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 |
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Term
| What are the repair mechanisms used for peptic ulcers |
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Definition
Restitution: rapid migration of cells to the surface
Regeneration: new epithelial production from progenitor cells |
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Term
| What is the most common site of HP-gastric Ulcers |
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Definition
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Term
| Which cause of peptic ulcers usually shows gastritis before ulcer formation |
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Definition
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|
Term
| Does alcohol increase the risk of either gastric or duodenal ulcers |
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Definition
| Does not increase the risk |
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Term
| How does H.pylori cause Duodenal ulcers |
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Definition
Decreases somatostatin production and increases acid production exposing the duodenum to acid conditions
Duodenal metaplasia allows colonization by H.pylori and subsequent ulcers |
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Term
| What cancers are associated with H.pylori |
|
Definition
Gastric Adenocarcinoma
MALT lymnphoma |
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|
Term
| How is low grade gastric MALT lymphoma treated |
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Definition
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|
Term
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Definition
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|
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 |
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|
Term
| When is culture of H.pylori recommended |
|
Definition
| Only if drug resistant H.pylori is indicated |
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|
Term
| When are Urea Breath tests used for H.pylori |
|
Definition
| 4-6 weeks after antibiotic therapy to confirm eradication |
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|
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 |
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|
Term
| When is stool antigen assay used for H. pylori diagnosis |
|
Definition
| If variability resolves, will be used for indicating eradication |
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|
Term
| When is histology used to diagnose H.pylori gastritis? |
|
Definition
| If endoscopy is required and Biopsy urease is negative |
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|
Term
| When is Biopsy Urease test used for H.pylori diagnosis |
|
Definition
| If patient is undergoing endoscopy |
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|
Term
| Why are ulcers caused by NSAIDs typically not caught in the early phases |
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Definition
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|
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 |
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|
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 |
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|
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 |
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|
Term
| In what men syndrome are peptic ulcers typically found |
|
Definition
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|
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 |
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|
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 |
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|
Term
| What areas have higher colonization rates with H.pylori? |
|
Definition
| Poor underdeveloped areas |
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