Peptic Ulcers Flashcards
What is the most common complication of peptic ulcer disease?
Bleeding
Bleeding accounts for around three-quarters of problems in peptic ulcer disease.
Which artery can be a significant source of gastrointestinal bleed in peptic ulcer disease?
Gastroduodenal artery
The gastroduodenal artery can be involved in significant gastrointestinal bleeding.
What is the most common presenting symptom of a bleeding peptic ulcer?
Haematemesis
Haematemesis is the primary symptom observed.
List other features associated with bleeding peptic ulcers.
- Melaena
- Hypotension
- Tachycardia
These features may accompany the bleeding.
What is the first-line treatment for upper gastrointestinal hemorrhage management?
Endoscopic intervention
This is the first approach in managing upper GI bleeding.
If endoscopic intervention fails in peptic ulcer bleeding, what are the next options?
- Urgent interventional angiography with transarterial embolization
- Surgery
Approximately 10% of patients may require these interventions.
What symptoms typically develop suddenly in perforation secondary to peptic ulcer disease?
Epigastric pain
This pain later becomes more generalized.
What might patients experience alongside epigastric pain in perforated peptic ulcers?
Syncope
Patients may describe feeling faint or lightheaded.
What is the first form of imaging recommended for diagnosing perforated peptic ulcers?
Plain x-rays
UptoDate recommends plain x-rays as the initial imaging.
What type of chest x-ray is usually required when a patient presents with acute upper abdominal pain?
Upright (‘erect’) chest x-ray
This test is useful to detect free air under the diaphragm.
What percentage of patients with a perforated peptic ulcer will have free air under the diaphragm?
Approximately 75%
This statistic highlights the effectiveness of the upright chest x-ray.
What is the primary risk factor associated with peptic ulcers?
Helicobacter pylori
It is associated with the majority of peptic ulcers.
What percentage of duodenal ulcers is associated with Helicobacter pylori?
95%
This indicates a strong correlation between H. pylori and duodenal ulcers.
What percentage of gastric ulcers is associated with Helicobacter pylori?
75%
This shows a significant link between H. pylori and gastric ulcers.
Name some drugs that are risk factors for peptic ulcers.
- NSAIDs
- SSRIs
- Corticosteroids
- Bisphosphonates
These medications can contribute to the development of peptic ulcers.
What syndrome is a rare cause of peptic ulcers characterized by excessive levels of gastrin?
Zollinger-Ellison syndrome
This syndrome is usually due to a gastrin-secreting tumor.
What is the unclear role in the risk factors for peptic ulcers?
Alcohol and smoking
The exact impact of these factors on ulcer development is not well established.
What symptom is common in duodenal ulcers?
Epigastric pain when hungry
This pain is often relieved by eating.
What symptom is common in gastric ulcers?
Epigastric pain worsened by eating
This is a distinguishing feature of gastric ulcers.
What test should be performed for Helicobacter pylori?
Urea breath test or stool antigen test
These tests are used first-line for H. pylori detection.
What should be administered if Helicobacter pylori is negative in peptic ulcer management?
Proton pump inhibitors (PPIs)
PPIs should be given until the ulcer is healed.
What treatment is given if Helicobacter pylori is positive?
Eradication therapy
This therapy targets the removal of H. pylori.
What is the most common complication of peptic ulcer disease?
Bleeding
Bleeding accounts for around three-quarters of problems in peptic ulcer disease.
Which artery can be a significant source of gastrointestinal bleed in peptic ulcer disease?
Gastroduodenal artery
The gastroduodenal artery can be involved in significant gastrointestinal bleeding.
