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210 exam 2 > peptic ulcer disease > Flashcards

peptic ulcer disease Flashcards

1
Q

what are the types of peptic ulcer disease

A

acute or chronic
gastric or duodenal
stress related
medication induced

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2
Q

what is acute peptic ulcer disease

A

superficial erosison
minimal inflmmation
short duration

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3
Q

what is chronic peptic ulcer disease

A

long duration
muscular wall erosion
for many months
more common than acute

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4
Q

when do peptic ulcer delelop

A

only in the presence of acid envionrment

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5
Q

when do stress related mucosal disease happen

A

acute ulcers that develop after major physiologic insult

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6
Q

gastric ulcers are more prevalent in

A

women

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7
Q

peak incidence of gastric ulcers

A

> 50 years of age

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8
Q

gastric secretion in gastric ulcer

A

normal to decreased

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9
Q

when do gastric ulcer pain usually happen

A

1-2 hours after meals

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10
Q

what are risk factors for gastric ulcers

A

H. pylori
medications
bile reflux

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11
Q

when do duodenal ulcers usually occur

A

increase between ages of 35-45 years

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12
Q

H. pylori is found in

A

90-95% of patients

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13
Q

what do increased risk of duodenal ulcers

A 
COPD
cirrhosis of liver
chronic pancreaitis 
hyperparathyroidism 
chronic kidney disease
zollinger ellison syndrome
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14
Q

when does pain start with duodenal ulcers

A

2-5 hours after meal

burning or cramp like

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15
Q

what is the gastric secretion of duodenal ulcer

A

increase

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16
Q

what are the 3 majors complications of ulcers

A

hemorrhage
perforation
gastric outlet obstruction
ALL EMERGENCY SITUATION

17
Q

what is the most common complication of peptic ulcer disease

A

hemorrhage

most lethal complicaiton

18
Q

what do we do with large perforations

A

immediate surgical closure

19
Q

what do we do with small perforation

A

spontaneoulsy seal themselves

20
Q

what are clinical manifestation of perfoartion

A 
sudden onset
pain radiates to back
rigid broadlike abdominal muscles
shallow rapid respirations 
tachycardia weak pulse
bowel sound absent
nausea vomiting
21
Q

bacterial peritonitis may occur within

A

6-12 hours after perforation

22
Q

which diagnostic studies is most accurate

A

endoscopy

23
Q

what are noninvasive tests of H. pylori

A

urea breath test
stool antigen test
serum or whole blood antibody tests

24
Q

who is barium contrast study reserved for

A

people who cannot undergo endoscopy

25
Q

what lab analysis are we looking for with ulcers

A

CBC
liver enzyme studies
serum amylase determination
stool examination of blood

26
Q

what is treatment for ulcer

A 
rest
drug therapy
smoking cessation
dietary modicfication
long term follow up care
27
Q

what is discontinued from recovering from ulcers

A

aspirin and NSAIDS for 4-6 weeks

if receiving low dose aspirin may need long term PPI treatment

28
Q

what is drug therapy for ulcers

A 
PPi
H2R blockers
antibiotics
antacids
anticholinergics
cytoprotective therapy
29
Q

what are examples of PPI

A

esomeprazole

omeprazole

30
Q

what are examples of H2R blockers

A

cimetidine
rantitidine
famotidine
nizatidine

31
Q

with antacids drugs effects on empty stomach last how long

A

20-30 mins

32
Q

with antacids drugs taken after meals last how long

A

3-4 hours

33
Q

when taking antacids we use percautions with

A

older patients
patients with increased BP, heart failure, liver cirrhosis and renal disease because of the increase of sodium preparations

34
Q

magnesium preparations are not to be used with patients with

A

renal failure

35
Q

what is an example of cytoprtective drug therapy

A

sucralfate

36
Q

what are the most common post op complications

A

dumping syndrome
postprandial hypoglycemia
bile reflux gartitis

37
Q

what is dumping syndrom

A

begins 15-30 mins after eating
weakness, sweating, palipitations, dizziness, abdominal cramps, borborygmi, urge to defecate
usually lasts 1 hours

210 exam 2 (9 decks)

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