Peptic Ulcers Disease Flashcards
what causes peptic ulcers?
breakdown of protective layer and increase in stomach acid
what breaks down protective layer?
NSAIDs steroids and H pylori
what can cause an increase in acid?
alcohol, caffeine stress, smoking and spicy foods
what is the presentation of peptic ulcers?
dyspepsia, nausea, vomiting, haematemesis, melaena, epigastric pain, iron deficiency anaemia, hypotension and tachycardia
how are gastric and duodenal ulcers different?
duodenal- improve with eating
gastric- worsen with eating
how are peptic ulcers diagnosed?
endoscopy- you can also do a a rapid urease test
treatment of peptic ulcers?
high dose PPI
complications of peptic ulcers?
bleeding, perforation, peritonitis, scarring and strictures
which artery is the complication of peptic ulcer bleeding?
gastroduodenal
what is first line treatment for peptic ulcer acute bleeding?
endoscopic intervention if this fails, urgent interventional angiography with transarterial embolisation or surgery
what can happen in perforation?
epigastric pain will become more generalised, patient may describe syncope
what to request in acute upper abdomen if fear of perforation?
air under diaphragm
what other things are associated with peptic ulcers?
corticosteroids, SSRIs, bisphosphonates, Zollinger Ellison- excessive levels of gastrin from a gastrin secreting tumour
30% of zollinger ellison syndrome occurs part of?
MEN I type syndrome
features of zollinger ellison syndome?
gastroduodenal ulcers, diarrhoea, malabsorption
