GORD PUD

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Questions and Answers

What is a common cause of Gastro-Oesophageal Reflux Disease (GORD)?

Decreased gastric acid secretion

Defective LES function (correct)

Increased lower oesophageal sphincter (LES) pressure

Overeating of high-protein foods

Which symptom is most commonly associated with GORD?

Abdominal bloating

Frequent urination

Constipation

Heartburn and regurgitation (correct)

Which lifestyle factor is recognized as a risk factor for GORD?

Low fiber diet

High protein intake

Obesity and pregnancy (correct)

Excessive water consumption

Which class of drugs is primarily used for acid suppression in GORD?

Proton Pump Inhibitors (PPIs) (D) Signup and view all the answers

What is a known side effect of proton pump inhibitors (PPIs)?

Headache, nausea, and diarrhea (C) Signup and view all the answers

Which bacteria is primarily associated with Peptic Ulcer Disease (PUD)?

Helicobacter pylori (B) Signup and view all the answers

What role do NSAIDs play in the development of Peptic Ulcer Disease?

They inhibit prostaglandin synthesis, leading to impaired mucosal defense (B) Signup and view all the answers

What is a common presenting feature of peptic ulcers?

Sharp, gnawing epigastric pain after meals (A) Signup and view all the answers

What is the primary pharmacological treatment for Helicobacter pylori-induced PUD?

Triple therapy: PPI, amoxicillin, and clarithromycin (D) Signup and view all the answers

Which class of drugs is commonly used for immediate symptomatic relief in mild GORD?

Antacids (C) Signup and view all the answers

Which dietary factors are known to relax the lower oesophageal sphincter and potentially contribute to GORD?

Garlic, onions, chocolate, fatty meals (A) Signup and view all the answers

What are the potential complications associated with untreated GORD?

Barrett's oesophagus and oesophageal carcinoma (D) Signup and view all the answers

Which side effect is associated with long-term use of NSAIDs in patients with peptic ulcer disease?

Gastric ulcers due to inhibition of prostaglandins (D) Signup and view all the answers

What lifestyle change is recommended for managing nocturnal GORD symptoms?

Elevate the head of the bed by 10-15 cm (C) Signup and view all the answers

Which medication class reduces gastric acid secretion by blocking H2 receptors on parietal cells?

H2 Receptor Antagonists (H2RAs) (C) Signup and view all the answers

What serious side effect is associated with prolonged use of Proton Pump Inhibitors?

Hypomagnesemia and fractures (D) Signup and view all the answers

What diagnostic test is typically used to confirm the presence of H.pylori in PUD patients?

Urea breath test (A) Signup and view all the answers

What function does alginate serve in the treatment of GORD?

Forms a protective barrier to prevent reflux (B) Signup and view all the answers

Which is considered a first-line treatment for ulcers induced by NSAID use?

Proton Pump Inhibitors (PPIs) (A) Signup and view all the answers

What is the role of misoprostol in managing NSAID-induced ulcers?

Increases mucosal protection by stimulating prostaglandin production (C) Signup and view all the answers

Which medication is a proton pump inhibitor that can be used for peptic ulcer disease?

Omeprazole (D) Signup and view all the answers

What is a common side effect of selective serotonin reuptake inhibitors when taken with NSAIDs?

Increased risk of gastrointestinal bleeding (A) Signup and view all the answers

What lifestyle modification is most effective for reducing nighttime gastroesophageal reflux disease (GORD) symptoms?

Elevating the head of the bed (A) Signup and view all the answers

Which symptom is considered the primary presenting symptom of peptic ulcer disease?

Burning pain after meals (A) Signup and view all the answers

Which class of drugs is commonly associated with an increased risk of bleeding when used with NSAIDs?

Selective serotonin reuptake inhibitors (SSRIs) (B) Signup and view all the answers

What dietary change can help in managing symptoms of gastroesophageal reflux disease (GORD)?

Eating smaller, more frequent meals (A) Signup and view all the answers

In relation to gastrointestinal issues, which drug is specifically designed to lower gastric acid production?

Esomeprazole (C) Signup and view all the answers

Which food item is commonly known to relax the lower oesophageal sphincter (LES) and exacerbate GORD symptoms?

Garlic (A) Signup and view all the answers

Which of the following symptoms is classified as an alarm symptom in GORD that necessitates immediate evaluation?

Dysphagia (A) Signup and view all the answers

What is the first-line pharmacological treatment recommended for moderate-to-severe GORD?

Proton Pump Inhibitors (PPIs) (A) Signup and view all the answers

Which medication is known to decrease the tone of the lower oesophageal sphincter and may worsen GORD symptoms?

Nitrates (D) Signup and view all the answers

What is a potential adverse effect associated with long-term use of Proton Pump Inhibitors?

Clostridium difficile infection (C) Signup and view all the answers

H.pylori infection is primarily associated with increasing the risk of which condition?

Peptic ulcers (C) Signup and view all the answers

Which test is designed to detect the presence of Carbon dioxide as an indicator of H.pylori infection?

Urea breath test (D) Signup and view all the answers

Which of the following is recognized as a first-line regimen for the eradication of H.pylori?

Clarithromycin, amoxicillin, esomeprazole (A) Signup and view all the answers

Study Notes

Gastro-Oesophageal Reflux Disease (GORD)

Commonly caused by defective lower oesophageal sphincter (LES) function.
Symptoms include heartburn and regurgitation.
Obesity and pregnancy are significant lifestyle risk factors.

Treatment Options for GORD

Proton Pump Inhibitors (PPIs) are the main drug class for acid suppression.
Antacids provide immediate relief for mild GORD symptoms.
Dietary factors like garlic, onions, chocolate, and fatty meals can relax the LES and aggravate GORD.

Complications and Management

Untreated GORD can lead to Barrett's oesophagus and oesophageal carcinoma.
Elevating the head of the bed is recommended for patients with nocturnal GORD symptoms.

Peptic Ulcer Disease (PUD)

Helicobacter pylori is the primary bacterium associated with PUD.
Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) inhibit prostaglandin synthesis, impairing mucosal defense and contributing to ulcer formation.
Common symptom includes sharp, gnawing epigastric pain after meals.

Pharmacological Treatments for PUD

Triple therapy for H. pylori-induced PUD consists of a PPI, amoxicillin, and clarithromycin.
Proton Pump Inhibitors are first-line for NSAID-induced ulcers.
Misoprostol increases mucosal protection by stimulating prostaglandin production.

Adverse Effects of Treatments

Long-term use of PPIs can lead to hypomagnesemia and fractures as serious side effects.
Common side effects of PPIs include headache, nausea, and diarrhea.
Long-term NSAID use may result in gastric ulcers due to reduced prostaglandin levels.

Testing and Additional Treatments

The urea breath test is used to confirm H. pylori infection in PUD patients.
Alginate forms a protective barrier that prevents reflux in GORD management.
H2 Receptor Antagonists (H2RAs) block gastric acid secretion by targeting H2 receptors on parietal cells.

Gastroesophageal Reflux Disease (GORD) Risks and Symptoms

Common risk factors for GORD include obesity, smoking, and hiatus hernia; a high-protein diet is not a common risk factor.
Garlic is known to relax the lower oesophageal sphincter (LES) and can exacerbate GORD symptoms.
Alarm symptom requiring immediate investigation is dysphagia, while heartburn and regurgitation are typical symptoms of GORD.

Treatment and Pharmacology

Proton Pump Inhibitors (PPIs) are considered the first-line treatment for moderate-to-severe GORD.
Nitrates can decrease LES tone and may worsen GORD symptoms.
Long-term PPI therapy can lead to Clostridium difficile infection as a potential adverse effect.

H. pylori Infection and Diagnosis

H. pylori infection increases the risk of gastric ulcers and gastric carcinoma.
The urea breath test for H. pylori detects carbon dioxide as a key indicator.
A first-line pharmacological regimen for eradicating H. pylori typically includes clarithromycin, amoxicillin, and esomeprazole.

Peptic Ulcer Disease (PUD) and Medications

NSAID-induced peptic ulcers occur due to inhibition of cyclo-oxygenase-1 (COX-1).
Commonly used mucosal protective agents for NSAID-induced ulcers include misoprostol and sucralfate.
Various PPIs, including omeprazole, pantoprazole, and esomeprazole, inhibit CYP2C19 and decrease the effectiveness of clopidogrel.

Symptoms and Lifestyle Modifications

The most common presenting symptom of peptic ulcer disease is gnawing or burning pain after meals.
Selective serotonin reuptake inhibitors (SSRIs) increase the risk of gastrointestinal bleeding when combined with NSAIDs.
Elevating the head of the bed is the most effective lifestyle modification for reducing nocturnal GORD symptoms.

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