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Flashcards in H.plyori and PUD Deck (20)
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1
Q

when is H.plyori acquired, when do consequences arise

A

in infancy, consequences arise later in life

2
Q

what is H.plyori (microbiological description)

A

Gram -ve flagellated bacillus

3
Q

what does H.plyori cause

A

majority of people = nothing
peptic ulcer (in stomach and duodenum)
gastric adenocarcinomas
chronic gastritis

4
Q

investigations for H.plyori

A

urease breath test (1st line)
stool antigen
serology (IgG) - not accurate with increasing age

5
Q

treatment of H.plyori

A

PPI + amoxycillin 1g bd + clarithromycin 500mg bd (1st line)

PPI + metronidazole 400mg bd + clarithromycin 250mg bd (2nd line)

6
Q

side effects of H.plyori treatment

A

(very common)
nausea
diarrhoea

7
Q

how is H.plyori spread

A

oral-oral

faececal -oral

8
Q

what is a peptic ulcer

A

a breach in the gastrointestinal mucosa due to acid and pepsin attack

9
Q

what causes peptic ulcers

A

H.plyori infection
excess acid due to inappropriate control of secretion
NSAIDs

10
Q

what is the morphological appearance of a peptic ulcer

A

2-10cm across with clear cut edges

“punched out” appearance

11
Q

what is the microscopic appearance of peptic ulcers

A

layer appearance:

base layer = inflamed granulation tissue
floor = necrotic fibrinopurulent debris
deepest layer = fibrotic scar tissue

12
Q

symptoms of peptic ulcer in STOMACH

A

dyspepsia
epigastric pain (nocturnal, worse on eating)
vomiting blood
loss of appetite (due to pain)

13
Q

diagnosis of peptic ulcer

A

gastric biopsy

H.pylori test (urease breath test)

14
Q

treatment of peptic ulcer

A

reduce acid secretion = PPI, H2 histamine receptor antagonist
eradicate H.pylori

15
Q

complications of peptic ulcer

A
perforation
anaemia
penetration 
haemorrhage
stenosi
intractable pain
16
Q

what drugs could be prescribed in peptic ulcers

A

PPI = omeprazole
H2 histamine receptor antagonist = ranitidine
eradicate H.pylori = PPI + amoxycillin 1g bd + clarithromycin 500mg bd (1st line)

PPI + metronidazole 400mg bd + clarithromycin 250mg bd (2nd line)

17
Q

what is the treatment of gastric ulcer

A

reduce acid secretion = PPI, H2 histamine receptor antagonist
eradicate H.pylori
follow up = endoscopy at 6/8 weeks

18
Q

what causes chronic ulcers

A

failure of mucosal defence

19
Q

give examples of NSAIDs

A

aspirin

ibuprofen

20
Q

symptoms of peptic ulcers in the DUODENUM

A

dyspepsia
epigastric pain (relived by eating but will occur 4-6hrs after meal)
blood in stool (melena)
vomiting/nausea