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INCO 2 > PUD > Flashcards

PUD Flashcards

1
Q

Impairment on the mucosa & deeper structure of esophagus, stomach & duodenum

A

Peptic ulcer disease

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2
Q

Main cause

A

Infection( Helicobacter pylori) - due to eating raw or improperly cooked meat

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3
Q

Patho of PUD

A

Increased action of aggressor or decreased action of protector( mucus)

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4
Q

What are the aggressors

A

HCL + pepsin ( increases secretion when stressed or presence of stimulants

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5
Q

Gastric lining protector

A

Mucus( decreases when there is decreased blood flow: vasoconstriction and presence of irritants)

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6
Q

Predisposing factors( 12) SCCGG-DAZ-FITT

A

Stress
Cigarette smoking
Coffee
Genetics
Gastritis
Drugs ( SAN)
Alcohol
Zollinger-Ellison syndrome
Fatty, spicy, highly acidic foods
Irregular, hurried meals
Type O blood
Type A personality

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7
Q

Stress triggers what?

A

Triggers SNS, if prolonged-> SNS exhausted causing activation of PNS: increases gastric motility & hyper-secretion of HCL

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8
Q

What factors causes vasoconstriction

A

Cigarette smoking
Alcohol
Caffeine

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9
Q

These drugs are ulcerogenic

A

Steroids, aspirin, NSAIDS ( should be taken with food)

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10
Q

Caused by pancreatic tumor( gastrinoma) stimulating gastric secretion: HCL

A

Zollinger- Ellison syndrome

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11
Q

Caused by repressed dependency needs

A

Type A personality ( stress personality)

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12
Q

Characteristics of Type A personality (6)

A

Over consciousness
Workaholism
Inability to concentrate in 1 task
Perfectionism
Parsimoniousness
Very punctual

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13
Q

Seen in Type 0 blood

A

High pepsinogen levels
- pepsinogen is activated into pepsin : HCL+ pepsin( aggressor)

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14
Q

How generics a factor in PUD

A

They have higher parietal cell mass
- parietal cells produce HCL

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15
Q

Other name of gastric ulcers

A

Poor man’s or laborers ulcer

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16
Q

Incidence of gastric ulcer

A

20% : 50 and above (older pips usually lose interest in food)

17
Q

Patho of gastric ulcer

A

Normal HCL secretion: there is decreased back diffusion of HCL into gastric mucosa

18
Q

This ulcer has normal gastric emptying & normal HCL secretion

A

Gastric ulcer

19
Q

Other name of duodenal ulcers

A

Executive ulcer

20
Q

Cause is primarily stress-related

A

Duodenal ulcers

21
Q

Incidence and age of duodenal ulcers

A

80%( 25-50: stressful years)

22
Q

Affects malnourished individuals

A

Gastric ulcers

23
Q

Usually happens in well-nourished individuals

A

Duodenal ulcers

24
Q

There is increased HCL secretion

A

Duodenal ulcers

25
Similarities of gastric and duodenal ulcers
Both have dull, aching, gnawing epigastric hunger-like pain
26
Pain that radiates to the left side of the abdomen
Gastric ulcer
27
Pain radiates on the right side
Duodenal
28
In gastric ulcer, pain is experienced how many hours after or during eating/meals
30min- 2hours - pain not relived by food but worsens it
29
S/sx of gastric ulcer
Nausea Hematemesis ( vomit w/ blood)
30
Complications of gastric ulcer
Hemorrhage & perforation
31
Duodenal ulcer pain occurs how many hours after eating? And why?
3-4 hours after eating - depending on food taken, the acidic chyme empties to the duodenum causing irritation to the exposed nerve ending in the duodenum.
32
Pain is relived by food
Duodenal ulcer
33
In duodenal ulcer pain is commonly experienced between
12 midnight and 3:00 AM- REM stage of sleep- time when there is increased acid secretion - this is the peak tune of movement of acidic chyme
34
S/sx of duodenal ulcers
Melena
35
Complication of duodenal ulcers
Obstruction Hemorrhage Perforation/peritonitis
36
Type of complication that is most life-threatening
Hemorrhage- blood loss of 20% (1,000 mls) is fatal leading to hypovolemic shock
37
S/sx in older adult with PUD: WADC
weight loss Anemia Dysphagia Chest pain
38
Diagnosis of PUD
1. Upper GI series 2. Gastrectomy/endoscopy- to identify inflammatory changes, ulcers & lesions 3. Biopsy specimen- presence of H.pylori 4. Gastric analysis- to diagnose achlorhydria & ZES 5. Physical examination

INCO 2 (6 decks)

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