Püd Flashcards
- What is the most proximal abdominal organ of the digestive tract?
The stomach.
- What are the gross anatomic parts of the stomach?
Fundus
- What are the main arterial supplies to the stomach?
Left gastric artery
- What are the main venous drainages of the stomach?
Left gastric vein
- What is the role of the vagus nerve in stomach innervation?
It affects secretion
- What are the four layers of the gastric wall?
Mucosa
- What are the main functions of the stomach?
Stores food
- What is peptic ulcer disease (PUD)?
Focal defects in the gastric or duodenal mucosa that extend into the submucosa or deeper.
- What causes peptic ulcers?
An imbalance between mucosal defenses and acid/peptic injury.
- What are the main etiologies of peptic ulcer disease?
H. pylori infection
- What is the final common pathway to ulcer formation?
Acid-peptic injury of the gastroduodenal mucosal barrier.
- What percentage of peptic ulcers are duodenal ulcers?
Two-thirds of all peptic ulcers.
- Where are most duodenal ulcers located?
Within the first portion of the duodenum.
- What is the typical size of duodenal ulcers?
Most are less than 1 cm in diameter.
- What is the gender prevalence of duodenal ulcers?
Twice as common in men compared to women.
- What is the relationship between gastric ulcers and cancer?
Gastric ulcers are strongly related to cancer
- What is the typical pain pattern for gastric ulcers?
Pain more commonly occurs with eating.
- What is the most common type of gastric ulcer?
Johnson type I
- What is the acid secretion pattern in Johnson type I gastric ulcers?
Normal or decreased acid secretion.
- What is Johnson type II gastric ulcer associated with?
Active or quiescent duodenal ulcer disease and excess acid secretion.
- What is Johnson type III gastric ulcer?
Prepyloric ulcers
- Where do Johnson type IV gastric ulcers occur?
Near the gastroesophageal (GE) junction.
- What is the acid secretion pattern in Johnson type IV gastric ulcers?
Normal or below normal.
- What are Johnson type V gastric ulcers associated with?
Long-term NSAID use.
- What are the common clinical manifestations of peptic ulcer disease?
Abdominal pain (burning
- What are the common complications of peptic ulcer disease?
Bleeding
- What is the most common complication of peptic ulcer disease?
Bleeding peptic ulcer.
- What are the typical presentations of a bleeding peptic ulcer?
Melena
- What is the first step in managing a bleeding peptic ulcer?
Secure IV line and resuscitate the patient.
- What is the role of endoscopy in managing bleeding peptic ulcers?
Injection with epinephrine
- What is the typical presentation of a perforated peptic ulcer?
Acute abdomen with severe
- What are the stages of perforation in peptic ulcer disease?
Stage of chemical peritonitis
- What diagnostic tests are used for perforated peptic ulcers?
CBC
- What is the treatment for perforated peptic ulcers?
Secure IV line
- What percentage of patients with PUD develop gastric outlet obstruction?
0.05
- What are the typical symptoms of gastric outlet obstruction?
Pain
- What is the treatment for gastric outlet obstruction?
Nasogastric suction
- What is intractable or nonhealing peptic ulcer?
A peptic ulcer that does not heal despite standard treatment.
- What is the role of H. pylori in peptic ulcer disease?
H. pylori is responsible for the majority of cases of PUD.
- What is the role of NSAIDs in peptic ulcer disease?
NSAIDs are a major risk factor for PUD due to their effect on mucosal defenses.
- What is Zollinger-Ellison syndrome (ZES)?
A condition caused by gastrinoma leading to excessive acid secretion and peptic ulcers.
- What is the role of serum gastrin testing in PUD?
To diagnose Zollinger-Ellison syndrome or other conditions causing hypergastrinemia.
- What is the role of endoscopy in diagnosing PUD?
Endoscopy is the gold standard for visualizing ulcers and obtaining biopsies.
- What is the role of H. pylori testing in PUD?
To confirm H. pylori infection
- What is the role of PPI (proton pump inhibitors) in PUD treatment?
PPIs reduce acid secretion
- What is the role of angiography in managing bleeding PUD?
Angiography can be used for embolization to stop bleeding in cases where endoscopy fails.
- What is the role of surgery in PUD?
Surgery is used for complications like perforation
- What is the typical acid secretion pattern in duodenal ulcers?
Increased acid secretion.
- What is the typical acid secretion pattern in gastric ulcers?
Variable acid secretion
- What is the role of histology in diagnosing PUD?
Histology helps differentiate between benign ulcers and malignant lesions