Peptic Ulcer Disease Flashcards
(53 cards)
What defines a peptic ulcer?
A break in the mucosal lining ≥5mm with depth at endoscopy or with histologic evidence of submucosal extension.
What defines an erosion in the GI tract?
A break in the mucosa <5mm.
What enzyme is primarily involved in mucosal breaks in PUD?
Pepsin.
What percentage of duodenal ulcers occur within 3 cm of the pylorus?
Approximately 90%.
When do gastric ulcers typically present?
In the sixth decade of life.
What is the most common location for duodenal ulcers?
The first portion of the duodenum (about 95% occurrences here)
Are malignant duodenal ulcers common?
No, they are extremely rare.
Which ulcers can indicate malignancy and should be biopsied?
Gastric ulcers.
Name three levels of the mucosal defense system.
Pre-epithelial, epithelial, subepithelial.
What growth factors mediate epithelial restitution?
EGF, TGF-α, FGF.
Which enzyme is key in prostaglandin synthesis?
Cyclooxygenase (COX).
Which COX isoform is constitutive?
COX-1.
Which COX isoform is inducible by inflammation?
COX-2.
What are common causes of PUD?
H. pylori, NSAIDs, gastrinoma.
Name two viral causes of PUD.
Cytomegalovirus, Herpes simplex virus.
Which infection is the most common cause of PUD?
Helicobacter pylori.
What complication of PUD is most common?
Gastrointestinal bleeding.
What is penetration in PUD?
An ulcer tunneling into an adjacent organ.
Which ulcer penetrates into the pancreas?
Duodenal ulcer.
Which ulcer penetrates into the liver?
Gastric ulcer.
What percentage of patients experience gastric outlet obstruction?
1–2%.
List the alarm features of PUD.
Anemia
Loss of weight / Lymph nodes (Virchow)
Weight loss
Anorexia
Recent onset of progressive symptoms / Relatives with hx of GI cancers
Masses / Melena
Swallowing difficulties-progressive
What is the typical DU pain pattern?
90 mins to 3 hrs post-meal, relieved by food/antacids.
What symptom is more common in GU than DU?
Weight loss.
