Medical Management of H pylori Infection
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Questions and Answers

What is the most common location of peptic ulcer disease?

  • Stomach
  • Lower esophagus
  • Duodenum (correct)
  • Small intestine

    • What is the primary cause of peptic ulcer disease?

  • Erosion of GI mucosa due to age
  • Inflammation of the stomach lining
  • Digestive action of HCl acid and pepsin (correct)
  • Infection of the digestive tract

    • What is a characteristic of chronic peptic ulcer disease?

  • Only occurs in people under 40 years old
  • Superficial erosion with minimal inflammation
  • Resolves quickly when the cause is identified and removed
  • Muscular wall erosion with formation of fibrous tissue (correct)

    • At what age is peptic ulcer disease most common?

    <p>40-60 years</p> Signup and view all the answers

    What is a feature of acute peptic ulcer disease?

    <p>Resolves quickly when the cause is removed</p> Signup and view all the answers

    In which age group is peptic ulcer disease uncommon?

    <p>Women of childbearing age</p> Signup and view all the answers

    What is the typical duration of chronic peptic ulcer disease?

    <p>Long duration</p> Signup and view all the answers

    What is the ratio of chronic to acute peptic ulcer disease?

    <p>4:1</p> Signup and view all the answers

    What is a primary cause of erosion in the gastric mucosa?

    <p>Increase in HCl concentration</p> Signup and view all the answers

    Which of the following stomach protective mechanisms is impaired in patients with peptic ulcers?

    <p>Gastric mucosal barrier</p> Signup and view all the answers

    Which blood type is more susceptible to peptic ulcers?

    <p>Blood type O</p> Signup and view all the answers

    What is a risk factor for peptic ulcers?

    <p>Eating habits - spicy foods</p> Signup and view all the answers

    Which of the following is NOT a destroyer of the mucosal barrier?

    <p>Bicarbonate secretion</p> Signup and view all the answers

    What is characteristic of gastric ulcers?

    <p>Hyposecretion of gastric acid</p> Signup and view all the answers

    What is an association of peptic ulcers?

    <p>Chronic pulmonary disease</p> Signup and view all the answers

    Which of the following is a causative factor of peptic ulcers?

    <p>Helicobacter pylori infection</p> Signup and view all the answers

    What percentage of patients with duodenal ulcers have H.pylori?

    <p>90%-95%</p> Signup and view all the answers

    What is the relationship between HCl acid secretion and duodenal ulcers?

    <p>Duodenal ulcers are associated with increased HCl acid secretion</p> Signup and view all the answers

    What is the characteristic of pain in patients with duodenal ulcers?

    <p>Pain is relieved by eating</p> Signup and view all the answers

    What is the characteristic of hemorrhage in gastric ulcers compared to duodenal ulcers?

    <p>Hemorrhage is more likely to occur in gastric ulcers</p> Signup and view all the answers

    What is the percentage of patients with duodenal ulcers who have no symptoms?

    <p>Many people with ulcers have no symptoms, but the exact percentage is unknown</p> Signup and view all the answers

    What is a risk factor for duodenal ulcers?

    <p>Blood group O</p> Signup and view all the answers

    What is the characteristic of vomiting in gastric ulcers compared to duodenal ulcers?

    <p>Vomiting is more common in gastric ulcers</p> Signup and view all the answers

    What is the percentage of patients with duodenal ulcers who may experience perforation or hemorrhage?

    <p>20%-30%</p> Signup and view all the answers

    What is the primary goal of conservative therapy for medical management?

    <p>To promote adequate rest and stress management</p> Signup and view all the answers

    What is the recommended duration of triple therapy for H pylori infection?

    <p>10 to 14 days</p> Signup and view all the answers

    What is the purpose of quadruple therapy in the treatment of peptic ulcer disease?

    <p>To heal ulcers and eliminate H pylori infection</p> Signup and view all the answers

    What is the role of bismuth salts in quadruple therapy?

    <p>To enhance the effect of antibiotics</p> Signup and view all the answers

    What is the mechanism of action of histamine (H2) receptors blockers?

    <p>Blocking histamine receptors</p> Signup and view all the answers

    Which of the following medications is an example of a proton pump inhibitor?

    <p>Omeprazole</p> Signup and view all the answers

    What is the purpose of Tables 37-1 and 37-3 in the context of peptic ulcer disease?

    <p>To present details on drug regimens and medications used to treat peptic ulcer disease</p> Signup and view all the answers

    What is the advice given to patients undergoing pharmacologic therapy for peptic ulcer disease?

    <p>To adhere to and complete the medication regimen</p> Signup and view all the answers

    What is the primary purpose of vagotomy in the surgical treatment of gastric acid secretion?

    <p>To reduce gastric acid secretion</p> Signup and view all the answers

    What is the effect of pyloroplasty on gastric emptying?

    <p>Increased gastric emptying</p> Signup and view all the answers

    What is the primary focus of the nurse's assessment in a patient with gastric acid secretion?

    <p>Pain management and nutritional habits</p> Signup and view all the answers

    What is a characteristic of vomitus that the nurse would note during assessment?

    <p>Its color and consistency</p> Signup and view all the answers

    What lifestyle habit would the nurse assess in relation to gastric acid secretion?

    <p>Smoking cigarettes</p> Signup and view all the answers

    What medication use would the nurse assess in relation to gastric acid secretion?

    <p>NSAIDs</p> Signup and view all the answers

    What is a potential psychological factor that the nurse would assess in relation to gastric acid secretion?

    <p>Anxiety and stress</p> Signup and view all the answers

    What is a potential family history factor that the nurse would assess in relation to gastric acid secretion?

    <p>History of ulcers</p> Signup and view all the answers

    Study Notes

    Peptic Ulcer Disease (PUD)

    • A peptic ulcer is an excavation (hollowed-out area) that forms in the mucosal wall due to erosion of the GI mucosa, resulting from the digestive action of HCl acid and pepsin.

    Types of PUD

    • Acute PUD: characterized by superficial erosion, minimal inflammation, and short duration; resolves quickly when the cause is identified and removed.
    • Chronic PUD: characterized by muscular wall erosion with formation of fibrous tissue, long duration, and present continuously for many months or intermittently; 4 times as common as acute erosion.

    Pathophysiology

    • Causes of erosion: increased concentration or activity of HCl-pepsin or decreased resistance of gastric mucosa.
    • Patients with duodenal ulcer secrete more acid, while those with gastric ulcer secrete normal or decreased levels of acid.

    Etiology and Pathophysiology

    • Stomach protective mechanisms: gastric mucosal barrier, mucus secretion, and bicarbonate secretion.
    • Impaired mucosal barrier leads to cellular destruction and inflammation.
    • Risk/predisposing factors: smoking, alcohol, stress, eating habits, familial tendency, people with blood type O, milk and caffeinated beverages, chronic use of NSAIDs, aspirin, corticosteroids, cytotoxic drugs, and Helicobacter pylori infection.

    Gastric Ulcers

    • Occur in any portion of the stomach, with normal or hyposecretion of gastric acid (HCl).
    • Weight loss may occur, and pain occurs 1/2 to 1 hour after a meal, which may be relieved by vomiting; ingestion of food does not help and may increase pain.
    • Vomiting is common, and hemorrhage is more likely to occur than with duodenal ulcer.

    Duodenal Ulcers

    • Account for ~80% of all peptic ulcers, with a familial tendency (people with blood group O have an increased risk).
    • Associated with increased HCl acid secretion, and H. pylori is found in 90% to 95% of patients, but not all individuals with H. pylori develop ulcers.
    • Vomiting is uncommon, and hemorrhage is less likely than with gastric ulcer, but if present, melena is more common than hematemesis; more likely to perforate than gastric ulcers.

    Clinical Manifestations

    • Symptoms may last for a few days, weeks, or months and may disappear then reappear.
    • Many people with ulcers have no symptoms; perforation or hemorrhage may occur in 20%-30% of patients who had no preceding manifestations.
    • Dull, gnawing pain or burning sensation in the midepigastrium or back, which is relieved by eating or taking antacids.

    Medical Management

    • Conservative therapy consists of adequate rest, dietary modification, drug therapy, elimination of smoking and alcohol, and stress management.
    • Pharmacologic therapy includes triple therapy (2 antibiotics and a proton pump inhibitor) or quadruple therapy (2 antibiotics, proton pump inhibitor, and bismuth salts) for 10 to 14 days to treat H. pylori infection.

    Surgical Therapy

    • Surgical procedures: vagotomy (totally or partially) with or without pyloroplasty, performed to reduce gastric acid secretion, and done in conjunction with gastrectomy; pyloroplasty: increases gastric emptying.

    Nursing Care Plan

    • Assessment: pain and methods used to relieve it, vomiting, food habits, lifestyle habits, use of irritating substances, smoking, alcohol, NSAIDs, anxiety, stress, family history of ulcer disease.

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    Related Documents

    Peptic Ulcer Disease Ch 37 PDF

    Description

    This quiz covers the conservative therapy and pharmacologic therapy for the management of H pylori infection, including dietary modification, drug therapy, and stress management.

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