.
The appendix then gets infected and swell and eventually rupture. Which is why patients can feel peritinitis.
Symptoms + Therapy for appendicitis?
Symptoms:
Fever
Nausea
Vomiting
Complications:
Perforation
Adhesion
Treatment:
Appendectomy is done where surgical removal of appendix is done.
Where is appendix located?
Mcburneys point
Tests for appendicitis?
Blood test:
Raised WWC
Raised GRP
Ultrasound:
Detect inflamed appendix
CT Scan
Pregnancy test to exclude
Urinalysis to exclude UTI
Where will the pain be for appendicitis?
Right illiac fossa
