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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
Q

Similarities of gastric and duodenal ulcers

A

Both have dull, aching, gnawing epigastric hunger-like pain

26
Q

Pain that radiates to the left side of the abdomen

A

Gastric ulcer

27
Q

Pain radiates on the right side

A

Duodenal

28
Q

In gastric ulcer, pain is experienced how many hours after or during eating/meals

A

30min- 2hours
- pain not relived by food but worsens it

29
Q

S/sx of gastric ulcer

A

Nausea
Hematemesis ( vomit w/ blood)

30
Q

Complications of gastric ulcer

A

Hemorrhage & perforation

31
Q

Duodenal ulcer pain occurs how many hours after eating? And why?

A

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
Q

Pain is relived by food

A

Duodenal ulcer

33
Q

In duodenal ulcer pain is commonly experienced between

A

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
Q

S/sx of duodenal ulcers

A

Melena

35
Q

Complication of duodenal ulcers

A

Obstruction
Hemorrhage
Perforation/peritonitis

36
Q

Type of complication that is most life-threatening

A

Hemorrhage- blood loss of 20% (1,000 mls) is fatal leading to hypovolemic shock

37
Q

S/sx in older adult with PUD: WADC

A

weight loss
Anemia
Dysphagia
Chest pain

38
Q

Diagnosis of PUD

A
  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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