Peptic ulcers Flashcards

1
Q

What is a peptic ulcer?

A

Ulceration of the mucosa of the stomach (gastric ulcer) OR duodenum (duodenal ulcer)!

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2
Q

Which type of peptic ulcer is more common?

A

Duodenal ulcer

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3
Q

When do duodenal ulcers characteristically cause pain?

A

Worse when hungry –> relieved when eating

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4
Q

When do gastric ulcers characteristically cause pain?

A

When eating!

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5
Q

a) What is the protective layer in the stomach?

b) Where is it excreted?

A

a) Mucus and bicarbonate

b) gastric mucosa (which gets damaged)

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6
Q

What breaks down the protective layer in the stomach? (common causes)

A

(1) NSAIDs or steroids

(2) H.Pylori

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7
Q

What things increase acid production?

A
  • stress
  • alcohol
  • caffeine
  • smoking
  • spicy food
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8
Q

Presentation of peptic ulcer?

A

1) epigastric pain/discomfort
2) dyspepsia
3) N&V
4) bleeding –> haematemesis, ‘coffee ground’ vomit, melaena
5) Iron deficiency anaemia

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9
Q

Diagnosis of peptic ulcer?

A

Endoscopy w/

  • rapid urease test (CLO) for H.Pylori
  • biopsy for malignancy
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10
Q

Management of peptic ulcer disease w/ negative H.Pylori?

A

(As GORD)

  • PPIs (omeprazole) until healed
  • Endoscopy surveillance
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11
Q

4 medications that cause cause peptic ulcers?

A

1) NSAIDs
2) steroids
3) SSRIs
4) bisphosphonates

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12
Q

Most common risk factor for peptic ulcer?

A

Helicobacter Pylori (95% duodenum, 75% gastric)

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13
Q

Management of peptic ulcer disease w/ positive H.Pylori?

A

Triple therapy:

  • 1x PPI
  • 2x antibiotics (amoxicillin + clarithromycin)
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14
Q

1st line investigation to look for H.Pylori?

A

urea breath test OR stool antigen

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15
Q

Complications of peptic ulcers?

A

1) Bleeding - from ulcer
2) Perforation –> ‘acute abdomen’ –> peritonitis!
3) Scarring and strictures (pyloric stenosis!)

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16
Q

Management of perforation of peptic ulcer?

A

Urgent surgical repair (usually laparoscopic)

17
Q

How might pyloric stenosis present given a history of peptic ulcers?

A

Upper abdo pain
Distension
N&V after eating