Peptic Ulcer

Question 1

What is a Peptic Ulcer?

Answer 1

Damaged lesion of the Gastric/duodenal mucosa where the protective layer has been destroyed

Question 2

Main Causes: (3)

Answer 2

1. Excess acid
2. H.Pylori
3. Lack of mucus

Question 3

Type 1

Answer 3

Polypoid

Question 4

Type 2

Answer 4

Fungating

Question 5

Type 3

Answer 5

Ulcerated

Question 6

Type 4

Answer 6

Infiltrative

Question 7

Who does it affect most?

Answer 7

The elderly

Question 8

Which is more common, duodenal or Gastric?

Answer 8

Duodenal (4 times more common)

Question 9

Main Risk factors: (4)

Answer 9

1. H.Pylori
2. Smoking
3. NSAIDs
4. Reflux

Question 10

Symptoms: (4)

Answer 10

Pain, Weightloss, Pain on eating, Haematemesis

Question 11

What is the main difference from reflux?

Answer 11

Pain on hunger and eating

Question 12

Signs: (6)

Answer 12

Epigastric pain, Anaemia, Malaena, Tachycardia, Tachypnoea, Hypotension (if actively bleeding)

Question 13

Main Differentials: (2)

Answer 13

Non-Ulcer Dyspepsia or Malignancy

Question 14

Investigations (3)

Answer 14

H.pylori stool test, Endoscopy, Ulcer Biopsy

Question 15

Drug Treatment

Answer 15

Triple Therapy with Amoxicillin, Clarithromycin/Metronidazole and PPI

Question 16

Non-Pharmaceutical Treatment

Answer 16

Smoking and alcohol cessation

Stop NSAIDs

Question 17

Complications (3)

Answer 17

Bleeding, Perforation, Malignancy