Peptic Ulcers

Question 1

Caused by

Answer 1

H. Pylori

Question 2

Clinical

Answer 2

Abd pain and epigastric burn related to meals. Bloating and abd fullness. Changes in appetite (gastric = feeling full with small amt of food; duodenal = need to eat to stop pain). Svr cases leads to Hematemesis and Melena

Question 3

Char

Answer 3

gram neg curved rod/ spiral microaerophile (oxidizes H2 released by other flora); forms biofilms

Question 4

Res

Answer 4

Humans

Question 5

RF

Answer 5

Smoking, alchohol, high stress, obesity

Question 6

Diag

Answer 6

Fecal Ag test (tracks tx; high spec and sense)
Urease Breath Test
Barium swallow
Serology (non diag for acute cases)

Question 7

Treatment

Answer 7

Triple - 2 antibiotics (metronidazole and one other) with proton pump inhib (prilosec) and maybe a cytoprotective agent (peptobismal)

Question 8

Virulence Factors

Answer 8

1. Mucinase - allows colonization of neutral pH area
2. Urease - neuts gastric acid by release of ammonia
3. Heat Shock protein - enhances urease prod (triggered by acid)
4. VacA - vacuolating cytotoxin = apop of gastric epi cells
5. CagA gene product - cytotoxic and increase host IR (Increases Il-8 = chemotactic for immune cells; Increases PAF = hypersecretion of gastric acids)

Not path w/o A’s