Peptic Ulcers

Question 1

Which type of peptic ulcer is 4 times more common?

Answer 1

Duodenal

Question 2

What is the main cause of PUs?

Answer 2

H.pylori

Question 3

What are the risk factors for PUs?

Answer 3

H.pylori, NSAIDs, smoking, stress, alcohol

Question 4

How would you diagnose a PU?

Answer 4

Upper GI endoscopy

Question 5

What are some differential diagnoses for DUs?

Answer 5

Non-ulcer dyspepsia, duodenal Crohn’s, TB, lymphoma, pancreatic cancer

Question 6

What are some potential complications of PUs?

Answer 6

Bleeding, perforation, malignancy, decreased gastric outflow

Question 7

How do you test for H.pylori?

Answer 7

Urease breath test

Question 8

What lifestyle modifications would you advise?

Answer 8

Weight loss, smoking cessation

Question 9

How would you manage a peptic ulcer?

Answer 9

Stop NSAIDs and/or eradicate H.pylori

Question 10

What drugs eradicate H.pylori?

Answer 10

Clarithromycin/metronidazole + amoxicillin + omeprazole

Question 11

How do gastric ulcers present?

Answer 11

Epigastric pain that’s worse on eating and relieved by antacids

Question 12

How do duodenal ulcers present?

Answer 12

Epigastric pain after meals and at night that’s relieved by eating or milk

Question 13

What drugs can help with peptic ulcers?

Answer 13

NSAIDs, SSRI, Corticosteroids, Bisphosphonates

Question 14

What else can cause peptic ulcers?

Answer 14

Increased acid production, NSAIDs, Mucosal ischaemia