Peptic ulcer disease

Question 1

6 main causes of upper GI bleed

Answer 1

1. peptic ulcer
2. esophagitis
3. gastritis
4. mallory weiss
5. varices
6. malignancy

Question 2

causes of peptic ulcer (3)

Answer 2

1. idiopathic
2. primary - h.pylori
3. secondary

Question 3

secondary causes of ulcer (4)

Answer 3

1. drug toxins (NSAIDs, crack)
2. excess acid
3. stress
4. ischemic/inflammatory

Question 4

where are NSAIDs more likely to effect

Answer 4

stomach

Question 5

2 key mechanisms that NSAID work by

Answer 5

1. direct effect on epithelial lining

2. COX-1 inhibition leads to poor clotting

Question 6

mech of h pylori

Answer 6

1. burrows in stomach
2. produces urease
3. catalyzes urea to bicarb to protect self
4. allows attachement to epi.

Question 7

3 demo graphics of h.pylori

Answer 7

1. community clusters
2. inverse proportion to socioecon status
3. prev increase with age

Question 8

**what is prob with serology test for h pylori

Answer 8

once you have it will always test pos. even when it is eradicated - can’t use for treatment follow-up

Question 9

3 h.pylori phenotypes

Answer 9

1. duodenal ulcer - in antrum
2. simple gastritis - mild througout
3. gastric cancer - fundus and body

Question 10

feat. of duodenal ulcer

Answer 10

high gastrin and acid secretion - acid goes into duod

Question 11

feat of simple gastririts

Answer 11

high gastrin, but normal acid - no sig. clinical outcome

Question 12

feat of gastric cancer type

Answer 12

high gastrin, but low acid - risk of cancer

Question 13

3 gen. factors that influence severity of infection

Answer 13

1. host genes
2. bacterial virulence
3. env. factors

Question 14

4 steps of treatment

Answer 14

1. ABCs - close monitoring
2. stop offending agents
3. endoscopic
4. medical

Question 15

2 principle of med mgmt

Answer 15

1. increase pH - proton pump inhib

2. cytoprotection

Question 16

outcomes if eradicate hpylori

Answer 16

1. GU 97%

22 DU 98%