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Session 3 CM- GI-4

CM- GI -4- PUD

What is ulceration of duodenum or stomach Peptic Ulcer Disease
Patient presents with epigastric pain, nausea, vomiting and variable blood in vomitus and self limited inflammation of gastric mucosa what condition are they suffering from Acute Gastritis
What are common cuases of acute gastritis Aspirin and NSAIDS, Alcohol, Acid and Alkali ingestion, Stress, Shock related mucosal ischemia, Sepsis
How does ETOH contribute to Gastric erosions Stimulates over secretion of HCL
How does aspirin and other NSAIDS contribute to gastric erosions inhibit local synthesis of prostaglandins weakening mucosal defense system
How does shock contribute to gastric erosion hypoprofusion results in increased susceptibility of mucosal cells to acid
What type of gastric stress ulcer is caused by brain injury Cushing ulcer
What type of gastric stress ulcer is caused by burns Curling ulcer
What are the 3 main types of non erosive gastritis Chronic Type A, Chronic Type B, hypertrophic gastritis
What type of chronic gastritis is caused by autoimmune disease and has a higher risk of gastric adenocarcinoma Chronic Type A gastritis
What type of chronic gastritis is caused by H. Pylori and increases your chance of adenocarcinoma and lymphoma Chronic Type B gastritis
What happens in late stages of chronic type a and B gastritis atrophy of gastric glands, intenstinal metaplasia, lymphocytic follicles in the mucosa
What is the number one infectious cause of PUD in the duodenum and gastric types H. Pylori
How does H. Pylori cause PUD induces an intense inflammatory and immune response causes mucosal injury
Which type of ulcer is more common gastric or duodenal Duodenal 4:1 over gastric ulcers
Patient presests with PUD which doesn't respond to usual treatment what is the likely cause of their ulcers zollinger-ellison syndrome a gastrin secreting tumor causing hyper acidity and ulceration
How can you tell a peptic ulcer from an adenocarcinoma smooth edges will indicate an ulcer rather than adenocarcinoma
Patient presents with s/sx of PUD you order an endoscopy and notice a small 1-2 cm diameter lesions with smooth sides and bottom. Borders are sharp what is the likely cause Peptic Ulcer
What is the most common complication from a peptic ulcer hemorrhage- look for melena and iron deficiency anemia
What other complications can arise from peptic ulcer disease besides hemorrhage Perforation, Stenosis and obstruction, penetration into pancrease
What is the most common malignancy of the stomach and what is the 5 yr survival rate Adenocarcinoma- 5yr survival rate is 20%
Where is the most likely place to find gastric cancer Pylorus and pyloric antrum
Patient is 30yrs old and presents complaining of s/sx of PUD based on what you know about PUD where is there ulcer most likely located Duodenal Ulcer- they are the most common and occur 25-75yrs. Gastric ulcers occur 55-65 yrs
What are the s/sx of PUD Clusters of pain gnawing, dull, aching hunger like pain in epigastric area
Patient complains of gnawing dull aching hunger like pain in epigastric area that is relieved by eating what is likely causing their symptoms be specific include location PUD in duodenal area pain can be relieved by eating and antacids. Gastric ulcers typically not relieved by food.
You are working up a patient for PUD and why would you order a UGI (upper gastroinetsinal contrast series) over a endoscopy Is is less invasive, expensive and is 90% accurate when using double contrast. Endoscopy is invasive and expensive but more accurate
What tests could you order to confirm PUD caused by H. Pylori Urea Breath test, Stool antigen test, specific antibody test or endoscopic bx
What treatments will you order for PUD H2 blockers, PPI and if it is caused by H. Pylori add 2 antibiotics may need to step it up to quadruple therapy
Created by: smaxsmith