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Finals: Medicine > Peptic Ulcer Disease > Flashcards

Peptic Ulcer Disease Flashcards

1
Q

Peptic Ulcer Disease is an umbrella term and refers to which types of ulcers

A

Duodenal and gastric

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2
Q

Which ulcer is the pain worsened by eating

A

Gastric ulcers

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3
Q

Which ulcer is the pain improves by eating

A

Duodenal ulcers

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4
Q

What is the main risk factor for peptic ulcer disease

A

Helicobacter pylori infection.

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5
Q

Helicobacter pylori infection is the main risk factor for peptic ulcer disease.

Name other risk factors

A

NSAID use

smoking

foods and drink that increase acid production e.g. acidic foods, coffee, fatty or spicy foods

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6
Q

What is the gold standard imaging investigation for peptic ulcer disease

A

Upper GI endoscopy

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7
Q

Name the two gold standard investigations for peptic ulcer disease

A

Upper GI endoscopy

testing for H Pylori infection by urea breath test or stool antigen test

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8
Q

What are the 3 classic features of peptic ulcer disease

A

dyspepsia - indigestion

abdominal discomfort

nausea

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9
Q

What is an ulcer

A

a deep break through the full thickness of the epithelium or mucosal surface

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10
Q

What are the most commonly identified aetiological factors of peptic ulcer disease

A

H. pylori infection and history of NSAID use

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11
Q
A
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12
Q

Which is the most common

a) Gastric ulcer
b) Duodenal ulcer

A

b) Duodenal ulcer

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13
Q

Epigastric pain worsened by eating is a feature of :

a) Gastric ulcer
b) Duodenal ulcer

A

a) Gastric ulcer

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14
Q

Epigastric pain relieved by eating is a feature of :

a) Gastric ulcer
b) Duodenal ulcer

A

b) Duodenal ulcer

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15
Q

Epigastric pain wrosened when hungry is a feature of :

a) Gastric ulcer
b) Duodenal ulcer

A

b) Duodenal ulcer

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16
Q

Weight loss is a feature of :

a) Gastric ulcer
b) Duodenal ulcer

A

a) Gastric ulcer

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17
Q

Weight gain is a feature of :

a) Gastric ulcer
b) Duodenal ulcer

A

b) Duodenal ulcer

18
Q

Haematemesis is a feature of :

a) Gastric ulcer
b) Duodenal ulcer

A

a) Gastric ulcer

19
Q

Melaena and coffee ground vomitus is a feature of :

a) Gastric ulcer
b) Duodenal ulcer

A

b) Duodenal ulcer

20
Q

Which peptic ulcer disease is associated with an increased risk of carcinoma

a) Gastric ulcer
b) Duodenal ulcer

A

a) Gastric ulcer

21
Q

Which peptic ulcer disease is aggravated immediately after food

a) Gastric ulcer
b) Duodenal ulcer

A

a) Gastric ulcer

22
Q

Which peptic ulcer disease is aggravated when thte stomach is empty (1-2 hours after a meal)

a) Gastric ulcer
b) Duodenal ulcer

A

b) Duodenal ulcer

23
Q

What aggrevates duodenal ulcers

A

When the stomach is empty (1-2 hours after a meal)

24
Q

Which peptic ulcer disease is alleviated by vomiting or alkali food

a) Gastric ulcer
b) Duodenal ulcer

A

a) Gastric ulcer

25
Q

Which peptic ulcer disease is alleviated by food intake

a) Gastric ulcer
b) Duodenal ulcer

A

b) Duodenal ulcer

26
Q

What two mechanism make the gastric mucosa prone to ulceration

A
  • Breakdown of the protective layer of the stomach and duodenum
  • Increase in stomach acid
27
Q

Breakdown of the protective barrier of the stomach and duodenum can cause peptic ulcer disease.

What two factors can breakdown the protective barrier

A

o Medications e.g. steroids or NSAIDs

o Helicobacter pylori (H.Pylori)

28
Q

Increase in stomach acid can cause peptic ulcer disease.

Name some of the causes of the increase in stomach acid

A

Stress

Alcohol

Caffeine

Smoking

Spicy foods

29
Q

What is the main risk factor of peptic ulcer disease

A

Helicobacter pylori infection

30
Q

What is the second most common risk factor of peptic ulcer disease

A

NSAID use

31
Q

Name some of the risk factors of peptic ulcer disease

A
  • Helicobacter pylori infection - most common cause
  • NSAID use - 2nd most common cause
  • Other medications e.g. SSRIs, chronic steroid use, bisphosphonates
  • Smoking
  • Severe stress
  • Zollinger-Ellison syndrome: rare cause characterised by excessive levels of gastrin, usually from a gastrin secreting tumour
  • Gastric emptying
32
Q

Increase in gastric emptying is a risk factor for which type of peptic ulcer disease

A

Duodenal ulcers

Increased gastric emptying for duodenal ulcers as there is more acid in the duodenum

33
Q

Delayed in gastric emptying is a risk factor for which type of peptic ulcer disease

A

Gastric ulcers

Delayed gastric emptying for gastric ulcers as there is an increase length of time the stomach is exposed to the acid

34
Q

What is the gold standard investigation for peptic ulcer disease

A

Upper GI endoscopy

35
Q

What test can be performed during endoscopy for investigating peptic ulcer disease

A

A rapid urease test can be performed to check for H. pylori

36
Q

What three investigations can be done to test for H.Pylori infection, as part of the workup of peptic ulcer disease

A
  • Rapid urease test - done only using endoscopy
  • Urea breath test
  • Stool antigen test
37
Q

Eradication therapy should be commenced in patients that are Helicobacter pylori positive.

Describe the eradication therapy for H pyolori

A

Eradication therapy is a triple-therapy that comprises: PPI and 2 antibiotics

Typically a 7-day course of oral PPI plus amoxicillin and either clarithromycin or metronidazole

If penicillin allergic, oral PPI plus clarithromycin and metronidazole

38
Q

What is the management of peptic ulcer disease that are H.Pylori negative

A

4-8 weeks of full dose PPI treatment and lifestyle advice, including:

  • Have more regular, smaller meals and eat 4 hours before bed
  • Smoking cessation
  • Avoid foods and drinks that increase stomach acid e.g. acidic foods, coffee, fatty or spicy foods
  • Weight loss
  • Stop causative medications e.g. NSAIDs, steroids, bisphosphonates, potassium supplements, SSRIs and crack cocaine
39
Q

By what mechanism are NSAIDs responsible for causing gastric ulceration?

A

Inhibition of prostagladin secretion

40
Q

Zollinger-Ellison syndrome is most commonly associated with which condition?

A

Multiple Endocrine Neoplasia syndrome

Finals: Medicine (91 decks)

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