2.04

Question 1

PUD Causes

Answer 1

H.Pylori (50% cases)
NSAIDs
Zollinger-Ellison syndrome

Question 2

Non-invasive H.pylori tests

Answer 2

C-13 breath test
Serological test (IgG)
Stool antigen

Question 3

Invasive H.Pylori tests

Answer 3

Urease test (via biopsy)
Histology (via biopsy)
Culture (via biopsy)

Question 4

PUD Ix

Answer 4

*Endoscopy * (definitive Ix)

Obs
H.pylori testing
ECG
FBC
LFTs
Amylase/Lipase

Question 5

Zollinger-Ellison pathophys

Answer 5

Gastrinoma
- Produces gastrin
Increases gastric acid production

Question 6

H.pylori PUD pathophys

Answer 6

Colonises antrum (least acidic)
- secretes urease - converts urea to ammonia
- pH rises around receptors - increases GA production

Question 8

PUD general clinical features

Answer 8

Epigastric pain
Dyspepsia
Haematemesis
Melena
Anaemia symptoms

Question 9

Types of Peptic ulcers

Answer 9

Duodenal
Gastric

Question 10

Duodenal ulcers CFs

Answer 10

Pain, day and night
Worse when hungry
Subsides after eating
Relieved w/ antacids

Question 11

Duodenal ulcer complication

Answer 11

Rupture
- Posterior ulcers will bleed from gastroduodenal artery

Question 12

Gastric ulcer CFs

Answer 12

Epigastric pain (worse after meal)
Anorexia & weight loss

Question 13

1st line H.Pylori eradication therapy

Answer 13

7 day course
- PPI
- Amoxicillin
Clarithromycin/Metronidazole

If allergic to penicillin:
- PPI
- Clarithromycin
- Metronidazole