Peptic Ulcer Dx

Question 1

Which is more common in men ,duodenal or gastric ulcers?

Answer 1

Duodenal

Question 2

Which is more common in women ,duodenal or gastric ulcers?

Answer 2

Gastric

Question 3

Is mortality rate high for Peptic ulcer

Answer 3

No

Question 4

Main location of peptic ulcers

Answer 4

Oesophagus
Stomach
Duodenum

Question 5

Disease associated with peptic ulcer

Answer 5

Zollinger-Ellison syndrome
Meckel’s diverticulum With ectopic gastric mucosa

Question 6

What is peptic ulcer disease

Answer 6

Breaks in the gastric and duodenal mucosa Due to the corrosive action of pepsin and hydrochloric acid

Question 7

Symptoms of peptic ulcer disease

Answer 7

Abdominal discomfort
pain (Epigastric, does not radiate, Burning or gnawing, Temporary relief with antacids)
nausea

Question 8

Which type of ulcer has worsening of pain When eating With patient presenting with weightloss

Answer 8

Gastric ulcer

Question 9

Which type of ulcer has relief of pain When eating

Answer 9

Duodenal ulcers

Question 10

Two main causes of peptic ulcer disease

Answer 10

Decreased Protective ability of mucosa
Acid hypersecretion

Question 11

Hostile factors leading to peptic ulcer

Answer 11

Gastric acid
H pylori
NSAIDs
Pepsin

Question 12

Protective factors that reduce chances of peptic ulcers

Answer 12

Prostaglandins
Mucus
Bicarbonate
Blood flow

Question 13

Enzyme affected by NSAIDs

Answer 13

COX 2

Question 14

Triad of zollinger Ellison syndrome

Answer 14

Peptic ulcer in unusual location (jéjunum )
massive gastric acid hypersecretion
Gastric producing islet cells tumor of pancreas (gastrinoma )

Question 15

Risk factors of peptic ulcers

Answer 15

H pylori
NSAIDs
Zollinger Ellison syndrome
Hypercalcemia
Genetic factors
Smoking
Stress
Alcohol
Diet

Question 16

Investigations

Answer 16

Barium X ray
Upper GI series
Endoscopy

Question 17

Lab test in patient with recurrent peptic ulcer

Answer 17

Serum gastrin ,Serum calcium - gastrinoma
Histology biopsy of gastric antrum during endoscopy - h . Pylori

Urea Breath tests - h. Pylori
Serologic Elisa for h. Pylori
Stool antigen testing for h pylori

Question 18

Most accurate method to diagnose h pylori

Answer 18

Endoscopic biopsy

Question 19

Treatment

Answer 19

Antacids - H2 antagonists , PPI
Mucosal protection - prostaglandins, sulcrafate
Antibiotics - h pylori

Question 20

Complications of ulcers

Answer 20

Perforation
Penetration
Hemorrhage
GOO

Question 21

Most common complication of ulcer

Answer 21

Hemorrhage

Question 22

Percentage of ulcer hemorrhage that resolve alone

Answer 22

75-80%

Question 23

Percentage of perforation

Answer 23

5-10%

Question 24

Two forms of perforation

Answer 24

Free perforation leading to acute abdomen
Contained perforation

Question 25

Symptoms of perforation

Answer 25

Severe abdominal pain Epigastrium pain worse Nausea Vomiting Acute illness

Question 26

Most common site of penetration

Answer 26

Pancreas

Question 27

Type of ulcer that lead to GOO

Answer 27

Duodenal ulcers

Question 28

GOO symptoms

Answer 28

Nausea vomiting Epigastric pain Epigastric Fullness