NURS 571 FINAL PEPTIC ULCER
peptic ulcer - Answers - ulcerations (>5 mm) mucosal surface in the esophagus,
stomach (gastric ulcer), or the first portion of the small bowel (duodenal ulcer) with
penetration to the submucosa.
two major causes of PUD - Answers - are infection with the (majority)H. pylori and the
use of (NSAIDs).
Less common causes of PUD include: - Answers - Non-NSAID medications, ,
Infections, , Mechanical (obstruction, foreign body, post-surgical), Acid hypersecretory,
Ischemic, Inflammatory and infiltrating disease (cancer) are less common
Peptic ulcers occur - Answers - when the normal protective mechanisms that govern
gastric mucosal function and repair are disrupted this is
NSAIDs - Answers - inhibit prostaglandin synthesis affects the amount of gastric acid
generated, the integrity of the mucosal barrier, the generation of glutathione, and the
rate of mucosal blood flow is what
develop duodenal ulcers - Answers - also have impaired duodenal bicarbonate
secretion
H. pylori infection - Answers - H. pylori develops pangastritis, which over time, reduces
gastric acid secretion, Inhibition of somatostatin secretion may involve cytokines
small number with H.pylori - Answers - development of an antrum predominant
gastritis, which increases basal and stimulated gastric acid secretion
Risk factors associated with PUD - Answers - Smoking, Alcohol abuse, Genetic
predisposition
H. pylori infection, NSAID use, Psychologic factors are risk factors of
differential for PUD - Answers - Drug-induced dyspepsia, Functional dyspepsia,
Gastroesophageal reflux, Biliary disease, Gastric malignancy
Chronic pancreatitis, Esophagitis, Acute coronary syndrome are differential for
Asymptomatic pts - Answers - present acutely with a complication of PUD, such as
perforation, bleeding, or obstruction, although they reported no prior symptoms they are
Common subjective complaints (PUD) - Answers - Upper abdominal pain or discomfort
exacerbated or relieved by eating, gastric and duodenal ulcer, N/V, belching, Early
satiety, Fatty food intolerance, GERD, Hematemesis, Dizziness or syncope, are
Objective findings (PUD) - Answers - Melena, , Hematochezia, Epigastric tenderness,
Hypotension, tachycardia, Anemia are
, Findings of Peptic Ulcer Perforation - Answers - Sudden onset of severe abdominal
pain, Tachycardia
Abdominal rigidity are signs of
esophagogastroduodenoscopy (EGD) - Answers - definitive diagnosis of PUD,
detection of gastroduodenal lesions, sensitivity 90% use
pneumoperitoneum - Answers - (air in the peritoneal space) is called
Ulcer biopsy - Answers - during endoscopy for lesions that appear malignant,
sarcoidosis, eosinophilic gastroenteritis, Crohn's disease, etc, and Gastric mucosal
biopsy for H pylori do
Lab Test in UGIB - Answers - (BUN), glucose, Aminotransferases, alkaline
phosphatase, and bilirubin, Lipase, amylase, CBC with diff, Urea breath test
H. pylori antigen stool testing are labs for
H. pylori positive - Answers - gastric biopsy again to confirm eradication after
completing treatment,
H. pylori negative gastric ulcers - Answers - EGD in 8 to 12 weeks again if bleeding
and symptoms continue after
Duodenal ulcers (PUD) - Answers - low risk of malignancy in patients a repeat upper
endoscopy is not routinely recommended if they have
Gastroprotective therapies - Answers - no alcohol, NSAID, smoking, dietary or acid-
suppressive medications, healthy weight, less stress, are
PUD life-threatening - Answers - Bleeding, Penetration, Perforation, Gastric outlet
obstruction are complications of
Medication for PUD - Answers - (PPI)- (Prilosec, Protonix, Nexium) to facilitate ulcer
healing, (BID for 1 month) then 1 per day for 8 weeks is the
H2 receptor antagonist - Answers - famotidine (Pepcid) or ranitidine (Zantac) are
known as
indefinitely PPI therapy - Answers - once daily, in H. pylori negative, Non-NSAID,
recurrent ulcers, NSAID use, Giant peptic ulcers (>2cm), >50 yrs
multiple co-morbidities you give
+ H. pylori confirmed ulcers - Answers - PPI therapy BID for 14 days + antibiotic
combination (triple or quadruple therapy) are for
peptic ulcer - Answers - ulcerations (>5 mm) mucosal surface in the esophagus,
stomach (gastric ulcer), or the first portion of the small bowel (duodenal ulcer) with
penetration to the submucosa.
two major causes of PUD - Answers - are infection with the (majority)H. pylori and the
use of (NSAIDs).
Less common causes of PUD include: - Answers - Non-NSAID medications, ,
Infections, , Mechanical (obstruction, foreign body, post-surgical), Acid hypersecretory,
Ischemic, Inflammatory and infiltrating disease (cancer) are less common
Peptic ulcers occur - Answers - when the normal protective mechanisms that govern
gastric mucosal function and repair are disrupted this is
NSAIDs - Answers - inhibit prostaglandin synthesis affects the amount of gastric acid
generated, the integrity of the mucosal barrier, the generation of glutathione, and the
rate of mucosal blood flow is what
develop duodenal ulcers - Answers - also have impaired duodenal bicarbonate
secretion
H. pylori infection - Answers - H. pylori develops pangastritis, which over time, reduces
gastric acid secretion, Inhibition of somatostatin secretion may involve cytokines
small number with H.pylori - Answers - development of an antrum predominant
gastritis, which increases basal and stimulated gastric acid secretion
Risk factors associated with PUD - Answers - Smoking, Alcohol abuse, Genetic
predisposition
H. pylori infection, NSAID use, Psychologic factors are risk factors of
differential for PUD - Answers - Drug-induced dyspepsia, Functional dyspepsia,
Gastroesophageal reflux, Biliary disease, Gastric malignancy
Chronic pancreatitis, Esophagitis, Acute coronary syndrome are differential for
Asymptomatic pts - Answers - present acutely with a complication of PUD, such as
perforation, bleeding, or obstruction, although they reported no prior symptoms they are
Common subjective complaints (PUD) - Answers - Upper abdominal pain or discomfort
exacerbated or relieved by eating, gastric and duodenal ulcer, N/V, belching, Early
satiety, Fatty food intolerance, GERD, Hematemesis, Dizziness or syncope, are
Objective findings (PUD) - Answers - Melena, , Hematochezia, Epigastric tenderness,
Hypotension, tachycardia, Anemia are
, Findings of Peptic Ulcer Perforation - Answers - Sudden onset of severe abdominal
pain, Tachycardia
Abdominal rigidity are signs of
esophagogastroduodenoscopy (EGD) - Answers - definitive diagnosis of PUD,
detection of gastroduodenal lesions, sensitivity 90% use
pneumoperitoneum - Answers - (air in the peritoneal space) is called
Ulcer biopsy - Answers - during endoscopy for lesions that appear malignant,
sarcoidosis, eosinophilic gastroenteritis, Crohn's disease, etc, and Gastric mucosal
biopsy for H pylori do
Lab Test in UGIB - Answers - (BUN), glucose, Aminotransferases, alkaline
phosphatase, and bilirubin, Lipase, amylase, CBC with diff, Urea breath test
H. pylori antigen stool testing are labs for
H. pylori positive - Answers - gastric biopsy again to confirm eradication after
completing treatment,
H. pylori negative gastric ulcers - Answers - EGD in 8 to 12 weeks again if bleeding
and symptoms continue after
Duodenal ulcers (PUD) - Answers - low risk of malignancy in patients a repeat upper
endoscopy is not routinely recommended if they have
Gastroprotective therapies - Answers - no alcohol, NSAID, smoking, dietary or acid-
suppressive medications, healthy weight, less stress, are
PUD life-threatening - Answers - Bleeding, Penetration, Perforation, Gastric outlet
obstruction are complications of
Medication for PUD - Answers - (PPI)- (Prilosec, Protonix, Nexium) to facilitate ulcer
healing, (BID for 1 month) then 1 per day for 8 weeks is the
H2 receptor antagonist - Answers - famotidine (Pepcid) or ranitidine (Zantac) are
known as
indefinitely PPI therapy - Answers - once daily, in H. pylori negative, Non-NSAID,
recurrent ulcers, NSAID use, Giant peptic ulcers (>2cm), >50 yrs
multiple co-morbidities you give
+ H. pylori confirmed ulcers - Answers - PPI therapy BID for 14 days + antibiotic
combination (triple or quadruple therapy) are for
