- Shuffle
Toggle OnToggle Off
- Alphabetize
Toggle OnToggle Off
- Front First
Toggle OnToggle Off
- Both Sides
Toggle OnToggle Off
Front
How to study your flashcards.
Right/Left arrow keys: Navigate between flashcards.right arrow keyleft arrow key
Up/Down arrow keys: Flip the card between the front and back.down keyup key
H key: Show hint (3rd side).h key
PLAY BUTTON
PLAY BUTTON
22 Cards in this Set
- Front
- Back
|
Risk Factors/Causes of PUD
|
H. Pylori
NSAIDs Smoking Booze Increased Gastrin Release Genetics Blood Group (O) |
|
H. Pylori
-gram? |
Negative
|
|
H. Pylori
where it lives |
on surface of mucosa, never penetrates
|
|
H. Pylori
produces? |
Urease and toxins
|
|
4 Things H. Pylori can cause?
|
Gastritis
Peptic Ulcer MALT lymphoma Gastric Cancer |
|
How does H. Pylori cause Duodenal Ulcers?
|
Ingestion
Colonization Antral Gastritis Inhibits D Cells Decreased Somatostatin Increased Gastrin Increased Acid DU |
|
How does H. Pylori cause MALT?
|
Ingestion
Colonization Releases Urease, toxins, and multiplies Prolif of B Cells Polyclonal Monoclonal Lymphoma |
|
How does H. Pylori cause Gastric Cancer?
|
Ingestion
Colonization Pan Gastritis Acute Gastritis Chronic Gastritis Gastric Atrophy CANCER |
|
Tests for H. Pylori
2 broad categories |
Endoscopic
Non-endoscopic |
|
Non-endoscopic Tests for H. Pylori
|
NON-ENDOSCOPIC
Serum H. Pylori AB (not good for confirming eradication) Urea Breath Test (better) Stool Ag Test (not as available) |
|
Endoscopic Tests for H. Pylori
|
Biopsy Urea Test (solid)
Histology Culture (100% specific) |
|
Typical Rx for H. Pylori induced Peptic Ulcers
|
TRIPLE:
PPI + Clarithromycin + Amoxicillin PPI + Clarithromycin + Metronidazole QUAD: PPI + Clarithromycin + Amoxicillin + Tetracycline |
|
When do you test for eradication?
|
1 month after stopping treatment
|
|
5 complications of peptic ulcers and %'s
|
Refractory ulcers
bleeding (15%) penetration (5%) perforation (7%) obstruction (2%) |
|
Refractory Ulcers
Patient Related Factors |
NSAIDs
Booze Smoking Hypersecretory states H.Pylori Fungal infections |
|
Refractory Ulcers
Ulcer Related Factors |
Large
Penetrated Linear |
|
Refractory Ulcers
Drug Related Factors |
Resistance
Inadequate dose tolerance |
|
Refractory Ulcers
Physician Related Factors |
Wrong Dx
|
|
How do Peptic Ulcers present?
|
Hematemesis (vomit blood)
Melena (black, tarry, smelly poo) Hematochezia (fresh blood from rectum) Also: Chest pain, sweating, pallor, dizziness, fainting, tired, shock |
|
Risk Factors for GI Bleeding
|
over 60
hematemesis w/ melena Drugs: nsaids, warfarin, steroids Continued bleeding bleeding in hospital CCF, COPD, Renal Failure, Liver Disease |
|
List of lesions and their risk of bleeding if untreated (in order from least risk to highest)
|
Clean Base
Black Spot Sentinel Clot Visible Vessel Arterial oozing Arterial Spurt |
|
Consequences of Prolonged Acid Suppression
|
Hypergastrinemia
Carcinoids Bacterial Overgrowth B12 def Gut infection |
