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17 Cards in this Set
- Front
- Back
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What so the cells of the stomach lining do? |
Mucus cells: produce mucus and biocarbonate Parietal cells: produces gastric acid and intrinsic factor Chief cells: Pepsinogen and gastric lipase G cells: gastrin |
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What are the possible causes of dyspepsia/PUD? |
H.pylori infection NSAID use Long term steroid use Alcohol Smoking Severe physiological stress Hypersecretory states (Zollinger-Ellison syndrome) |
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How should H.pylori -ve NSAID- induced ulcers be managed? |
stop NSAID and standard dose h2-receptor antagonist (ranitidine) |
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How should h.pylori +ve ulcers be treated? |
Eradication therapy: 7 day course of PPI + amoxicillin 1g and clarithyromycin 500mg/metronidazole 400mg TDS |
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What are the NICE guideline for treatment of patient presenting with dyspepsia? |
<55 'test and treat:' Test for H.pylori- urea breath test or stool antigen, 4 weeks full dose PPI >55 with unexplained persistent symptoms- URGENT endoscopy referral (don't prescribe PPI pre-endoscopy) |
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What are the general lifestyle advice for someone with PUD? |
Stop smoking reduced alcohol intake lose weight increase exercise small regular meals reduce fatty/spicy foods |
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How long is PPI treatment continued after eradication therapy? |
2 months |
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What are some of the risks of PPIs? |
Low magnesium Increased risk of c.difficile and infective diarrhoea Acute interstitial nephritis Microscopic colitis |
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In an upper GI bleed might the level of urea be? |
High - due to digestion of blood cells |
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What score is used to assess need for admission with GI bleed? |
Blatchford score |
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In someone that is haemodynamically stable but with symptoms of GI bleed within how long should an endoscopy be done? |
24 hours |
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What score is used post endoscopy to measure risk of mortality and re-bleeding? |
Rockall score |
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What are the therapeutic options for treating upper GI bleeding from peptic ulceration? |
Endoscopic therapy: Adrenaline injection Clips Argon-plasma coagulation Heat probe Haemoscpray Proton pump inhibitor (not pre-endoscopy) |
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What is the recommended PPI treatment post-GI bleed? |
80mg omeprazole bolus IV STAT 8mg/hour omeprazole for 72 hrs IV High dose oral therapy 2 months |
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After a GI bleed when should a follow up endoscopy be done? |
6-8 weeks |
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Why shouldn't COX2 inhibitors be given to someone with cardiovascular/cerebrovascular disease? |
They are prothrombotic |
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