Peptic Ulcer Flashcards Preview

Pathophysiology > Peptic Ulcer > Flashcards

Flashcards in Peptic Ulcer Deck (21):
1

What kind of disease is it when you have a Peptic Ulcer?

Ulcerative disease

2

Where do peptic ulcers occur?

Stomach (20%) and Duodenum (80%)

This is because acid buffers are coming through from the pancreas.

3

What layer does it affect mostly and what is the prevalence?

Primarily impacts the mucosa BUT can penetrate.

10% prevalence

Remission and exacerbations

4

Et. of Peptic Ulcer disease

H. Pylori or (Hecilobacter pylori)

Site and adhesion= proteins that attach to the epithelial lining.

5

How do the H. Pylori survive?

H. Pylori make urease which breaks down urea into ammonia and carbon dioxide..this broken down form of urea is a barrier to HCl and neutralizes the acid.

6

Mnfts of Peptic Ulcer disease

Pain, nausea, burning, cramping, vomiting.

7

Complications of Peptic Ulcer disease

Perforation causing Peritonitis

Hemorrhage (occult blood)

Obstruction of the bowel ( d/t edema, spasm or scar tissue from healing)

8

Risk factors of Peptic Ulcer disease

HCl and biliary acid

Chronic gastritis

NSAIDS (too much can cause ulcers)

Caffeine, alcohol and smoking

9

Patho of Peptic Ulcer Disease

Role of H pylori is not clear

Inflammatory mediators
(Infection, inflam, tissue damage)

Hyper-gastrionemia
(increased gastrin, increased acid, tissue damage)

Risk factors impede defences against gastric acid

10

Dx of Peptic Ulcer Disease

Hx
Serology
UBT
Fecal Antigens
Endoscopy
Barium swallow

11

What are we looking for in Serology for suspected Peptic Ulcers?

Antibodies in the blood for H.pylori

12

Describe the UBT

Urea with high concentrations of C14 (radioactive and measurable) are ingested. Once ingested, if H.pylori is present, Carbon levels will rise as urea is being broken down into more carbon molecules. If not, H.pylori is not present.

13

What is the Barium Swallow?

Contrast medium to detect ulcers

14

Tx for Peptic Ulcers

Anti-acids (neutralize the acid, OTC)

Triple regimen. PPI with 2 antibiotics or H2RA with 2 antibiotics.

15

What are some H2RA?

Zantac and Tagamet

16

What does a H2RA do?

It blocks the production of histamine in the parietal cells which decreases the production of acid

17

What are two antibiotics that go with H2RA

Flagyl and Biaxin

18

What does a Proton Pump Inhibitor do?

Blocks the secretion of HCl

19

If complications occur such as (obstruction, perforation and hemorrhage) what treatment should take place?

Surgery

20

How long do you take the triple regimen for?

About 2 weeks

21

What are some examples of a PPI

Losec
Panet
Mexium