Peptic Ulcer Disease Flashcards

1
Q

What is PUD?

A

Full thickness ulcerations of duodenal / gastric mucosa.

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2
Q

How do PUD ulcers form?

A

When exposure to acid + digestive enzymes overcomes mucosal defense mechanisms

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3
Q

What are the risk factors for PUD? (4 things)

A
  1. H pylori
  2. NSAIDs
  3. SSRIs
  4. Corticosteroids
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4
Q

What is stomach mucosa prone to ulceration from? (2 things)

A
  1. Breakdown of protective layer of stomach + duodenum
  2. Increase in stomach acid
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5
Q

What is the protective layer of the stomach comprised of? (2 things)

A
  1. Mucus
  2. Bicarbonate
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6
Q

What can the protective layer of the stomach be broken down by? (2 things)

A
  1. Medications (e.g steroids / NSAIDs)
  2. Helicobacter pylori
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7
Q

What can an increase in stomach acid be caused by? (5 things)

A
  1. Smoking
  2. Stress
  3. Caffeine
  4. Alcohol
  5. Spicy foods
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8
Q

What are the CF of PUD? (5 things)

A
  1. Epigastric discomfort / pain
  2. Nausea + vomiting
  3. Dyspepsia
  4. Bleeding –> haematemesis + coffee ground vomiting + melaena
  5. Iron deficiency anaemia (bc constant bleeding)
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9
Q

What does eating do to the epigastric pain of gastric VS duodenal ulcers?

A

Gastric ulcers = eating worsens pain
Duodenal ulcers = eating relieves pain (pain when hungry)

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10
Q

What is the best diagnostic test for PUD?

A

OGD endoscopy

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11
Q

What should be done during endoscopy for sus PUD? (2 things)

A
  1. Rapid urease test to check for H pylori
  2. Biopsy (to exclude cancer)
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12
Q

What is the management in H pylori NEGATIVE PUD?

A

PPI

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13
Q

What is the management in H pylori POSITIVE PUD?

A

Eradication therapy
(Triple therapy of PPI + 2 abx including amoxicillin)

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14
Q

What are the complications of PUD? (2 things)

A
  1. Perforation
  2. Bleeding
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