peptic ulcer disease Flashcards
what are the types of peptic ulcer disease
acute or chronic
gastric or duodenal
stress related
medication induced
what is acute peptic ulcer disease
superficial erosison
minimal inflmmation
short duration
what is chronic peptic ulcer disease
long duration
muscular wall erosion
for many months
more common than acute
when do peptic ulcer delelop
only in the presence of acid envionrment
when do stress related mucosal disease happen
acute ulcers that develop after major physiologic insult
gastric ulcers are more prevalent in
women
peak incidence of gastric ulcers
> 50 years of age
gastric secretion in gastric ulcer
normal to decreased
when do gastric ulcer pain usually happen
1-2 hours after meals
what are risk factors for gastric ulcers
H. pylori
medications
bile reflux
when do duodenal ulcers usually occur
increase between ages of 35-45 years
H. pylori is found in
90-95% of patients
what do increased risk of duodenal ulcers
COPD cirrhosis of liver chronic pancreaitis hyperparathyroidism chronic kidney disease zollinger ellison syndrome
when does pain start with duodenal ulcers
2-5 hours after meal
burning or cramp like
what is the gastric secretion of duodenal ulcer
increase
what are the 3 majors complications of ulcers
hemorrhage
perforation
gastric outlet obstruction
ALL EMERGENCY SITUATION
what is the most common complication of peptic ulcer disease
hemorrhage
most lethal complicaiton
what do we do with large perforations
immediate surgical closure
what do we do with small perforation
spontaneoulsy seal themselves
what are clinical manifestation of perfoartion
sudden onset pain radiates to back rigid broadlike abdominal muscles shallow rapid respirations tachycardia weak pulse bowel sound absent nausea vomiting
bacterial peritonitis may occur within
6-12 hours after perforation
which diagnostic studies is most accurate
endoscopy
what are noninvasive tests of H. pylori
urea breath test
stool antigen test
serum or whole blood antibody tests
who is barium contrast study reserved for
people who cannot undergo endoscopy
what lab analysis are we looking for with ulcers
CBC
liver enzyme studies
serum amylase determination
stool examination of blood
what is treatment for ulcer
rest drug therapy smoking cessation dietary modicfication long term follow up care
what is discontinued from recovering from ulcers
aspirin and NSAIDS for 4-6 weeks
if receiving low dose aspirin may need long term PPI treatment
what is drug therapy for ulcers
PPi H2R blockers antibiotics antacids anticholinergics cytoprotective therapy
what are examples of PPI
esomeprazole
omeprazole
what are examples of H2R blockers
cimetidine
rantitidine
famotidine
nizatidine
with antacids drugs effects on empty stomach last how long
20-30 mins
with antacids drugs taken after meals last how long
3-4 hours
when taking antacids we use percautions with
older patients
patients with increased BP, heart failure, liver cirrhosis and renal disease because of the increase of sodium preparations
magnesium preparations are not to be used with patients with
renal failure
what is an example of cytoprtective drug therapy
sucralfate
what are the most common post op complications
dumping syndrome
postprandial hypoglycemia
bile reflux gartitis
what is dumping syndrom
begins 15-30 mins after eating
weakness, sweating, palipitations, dizziness, abdominal cramps, borborygmi, urge to defecate
usually lasts 1 hours
