Stomach Flashcards
What are the four regions of the stomach?
Fundus
What are the two sphincters in the stomach?
Pyloric sphincter
What are the four layers of the stomach wall?
Mucosa
What is the definition of a peptic ulcer?
A break in the lining of the mucosa ≥5 mm with submucosal extension.
What is the difference between an ulcer and an erosion?
Ulcer ≥5 mm
What are the four types of gastric ulcers?
Type I (body)
What is the most common cause of peptic ulcer disease (PUD)?
Helicobacter pylori (H. pylori) infection.
What percentage of H. pylori-infected individuals develop peptic ulcers?
10-15%.
What is the role of H. pylori in gastric cancer?
It increases the risk of gastric adenocarcinoma.
What is the prevalence of H. pylori infection in the population?
~80%.
What is the primary mechanism of NSAID-induced gastric damage?
Inhibition of prostaglandin synthesis (COX-1 inhibition).
What are the two COX isoforms?
COX-1 (protective)
What is the most common symptom of peptic ulcer disease?
Epigastric pain
What is the gold standard for diagnosing peptic ulcers?
Esophagogastroduodenoscopy (EGD).
What is the purpose of taking biopsies during EGD for gastric ulcers?
To rule out malignancy.
What are the three main complications of peptic ulcer disease?
Bleeding
What is the most common complication of PUD?
Gastrointestinal bleeding (15% of cases).
What is the mortality rate of ulcer-related hemorrhage?
5-10%.
What is the second most common complication of PUD?
Perforation (6-7% of cases).
What is gastric outlet obstruction?
A complication of PUD causing nausea
What is the treatment goal for H. pylori-related ulcers?
Eradication of H. pylori to prevent recurrence.
What is the first-line treatment for H. pylori infection?
Triple therapy (PPI + two antibiotics).
What is the role of proton pump inhibitors (PPIs) in PUD?
They inhibit gastric acid secretion by blocking H+
When should PPIs be taken for maximum effectiveness?
Immediately before breakfast.
What is the duration of PPI therapy for peptic ulcers?
8 weeks for healing.
What is the recommended follow-up for H. pylori eradication?
Noninvasive tests (urea breath test or fecal antigen test).
What is the treatment for NSAID-induced ulcers?
Discontinue NSAIDs and start PPI therapy.
What is the most common cause of upper gastrointestinal bleeding (UGIB)?
Peptic ulcer disease.
What is the management approach for acute UGIB?
Volume resuscitation followed by endoscopy.
What is the role of endoscopic therapy in UGIB?
To control active bleeding (e.g.
What is the mortality rate of perforated ulcers?
High
What is the clinical presentation of a perforated ulcer?
Sudden onset of severe abdominal pain and peritonitis.
What is the treatment for a perforated ulcer?
Surgical repair and PPI therapy.
What is the most common site of duodenal ulcer penetration?
The pancreas.
What is the most common site of gastric ulcer penetration?
The left hepatic lobe.
What is the role of antacids in PUD treatment?
Symptomatic relief
What is the role of mucosal protective agents in PUD?
They enhance mucosal defense (e.g.
What is the most common symptom of gastric outlet obstruction?
Postprandial vomiting.
What is the diagnostic approach to gastric outlet obstruction?
Endoscopy or imaging (e.g.
What is the treatment for gastric outlet obstruction?
Endoscopic dilation or surgery.
What is the most common cause of refractory ulcers?
Persistent H. pylori infection or NSAID use.
What is the role of H2 receptor antagonists (H2RAs) in PUD?
They reduce gastric acid secretion but are less effective than PPIs.
What is the most common endoscopic finding in peptic ulcers?
A well-defined mucosal defect with surrounding inflammation.
What is the most common location for duodenal ulcers?
The duodenal bulb.
What is the most common location for gastric ulcers?
The lesser curvature of the stomach.
What is the role of COX-2 selective NSAIDs in PUD?
They reduce gastric damage compared to non-selective NSAIDs.
What is the most common symptom of H. pylori gastritis?
Asymptomatic
What is the most common complication of chronic H. pylori infection?
Peptic ulcer disease or gastric cancer.
What is the most common cause of stress ulcers?
Critical illness or severe physiological stress.
What is the treatment for stress ulcers?
PPIs or H2RAs for prophylaxis
