Peptic Ulcer

Question 1

Peptic Ulcer Endoscopy Criteria

Answer 1

• Patient over 55 and presenting for first time
• ID anaemia, chronic blood loss, weight loss, progressive dysphagia, persistent vomiting, epigastric mass
• In patients over 55 referral should also be considered if there is: previous gastric ulcer, previous gastric surgery, pernicious anaemia, NSAID use, FHx of gastric carcinoma

Question 2

Peptic Ulcer Ix

Answer 2

-Carbon-13 urea breath test or stool antigen test

Question 3

Peptic Ulcer H. Pylori Positive Management

Answer 3

• Seven day course of PPI and amoxicillin and either clarithromycin or metronidazole
• If penicillin allergic, remove amoxicillin

Question 4

Peptic Ulcer Complications

Answer 4

• Haematemesis/Malaenia associated with erosion of large blood vessel
• Perforation of lecture causes acute abdomen with epigastric pain