Upper GI: peptic Ulcer Disease Flashcards Preview

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Flashcards in Upper GI: peptic Ulcer Disease Deck (20):
1

State the 5 main causes of peptic ulcer disease 😂

1. H pylori 2. NSAIDS 3. Smoking 4. Zollinger Ellison's syndrome 5. acid/alcohol consumption

2

Describe the relationship between H pylori and peptic ulceration

H pylori may causes gastritis in the antrum leading to an inflammatory response. It does this by the releasing proteins CagA and VacA. H pylori can increase acid secretion in 2 ways: 1) decrease the production of somatostatin D cells (Decrease acid production)
2. Decrease inhibition of gastrin release from G cells. Gastrin acts to increase acid release from parietal cells ,thus leading to peptic ulceration

3

What potent inflammatory mediator of the gastric mucosa are the proteins released by H pylori associated with ? 😭

Associated with potent inflammatory mediator of gastric mucosa IL-8

4

What are full names of the proteins releases ?

CagA: cytotoxic associated protein A
VacA: vacuolating toxin A

5

Describe how H pylori can cause gastritis by binding to adhesion molecules

H pylori binds to adhesion molecules BabA, which bind to Lewis antigen causing gastritis

6

Describe the relationship between smoking and peptic ulceration

1. Impairs mucosal healing
2. Nicotine increases acid secretion

7

State how smoking can impair mucosal healing

Increases acid and bile salt reflux

8

State 3 ways in which nicotine can increase acid secretion in peptic ulcer disease

1. Via H2 receptors releasing histamine, 2. parietal cells, 3, stimulate pepsinogen release from chief cells

9

Describe the relationship between NSAIDS and peptic ulceration 😭

NSAIDs inhibit COX enzymes, most importantly COX-1 in the stomach, therefore inhibiting prostaglandin synthesis. Prostaglandins are involved in decreasing acid production and promoting bicarbonate and mucous secretion(protective). Prostaglandins also increase blood flow to the muscosa, another protective factor .

10

Which peptic ulcer is more common ?

Duodenal ulcers

11

State the peak age group for duodenal ulcers
😭

44-55

12

State 2 symptoms of duodenal ulcers 😭

1. severe localised epigastric, which often occurs at NIGHT and BEFORE MEALS
2. Relieved by eating food or drinking milk

13

What is the peak age group for peptic ulcers ?

55-65

14

State 3 symptoms of gastric ulcers 😭

1. epigastric pain
2. worse on eating
3. relieved by antacids

15

State 3 symptoms that both duodenal and gastric ulcers have in common 😭😭

1. Pain may radiate to the back
2. Pain may be associated with nausea and anorexia/weight loss
3. Bleeding and perforation may appear in vomit/faeces, although vomiting is not always present

16

What are additional signs and symptoms of peptic ulcer disease 😭

ALARMS55
Anorexia
Loss of weight//appetite
Anaemia
Rapid onset
Malaena/haematemesis
Swallowing difficulties
Age >55

17

State why endoscopy is done for peptic ulcers (2) 😭

1. To visualize ulcerations
2. exclude gastric malignancy

18

Endoscopy is done based on what, for peptic ulcers ?

ALARMS55
Anorexia
Loss of weight//appetite
Anaemia
Rapid onset
Malaena/haematemesis
Swallowing difficulties
55

19

State the 3 non-invasive tests used to investigate peptic ulcers 😭

1. Serological tests
2. Stool antigen test- antibodies detect H pylori
3. 13C urea breath test

20

State the 3 invasive tests used to investigate peptic ulcers 😭

1. Biopsy urease, 2. histologically and 3. culture