peptic ulcer Flashcards

1
Q

what is a peptic ulcer

A

breach of the gi mucosa by acid/pepsin attack

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2
Q

aetiology

A

H pylori
NSAIDs
smoking etc

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3
Q

general symptoms

A
burning epigastric pain
feeling of fullness and nausea 
dyspepsia 
inc acid production 
reflux symptoms
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4
Q

which type is relived by eating or milk

A

duodenal

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5
Q

when does gastric pain come on

A

1-2 hours after eating

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6
Q

when does duodenal pain come on

A

3-4 hours after, before meals or at night

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7
Q

melena seen in

A

duodneal ulcer

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8
Q

haematemesis seen in

A

gastric ulcer - relieved by vomiting

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9
Q

investigations

A

h pylori diganosis

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10
Q

how do we diagnose h pylori

A

stool antigen or C urea breath test

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11
Q

if H pylori is negative

A

endoscopy

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12
Q

what would you stop before endoscopy

A

PPI - 2 weeks before

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13
Q

complications

A
perforation 
penetration 
haemorrhage 
stenosis 
intractable pain
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14
Q

perforation

A

Causes acute abdomen with epigastric or generalised abdominal pain, tenderness, rebound tenderness and guarding that may progress to generalised rigidity.

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15
Q

treatment

A

antacids, H2 antagonists, PPI and h pylori eradication therapy

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16
Q

what if triple therapy doesnt work for h pylori

A

stop PPI for 2 weeks, retest

try metoclopramide or bismuth chelate

17
Q

what are gastric ulcers relieved by

A

vomiting

18
Q

what is bismuth chelate

A

a mucosal strengthener

19
Q

what is metoclopramide

A

a pro kinetic anti emetic

20
Q

what else is metoclopramide used in

A

gastroparesis and after MI