Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

RM - GI Conditions Profile > Peptic Ulcers > Flashcards

Peptic Ulcers Flashcards

1
Q

Define peptic ulcers

A

A breach in the gastrointestinal mucosa as a result of acid or pepsin attack

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What exacerbates the mucosal damage in a peptic ulcer formation?

A

The hyper-acidic environment of the stomach

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What percentage of the population are affected by duodenal ulcers?

A

10%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What type of peptic ulcer is more common?

A

Duodenal (2-3x)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What age of people are peptic ulcers more common in?

A

Elderly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Peptic ulcers are more common in _____ countries

A

Developed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Peptic ulcers are linked with (deprivation/weath)

A

Deprivation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What causes 90% of DUs and 60% of GUs?

A

H. pylori

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the 2 most prevalent causes of peptic ulcers?

A

H. pylori

NSAIDS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What condition/symptom is commonly caused by peptic ulcers?

A

Dyspepsia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the 4 (relatively) minor risk factors for peptic ulcers?

A

Increased stomach acid/duodenal acid load
Smoking
Blood group O
Stress

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What rare condition is associated with the formation of peptic ulcers, and why?

A

Zollinger-Ellison syndrome

Tumour that secretes gastrin (=> increased acid)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Is a family history of peptic ulcers associated with their formation?

A

Yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What risk factors often combine to form a peptic ulcer?

A

Too much acid and damage to mucosa

Increased attack and failure of defence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What thyroid condition are peptic ulcers associated with?

A

Hyperparathyroidism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What kind of pain is a classic feature of peptic ulcer presentation?

A

Recurrent, burning epigastric pain (can radiate to the back)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What kind of pain is very indicative of a peptic ulcer?

A

Pain that can be pointed to with one finger

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

When are the 2 times that DUs are classically painful?

A 
Before eating (relived by eating)
At night (as well as the day)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What percentage of DUs are asymptomatic?

A

50%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is able to relive the pain of both types of peptic ulcers?

A

Antacids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What symptom is often associated with peptic ulcer pain?

A

Nausea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What 2 systemic symptoms are gastric ulcers often associated with?

A

Weight loss

Anaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What does persistent and severe pain in peptic ulcers indicate?

A

Complications such as penetration into other organs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What clinical feature can sometimes be induced/seen in peptic ulcer patients?

A

Epigastric tenderness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What information is needed to help formulate a treatment plan for peptic ulcer patients?

A

H. pylori infection status

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What are the 3 non-invasive tests for H. pylori?

A

Serological testing
Urease breath test
Faecal antigen test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What 2 immunoglobulins are looked for in an H. pylori serology test?

A

IgA, IgG

28
Q

What are the 2 disadvantages of the serology test for H. pylori?

A

Not accurate in older patients

Does not show changes in infection status quickly (1 year) => no use in confirming presence or irradication

29
Q

Describe a Urease Breath Test for H. pylori

A

Ingest urea, then test the CO2 concentration in the breath

30
Q

What 2 medications must be stopped for a H. pylori Urease Breath Test ?

A

PPIs (2 weeks)

Antibiotics (4 weeks)

31
Q

What is the most common method for testing H. pylori infection?

A

Faecal antigen test

32
Q

What 2 things can a H. pylori faecal antigen test be used for?

A

Diagnosis of infection

Monitoring effect of irradication therapy

33
Q

What must be stopped before a H. pylori faecal antigen test?

A

PPIs for 2 weeks

34
Q

What are the 3 invasive tests for H. pylori?

A

Biopsy urease test
Histology
Culture

35
Q

When is a biopsy culture of H. pylori taken?

A

If antibiotic sensitivities need to be determined

36
Q

What should all peptic ulcer patients get as treatment?

A

Anti-secretory therapy

H. pylori test

37
Q

If a <55y/o has a negative H. pylori test, what treatment should be given?

A

Immediate anti-secretory therapy

38
Q

What is required in all >55y/o patients presenting with a peptic ulcer?

A

Endoscopic diagnosis with biopsy (to rule out cancer)

39
Q

What is the investigation for any patient presenting with a possible peptic ulcer, and the presence of an ALARM Symptom?

A

Endoscopy

40
Q

If a patient’s peptic ulcer is not due to H. pylori or NSAIDs, what 2 things should be done?

A

Nutrition advice

Reducing co-morbidities

41
Q

What lifestyle advice is particularly important in the treatment of peptic ulcers?

A

Stop smoking - allow mucosa to heal

42
Q

What is the most common form of H. pylori eradication therapy?

A

Triple therapy for 1 week

43
Q

How effective is triple therapy for H. pylori?

A

85% successful

44
Q

What are the 2 common combinations for H. pylori triple therapy?

A

PPI, Amyoxycillin and clarithromycin

PPI, Metronidazole and clarithromycin

45
Q

What is the advantage and disadvantage of 2 week H. pylori eradication regimens?

A

Better eradication

Poorer compliance

46
Q

When is quadruple therapy used in H. pylor?

A

When culture sensitivities need to be catered to

47
Q

Why is compliance of eradication therapy so poor?

A

Side effects (nausea/diarrhoea) are common

48
Q

What should be done if a peptic ulcer patient is still symptomatic post H. pylori eradication therapy?

A

Retest for H. pylori

49
Q

What are the 2 options for anti-secretory therapy?

A

PPIs or H2RA (H2 receptor antagonists)

50
Q

What type of anti-secretory therapy is better at healing DUs?

A

PPIs

51
Q

What are 2 other, potential treatments for peptic ulcers (DUs)

A

Antacids and sucralfate

52
Q

What are the 2 protocols for DU follow up?

A

If uncomplicated - no need to follow up

If still symptomatic - then follow up

53
Q

What is the post-therapy follow up for GUs?

A

Endoscope 6-8 weeks to ensure healing and no malignancy

54
Q

What are the 5 complications of peptic ulcers?

A

Perforation - breaches peritoneum
Penetration - burrows into adjacent organs
Haemorrhage
Stenosis of gastric outlet/duodenal obstruction
Intractable pain - erodes nerve plexus

55
Q

What condition can occur secondary to a haemorrhage of a peptic ulcer?

A

Anaemia

56
Q

What type of peptic ulcer perforates more commonly?

A

DU

57
Q

What are the 2 causes of gastric outflow obstruction that can occur secondary to a peptic ulcer?

A

Odema around an active ulcer

Scarring due to ulcer healing

58
Q

What are the 2 more common causes of gastric outflow obstruction?

A

Crohn’s or pancreatic tumour

59
Q

What is the classic symptom of gastric outflow obstruction?

A

Vomiting without pain

60
Q

Where are GUs commonly seen?

A

Lesser curvature, near the incisura

Also seen at the oesophago-gastric junction

61
Q

Where are DUs most commonly seen?

A

Duodenal cap

62
Q

What diameter are peptic ulcers?

A

2-10 cm

63
Q

What is characteristic about ulcer edges?

A

Clear, punched out

64
Q

What are the 3 microscopic layers of a peptic ulcer?

A

Necrotic, fibrinopurulent debris
Base - inflamed granulation tissue
Deepest layer - fibrotic scar tissue

65
Q

What 2 genes, expressed by H. pylori, are associated with a greater incidence of peptic ulcers?

A

CagA

VacA

66
Q

What do CagA and VagA induce?

A

IL-8

=> greater immune responce

67
Q

What are the 2 gastric cancers that can occur due to H. pylori?

A

Gastric adenocarcinoma

Gastric B-Cell Lymphoma

RM - GI Conditions Profile (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions