Shared Flashcard Set

Details

GI-ICM
Peptic Ulcer Disease
24
Medical
Graduate
02/08/2011

Additional Medical Flashcards

 


 

Cards

Term
What is the protective barrier of the  stomach and duodenum and how is it altered by NSAIDs and H.pylori
Definition

Barrier: Composed of Mucus and bicarb

NSAIDs: Decreases prostaglandin production responsible for the increasing mucus and bicarb production and decreasing acid production

H.pylori: Disruption of the mucousal barrier

Term
What are the repair mechanisms used for peptic ulcers
Definition

Restitution: rapid migration of cells to the surface

Regeneration: new epithelial production from progenitor cells

Term
What is the most common site of HP-gastric Ulcers
Definition
antrum
Term
Which cause of peptic ulcers usually shows gastritis before ulcer formation
Definition
H.pylori
Term
Does alcohol increase the risk of either gastric or duodenal ulcers
Definition
Does not increase the risk
Term
How does H.pylori cause Duodenal ulcers
Definition

Decreases somatostatin production and increases acid production exposing the duodenum to acid conditions

Duodenal metaplasia allows colonization by H.pylori and subsequent ulcers

Term
What cancers are associated with H.pylori
Definition

Gastric Adenocarcinoma

MALT lymnphoma

Term
How is low grade gastric MALT  lymphoma treated
Definition
Antibiotics
Term
How is H. pylori spread
Definition

Fecal-Oral

Oral-Oral

Term
With the exception of the serology test the following substances will give negative results for H.pylori in a colonized host
Definition

Antibiotics

Bismuth Compounds

PPI's

Term
When is culture of H.pylori recommended
Definition
Only if drug resistant H.pylori is indicated
Term
When are Urea Breath tests used for H.pylori
Definition
4-6 weeks after antibiotic therapy to confirm eradication
Term
When is Elisa used to diagnose H.pylori
Definition
Used for patients who do not require Endoscopy and have not been treated with Antibiotics
Term
When is stool antigen assay used for H. pylori diagnosis
Definition
If variability resolves, will be used for indicating eradication
Term
When is histology used to diagnose H.pylori gastritis?
Definition
If endoscopy is required and Biopsy urease is negative
Term
When is Biopsy Urease test used for H.pylori diagnosis
Definition
If patient is undergoing endoscopy
Term
Why are ulcers caused by NSAIDs typically not caught in the early phases
Definition
Typically Asymptomatic
Term
How do NSAIDs cause ulcers
Definition

Direct toxicity to mucosal cells

Inhibition of Prostaglandins causing:

Decreased Bicarb and Mucus

Decrease Mucosal blood flow

Increased Gastric Acid Secretion

Term
What are the risk factors for NSAID ulcers
Definition

Elderly

Past Ulcer

Co-morbid Disease

Anti-coag

Steroids only if used with NSAIDs

High dose

Term
Under what conditions is smoking not a risk factor for developing peptic ulcers
Definition
In a patient seronegative H.pylori patient not using NSAIDs
Term
In what men syndrome are peptic ulcers typically found
Definition
MEN-1
Term
What is the treatment regimen for H.pylori ulcers?
Definition

One week of:

PPI w/ Clarithromycin and Amoxicillin

If allergic to Penicillins:

PPI w/ Clarithromycin and Metronidazol

Term

How are NSAID peptic ulcers treated

How are NSAID peptic ulcers prevented

Definition

Tx: Discontinued NSAID or lowest effective dose

Use PPI or H2

Prevented: Discontinued NSAID or lowest effective dose

Use Misoprostol or PPI

Term
What areas have higher colonization rates with H.pylori?
Definition
Poor underdeveloped areas
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