Peptic ulcer disease and gastritis Flashcards
What is a duodenal/gastric ulcer?
1 - thickening of mucosal membrane
2 - increased HCL production
3 - a break in the mucosal lining
4 - metaplasia of gastric to duodenal cells
3 - a break in the mucosal lining
- caused by excessive HCL production or lack of mucus production
What is the incidence of gastric/duodenal ulcers in the developed world?
1 - 0.1%
2 - 1%
3 - 10%
4 - 30%
3 - 10%
Are gastric of duodenal ulcers more common?
- duodenal ulcer
Are posterior of anterior duodenal ulcers more common?
- anterior are more common
Which of the following is NOT a common symptom of gastric/duodenal ulcers?
1 - Epigastric pain
2 - Palpitations
3 - Bloating
4 - Satiety
5 - Haematemesis
6 - Malaena
2 - Palpitations
Which of these is NOT a typical presentation of a patient with a peptic ulcer?
1 - epigastric pain when eating
2 - bitter regurgitation/reflux
3 - epigastric pain hours after eating
4 - weight gain due to excessive food to relieve the pain
Which of these is NOT a typical presentation of a patient with a duodenal ulcer?
1 - epigastric pain when eating
2 - episodic waking in early hours
3 - epigastric pain hours after eating
4 - nausea/vomitting
5 - weight loss
3 - epigastric pain hours after eating
What is the most common site for a peptic ulcer in the stomach?
1 - fundus
2 - body
3 - antrum
4 - cardia
3 - antrum
- particularly along the lesser curve
What is the most common site for a duodenal ulcer in the duodenum?
1 - 1st part
2 - 2nd part
3 - 3rd part
4 - 4th part
1 - 1st part
What is Zoillinger-Ellison syndrome?
1 - pancreatic tumour secreting lipase
2 - stomach tumour secreting HCL and pepsin
3 - gall bladder tumour secreting Ca2+
4 - stomach tumour secreting gastrin
2 - stomach tumour secreting HCL and pepsin
- rare condition
- causes widespread peptic ulceration
Although there are a number of causes of peptic/duodenal ulcers, what is the primary cause worldwide?
1 - NSAIDs
2 - smoking
3 - helicobacter pylori
4 - high BMI
3 - helicobacter pylori
The following are all methods for diagnosing helicobacter pylori, but which is the most sensitive?
1 - stool antigen test
2 - endoscopy with biopsy
3 - hydrogen breathe test
4 - serum anti-H.pylori immunoglobulin test
2 - endoscopy with biopsy
- sample must be tested for urease production by the bacteria immediately and histology
One of the tests used to diagnose H. pylori is the CLO test. What is the purpose of this test?
1 - urease is measured in the blood
2 - level of urease is measured in a sample taken from the stomach
3 - the level of urease in a breath test can indicate the presence of H. pylori
4 - all of the above
2 - level of urease is measured in a sample taken from the stomach
- biopsy of stomach is tested
If a patient has been diagnosed with a peptic/duodenal ulcer, order the management plan:
- surgery
- lifestyle change
- PPIs
- H pylori medication
1st - lifestyle change
2nd - PPIs
3rd - H pylori medication
4th - surgery
If an ulcer is actively bleeding what treatment should they receive?
1 - PPI only
2 - endoscopically
3 - lifestyle intervention only
4 - H/ pylori antibiotics with PPI
2 - endoscopically
- this approach is diagnostic and therapeutic
Following an endoscopy to treat an actively bleeding ulcer, how soon will patients receive another oesophago-gastro-duodenoscopy (OGD)?
1 - 4 weeks
2 - 8 weeks
3 - 16 weeks
4 - 6 months
2 - 8 weeks
- important to ensure ulcer is healing properly
Helicobacteria Pylori is the most common cause of peptic ulcers worldwide. This is typically treated with 2 antibiotics and a PPI for 2 weeks. Which of the following is NOT typically 1st line treatment?
1 - Gentamicin
2 - Amoxicillin
3 - Lansoprazole
4 - Clarithroymocin
1 - Gentamicin
If a patient requires surgery for a gastric ulcer, what surgery would be performed?
1 - partial gastrectomy
2 - gastric bypass
3 - Roux-en-y bypass
4 - gastrectomy
1 - partial gastrectomy
- where the ulcer is located
Which cell in the stomach secrete HCL?
1 - chief cells
2 - parietal cells
3 - G cells
4 - I cells
2 - parietal cells
- chief cells secrete pepsinogen and gastric lipase
G cells secrete gastrin
I cells secrete CCK