Peptic ulcer disease Flashcards

1
Q

briefly describe what causes peptic ulcer disease

A

a disruption in the balance between the gastric acid and alkaline fluid in the stomach, leads to mucosal injury and formation of peptic ulcers

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2
Q

describe the risk factors for developing peptic ulcers

A

predominantly middle-aged men, NSAIDs, smoking, helicobactor pylori infection, Zolinger-Ellison syndrome

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3
Q

what is the more common type of peptic ulcer disease

A

duodenal ulcer

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4
Q

what does dyspepsia mean and what it is often used to describe

A

means disturbed digestion(indigestion), can also cover nausea/vomiting, bloating/burping, epigastric discomfort

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5
Q

describe what worsens and what relives pain in gastric ulcers

A

epigastric pain worsened by eating(increased HCl production), and eased by antacids + lying flat

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6
Q

describe what relieves epigastric pain caused by duodenal ulcers

A

relieved by eating

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7
Q

describe how a ruptured duodenal ulcer presents

A

rectal bleeding/melaena

melaena = blood in faeces

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8
Q

describe how a ruptured gastric ulcer presents

A

haematemesis

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9
Q

what are gastric ulcers associated with and what is a sign of that association

A

associated with gastric malignancy

sign = Virchow’s node

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10
Q

where is Virchow’s node seen

A

left supraclavicular fossa

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11
Q

what ‘alarm’ symptoms must be asked about when a patient presents with dyspepsia (4)

A

abdominal mass, haematemesis, rectal bleeding/melaena, weight loss

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12
Q

when would a patient presenting with dyspepsia be tested for H. pylori

A

after 1 month of uncomplicated dyspepsia with no relief from antacids or weight loss

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13
Q

what tests can be done for H. pylori

A

breath test or stool antigen

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14
Q

how does the H. pylori test affect pharmacological treatment of peptic ulcers

A

must be done 2-4 weeks since last PPI(protein pump inhibitor)/antibiotic dose

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15
Q

if the H. pylori test is +ve, what is the first line therapy for patients with no penicillin allergy

A

Triple therapy: PPI
+ amoxicillin
+ either metronidazole or clarithromycin

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16
Q

give an example of a PPI(protein pump inhibitor)

A

omeprazole

17
Q

if H. pylori test is +ve, what is the first line therapy for patients with a penicillin allergy

A

Triple therapy: PPI
+ metronidazole
+ clarithromycin

18
Q

how is a ruptured peptic ulcer treated

A

this is an emergency, ABCDE

admit ASAP for surgical treatment