Dyspepsia + Peptic Ulcers Flashcards Preview

Gastrointestinal > Dyspepsia + Peptic Ulcers > Flashcards

Flashcards in Dyspepsia + Peptic Ulcers Deck (12):
1

What is Dyspepsia?

Epigastric pain or burning.

2

What are the two categories of causes of Dyspepsia?

Organic - 25%
(e.g. Peptic ulcer disease, Drugs (NSAIDs, COX2 inhibitors), gastric cancer)
Functional - 75%
(e.g. idiopathic, associated with IBS etc.)

3

On examination what would you find in uncomplicated and in complicated Dyspepsia?

Uncomplicated - Tenderness only.

Complicated - Cachexia, mass, evidence of gastric outflow obstruction, peritonism

4

For treatment of Dyspepsia what are the Alarm features that would cause you to send the patient to a specialist?

Dysphagia
Evidence of GI blood loss
Recurrent vomiting
Unexplained weight loss
Upper abdominal mass

5

What should you consider in uncomplicated dyspepsia?

Lifestyle changes
Antacids

6

If symptoms persist after lifestyle consideration and antacid use what is the next move?

H. pylori test.
If positive then eradicate

7

After H. pylori is negative or eradicated then consider the patients age, what would happen now?

>54 see a specialist

8

How would you diagnose an infection of H.pylori?

Urease breath test
Biopsy - histology, culture/sensitivity
Faecal antigen test

9

What is the treatment of Peptic ulcer Disease?

PPI
Test for H.pylori
- (if +ve - Eradicate and confirm)
- (if -ve - Antisecretory therapy)
Withdraw NSAIDs
lifestyle change

For non-Hp/NSAID ulcers - Nutrition and optimise comorbidities

10

In the treatment of H.pylori infection what would be the commonest drugs used in week 1?

PPI + Amoxycillin + Clarithromycin
(or)
PPI + Metronidazole + Clarithromycin

11

What are the complications of peptic ulcer disease?

Anaemia
bleeding
perforation
gastric outlet/duodenal obstruction - fibrotic scar

12

What would you do to follow up treatment for a Gastric Ulcer?

Endoscopy at 6-8 weeks to ensure healing and no malignancy.