Exam (elaborations)
PUD - PEPTIC ULCER DISEASE EXAM STUDY GUIDE QUESTIONS AND ANSWERS
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PUD - PEPTIC ULCER DISEASE EXAM STUDYGUIDE QUESTIONS AND ANSWERS
Peptic Ulcer Disease - ANSWER Gastric, Duodenal, or Esophageal depending
on location. Excavation that occurs in the Mucosa wall of the stomach, pylorus,
duodenum, or esophagus. Erosion may go into stomach muscle or as deep as the
peritoneum.
Peptic Ulcer Disease Pathophysiology - ANSWER Ulcers mainly occur in the
gastroduodenal mucosa as a result of erosion, damage, acid secretion, or
decreased resistance causing infection.
Erosion in Peptic Ulcers - ANSWER increased acid-pepsin secretion or
decreased resistance of Mucosa leads to erosion
Damage to Mucosa in Peptic Ulcers - ANSWER damage to mucosa causing
less protection against HCl
Acid Secretion in Gastric Peptic Ulcers - ANSWER Patients with gastric PUD
tend to secrete normal to decreased levels of HCl
Acid Secretion in Duodenal Peptic Ulcers - ANSWER Patients with Duodenal
PUD tend to secrete excess HCl
Decreased Resistance to Mucosa in Peptic Ulcers - ANSWER Damage to
gastroduodenal Mucosa leads to decreased resistance to bacteria such as H.
Pylori leading to infection
Peptic Ulcer Disease Risk Factors - ANSWER Ages 40-60
Children & Infants
After menopause incidence in women = men
3 Major Causes of Peptic Ulcer Disease - ANSWER 1) H. Pylori Infection
2) Chronic NSAID use
3) Hypersecretory Disease: Zollinger Ellison Syndrome (ZES)
Other Causes of PUD - ANSWER -Salicylates
, -Pancreatitis, Hepatic Disease, Crohn's, Gastritis
-Excess HCl
-ingested milk, caffeine, & alcohol
-Blood Type O
Peptic Ulcer Disease Clinical Manifestation - ANSWER -Dull gnawing pain or
burning sensation in midepigastrium, or back that is relieved by eating
(duodenal ulcer)
-Pyrosis (Heartburn)
-Vomiting d/t obstruction of pyloric orifice
-Constipation or Diarrhea
-GI bleeding seen with Melena (tarry) Stools
Complications of PUD - ANSWER -Hemorrhage (most common
complication)
-Perforation & Penetration
-Pyloric Obstruction
Hemorrhage Complication of PUD - ANSWER Hemorrhage, the most
common complication, occurs in 10% to 20% of patients with peptic ulcers in
the form of hematemesis or melena. Signs include: cool skin, confusion,
increased heart rate, labored breathing, and blood in the Stool.
Perforation Complication of PUD - ANSWER Perforation is the erosion of the
ulcer through the gastric serosa into the peritoneal cavity without warning.
Signs include: sudden abdominal pain, referred pain to shoulders (especially
right), vomiting and collapse, extremely tender and *rigid abdomen*,
hypotension and tachycardia, or other signs of shock
Penetration Complication of PUD - ANSWER Erosion of the ulcer through the
gastric serosa into adjacent structures. Signs include: back and epigastric pain
not relieved by medications that were effective in the past.
Pyloric Obstruction Complication of PUD - ANSWER Pyloric obstruction
occurs when the area distal to the pyloric sphincter becomes scarred and
stenosed from spasm or edema or from scar tissue that forms when an ulcer
alternately heals and breaks down. Signs include: nausea, vomiting, distended
abdomen, and abdominal pain
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