Week 2 Pre-Learning: GI Tract - PUD, Gastritis Flashcards

1
Q

Why does peptic ulcer disease occur?

A
  1. when ulcerative lesions are caused by exposure of the stomach or duodenal mucosa to HCL acid-pepsin secretions
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2
Q

How do peptic ulcers occur? (2)

A
  • GI mucosa is normally protected by mucous containing HCO3- and mucin
  • Ulcers develop when there is excess acid or diminished mucosal defense
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3
Q

What are the most common causes of PUD? (2)

A
  • H. pylori infection
  • NSAID use
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4
Q

Aggressive and defensive factors of PUD diagram

A
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5
Q

What percentage of people with PUD are infected with H. Pylori but do not develop ulcers?

A

up to 90%

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6
Q

What percentage of chronic NSAID users will develop pressure ulcers?

A
  • 20%
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7
Q

What are the risk factors for PUD? (4)

A
  1. Diet - lack of protective foods (fibre, vitamin A)
  2. Smoking
  3. Alcohol
  4. Stress
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8
Q

What is the function of prostaglandins related to ulcers and gastritis? (3)

A
  1. Promotes secretion of bicarb and protective mucus
  2. Suppress secretion of gastric acid
  3. Maintains submucosal blood flow via vasodilation
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9
Q

Why does chronic NSAID use cause PUD? (4)

A
  • NSAIDS suppress prostaglandins, increasing the risk for peptic ulcers and GI bleeding (GIB) by:
    1. Decrease in that protective mucous production and decrease in neutralizing bicarb
    2. Increased production of gastric acid
    3. Decreased blood flow to the GI submucosa due to vasoconstriction
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10
Q

What are the symptoms of PUD? (2)

A
  • can be asymptomatic
  • pain is described as burning
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11
Q

What is a symptom for gastric ulcers?

A
  • gaseous in epigastric area 1-2 hours after eating
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12
Q

What is a symptom for duodenal ulcers?

A

cramp-like in midepigastric or back pain, 2-4 hours after eating

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13
Q

What are three complications of PUD?

A
  • Hemorrhage
  • Perforation
  • Gastric outlet obstruction
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14
Q

What is a hemorrhage caused by?

A
  • due to erosion of granulation tissue at base of ulcer (more common in duodenal ulcer)
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15
Q

What are symptoms of a hemorrhage? (3)

A
  • hematemesis
  • Melena
  • occult bleeding
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16
Q

What is a perforation in relation to PUD?

A
  • ulcer penetrates serosal surface and gastric/duodenal contents enters peritoneal cavity (peritonitis)
17
Q

What is a gastric outlet obstruction?

A
  • Ongoing inflammation can cause obstruction of gastric outlet
18
Q

What are the symptoms of a gastric outlet obstruction? (2)

A
  • belching
  • projectile vomiting
19
Q

What is gastritis?

A
  • Inflamed stomach mucosa with significant risk of GI bleeding (especially in hospitalized patients)
20
Q

What are the causes of gastritis? (5)

A
  • alcohol
  • NSAIDS
  • H. Pylori
  • Crohn’s disease
  • stress (ie. major surgery)
21
Q

What are the clinical manifestations of gastritis? (5)

A

often asymptomatic but can have:
- anorexia
- N+V
- Epigastric tenderness
- feeling of fullness

22
Q

What are complications of gastritis?

A

bleeding

note that gastritis does not mean you will have PUD