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Year Two - Gastroenterology System > Peptic Ulceration > Flashcards

Peptic Ulceration Flashcards

1
Q

What is the peptic ulceration?

A

It is is defined as a condition in which there is ulceration of the gastrointestinal mucosa

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2
Q

In which two areas of the gastrointestinal tract does peptic ulceration tend to develop?

A

Stomach

Duodenum

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3
Q

What is more common - gastric ulcers or duodenal ulcers?

A

Duodenal ulceration

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4
Q

What are the two general causes of peptic ulceration?

A

Increased secretion of gastric acid

OR

The breakdown of gastrointestinal mucosa

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5
Q

What are the six risk factors of peptic ulceration?

A

Helicobacter Pylori Infection

NSAID Administration

Steroid Administration

Smoking

Alcoholism

Stress

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6
Q

What is the most common risk factor of peptic ulceration?

A

Helicobacter Pylori Infection

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7
Q

What are the five clinical features of peptic ulceration?

A

Epigastric Pain

Nausea & Vomiting

Haematemesis

Abdominal Bloating

Heartburn

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8
Q

Do gastric ulcer features improve upon eating or worsen?

A

Worsen

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9
Q

Do duodenal ulcer features improve upon eating or worsen?

A

Improve

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10
Q

Which two investigations are used to diagnose peptic ulceration?

A

Helicobacter Pylori Testing

Endoscopy + Biopsy

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11
Q

What two tests are used to identify H.Pylori infection?

A

Urea Breath Test

Stool Antigen Test

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12
Q

What is the urea breath test?

A

It involves consumption of a urea containing liquid, which is a chemical broken down by H.Pylori into ammonia and carbon dioxide

After fifteen minutes, the volume of carbon dioxide exhaled is measured

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13
Q

What is a positive urea breath test?

A

Increased volumes of exhaled carbon dioxide

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14
Q

Which two drug classes can reduce the accuracy of the urea breath test?

A

Antibiotics within 4 weeks

Antisecretory drugs, such as PPIs, within 2 weeks

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15
Q

What is a stool antigen test?

A

It involves testing a stool sample for the presence of H.Pylori infection

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16
Q

What is the gold standard investigation used to diagnose peptic ulceration?

A

Endoscopy + Biopsy

17
Q

How is endoscopy, with biopsy, used to investigate peptic ulceration?

A

The endoscopy is used to visualise peptic ulceration

The biopsies are conducted to exclude malignancy

18
Q

What are the five conservative management options of peptic ulceration?

A

NSAID Cessation

Steroid Cessation

Smoking Cessation

Alcohol Cessation

Stress Reduction

19
Q

What are the four pharmacological management options of peptic ulceration?

A

Antacid Drugs

Proton Pump Inhibitors (PPIs)

H2 Receptor Antagonist

Antibiotics

20
Q

Name two antacid drugs used to manage peptic ulceration

A

Gaviscon

Rennie

21
Q

When are antacid drugs used to manage peptic ulceration?

A

They are over the counter medications that patients can be advised to purchase

22
Q

What is the mechanism of action of antacids?

A

They neutralise stomach acid and inhibit pepsin

23
Q

How do antacid drugs treat peptic ulceration?

A

They can be administered to provide temporary symptomatic relief, however, don’t provide resolution of the underlying damage

24
Q

Name two proton pump inhibitors (PPIs) used to manage peptic ulceration

A

Omeprazole

Lansoprazole

25
Q

When are proton pump inhibitors used to manage peptic ulceration?

A

They are the first line management option

26
Q

How do proton pump inhibitors (PPIs) manage peptic ulceration?

A

They inhibit gastric acid secretion by binding to the hydrogen potassium ATPase pump that resides on the luminal surface of the parietal cell membrane

This provides time for the damaged tissue to heal

27
Q

What are the two side effect of PPIs?

A

Hyponatraemia

C.Difficile Infection

28
Q

Name a H2 receptor antagonist used to manage peptic ulceration

A

Ranitidine

29
Q

When are H2 receptor antagonists used to manage peptic ulceration?

A

They are the second line management option

30
Q

How do H2 receptor antagonists treat peptic ulceration?

A

They inhibit gastric acid secretion and by binding to histamine type 2 receptors on the basolateral surface of gastric parietal cells

This provides time for the damaged tissue to heal

31
Q

Name three antibiotics are used to manage peptic ulceration

A

Amoxicillin

Clarithromycin

Metronidazole

32
Q

When are antibiotics used to manage peptic ulceration?

A

When peptic ulceration is related to H.Pylori infection

They are administered in combination with proton pump inhibitors

33
Q

What investigation is used to test effectiveness of H.plorie eradication therapy?

A

Urea Breath Test

34
Q

What are the three complications of peptic ulceration?

A

Gastrointestinal Bleeding

Gastrointestinal Perforation

Gastric Obstruction

35
Q

What investigation is used to diagnose peptic ulcer perforation?

A

Erect CXR

36
Q

What is a feature of peptic ulceration perforation on CXR?

A

Free air under the diaphragm

Year Two - Gastroenterology System (33 decks)

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