wk 3 13 dyspepsia and peptic ulcer

Question 1

3 things which define dyspepsia

Answer 1

epigastric pain/burning 
postprandial fullness (post meal)
early satiety (early fullness)

Question 2

t/f dyspepsia increases if infected with h.pylori

Answer 2

true

Question 3

NSAID use reduces dyspepsia t/f

Answer 3

false

increases

Question 4

3 organic causes of dyspepsia

Answer 4

peptic ulcers
drugs (NSAIDS,COX2 inhibitors)
gastric cancer

Question 5

idiopathic is the majority cause of dyspepsia

Answer 5

true

Question 6

likley found on examination for uncomplicated dyspepsia

Answer 6

epigastric tenderness only

Question 7

if complicated, waht would be expected to be found

Answer 7

cachexia (wasting)
mass
evidence gastric outflow obstructionv(vomiting)
peritonism

Question 8

other than dyspepsia, what coould be associated with ‘indigestion’

Answer 8

heart
liver
gall bladder
pancreas
bowel
drugs - NSAID
heartburn (reflux)

Question 9

other than physical signs, wwhat can cause dyspepsia

Answer 9

genetic
psychosocial
visceral hypersensitivty

Question 10

outlline characteristics of peptic ulcer disease

Answer 10

pain predominant dyspepsia (to back)
often nocturnal 
aggregvated/relieved by eating (depends where) 
relapsing/remitting chronic illness
more common in lower socio-economic 
family history common

Question 11

t/f h.pylori causes 90% of gastric ulcers

Answer 11

false - 90% of Duodenul Ulcers

60% of gastric ulcers

Question 12

other than h.pylori, what can cause peptic ulcer

Answer 12

NSAIDS

Question 13

h.pylori is transmitted

Answer 13

oral-oral/ faecal oral spread

acquired in infancy, consequences of infection do not arise until later in life

Question 14

t/f h.pylori can cause cancer

Answer 14

true

1%

Question 15

food increases pH, what does this cause

Answer 15

g cells to produce gastrin

stimualtes parietal produces acid- lowers pH

Question 16

how would chronic gastric atrophy

Answer 16

thin sheet, no folds

Question 17

h.pylori infection diagnosis

Answer 17

FAT (faecal antigen test) - main

gastric biopsy
urease test

carbon urea breath test (not used as much)
histology
culture

Question 18

treatment of PUD

Answer 18

antisecretory therapy (PPI)
test for h.pylori
if +ve - eradicate and confirm

if -ve 
withdraw NSAIDS
lifestyle
non-HP/non-NSAID ulcers - nutrition 
surgery infrequent

Question 19

eradication therapy of H.pylori

Answer 19

triple 1 week

- PPI+amoxicillin 1g bd (metronidazole 400mg bd) + clarithromycin 500mg bd

Question 20

complications of peptic ulcers

Answer 20

anaemia
bleeding
perforation
fibrosis - obstruction q

Question 21

t/f uncomplicated DU requires no follow up

Answer 21

true

only if ongoing symptoms

Question 22

GU requires follow up t/f

Answer 22

true ]higher gstric cancer chance

endoscopy 6-8 weeks