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3 Cards in this Set
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PUD
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Presentation varies depends on the location of mucosal injury.
Gastric ulcer and gastritis= pain after eating and improves an hour later. Can experience N/V, weight loss. Risk: smoking, NSAID, or corticosteroid use. Diagnosis: biopsy and endoscopy. If biopsy negative for H.pylori, then reason for ulcer is most likely due to NSAID. Treat with misoprostol to minimize gastric injury with NSAID used. |
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Duodenal ulcers
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Induce pain when stomach is empty. About 2hrs after meal.
Pain relieves by eating or antacid. Pt awaken during the night with symptoms. Symptoms happen in clusters, interspersed with period of wellness. PE: notable epigastric tenderness to palpation. Maybe LUQ tenderness. Duodenal are common than gastric ulcers. Duodenal ulcer pt needs to be tested for H.pylori. Tests are: endoscopy, urea breath test and stool antigen. Stool antigen is more sensitive and specific, can also be evaluated 8 weeks after therapy for test of cure. H.pylori is most common for duodenal ulcer. NSAID and corticosteroid are other risk factors. |
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Fatty liver, cirrhosis and primary billiary cirrhosis.
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Fatty liver: it's due to high incidence of obesity, DM, Hypertriglyceremia and metabolic syndrome.
Most Pts are asymptomatic and diagnosis incidentally via sono. Labs: maybe slightly increase transaminases or alk Phos. Treat underlying causes. Cirrhosis: end result of liver fibrosis and nodular regeneration. S/S: spider angioma, Palma erythema, duputyten contracture, glossitis, Chelitis, weight loss and waisting, jaundice, + HSM with liver edge firm with sharp or nodular edge. Ascitis and encephalopathy. Primary biliary cirrhosis: mostly in Middle Ages women, asymptomatic. Labs: alk Phos elevated. Check for antimicrocrosomol antibodies. |
