Peptic Ulcer Disease

Question 1

definition of dyspepsia

Answer 1

• epigastric pain or burning
• fullness after meals
• bloating

Question 2

what are the red flags

Answer 2

ALARM Symptoms

A - Anaemia
L - Loss of weight
A - Anorexia
R - Recent onset/Progressive
M - Melaena/Haematemesis

S - Swallowing difficulty

Question 3

how is H.pylori infections diagnosed

Answer 3

Faecal antigen test (FAT)
Urease test
Serology

Question 4

treatment for H.pylori

Answer 4

PPI + amoxycillin 1g bd + clarithromycin 500mg bd

Question 5

treatment for H.pylori is penicillin allergic

Answer 5

PPI + metronidazole 400mg bd + clarithromycin 250mg bd

Question 6

what are complications of peptic ulcer disease

Answer 6

anaemia
bleeding
perforation
duodenal obstruction

Question 7

what type of ulcer is relieved by eating or drinking milk

Answer 7

duodenal ulcer

Question 8

what are symptoms of a duodenal ulcer

Answer 8

epigastric plan before meals or at night

Question 9

1st line investigation for duodenal ulcer

Answer 9

test for H.pylori

upper GI endoscopy - stop PPI 2 weeks before

Question 10

what is zollinger-ellison syndrome

Answer 10

excessive acid secretion usually from a gastrin secreting tumour

Question 11

how is zollinger-ellison syndrome diagnosed

Answer 11

by measuring gastrin concentrations (must be off PPI’s)

Question 12

who more commonly gets gastric ulcers and where do they occur

Answer 12

elderly

lesser curve of the stomach

Question 13

what are symptoms of gastric ulcers

Answer 13

epigastric pain - related to meals and/or relieved by antacids
weight loss