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Questions and Answers
What is the primary goal of treatment for peptic ulcer disease (PUD)?
Which diagnostic procedure is often chosen first for detecting peptic ulcers?
What is the primary limitation of biopsy tests for H.pylori detection?
How does the rapid urease test for H.pylori work?
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What preparations should be made before performing a urea breath test?
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In which condition is gastric analysis primarily performed?
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What can non-invasive methods to detect H.pylori infection include?
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Which method can be used to measure the effectiveness of treatment to eradicate H.pylori?
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What is the purpose of proton pump inhibitors in the treatment of peptic ulcer disease?
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Which treatment regimen is considered 'triple therapy' for eradicating H.pylori?
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What is a primary long-term complication of gastric resection surgery for peptic ulcer disease?
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What is one reason why misoprostol is contraindicated in pregnant women?
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How does sucralfate aid in the healing of duodenal ulcers?
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What dietary recommendation can help prevent further ulcers in patients with a history of PUD?
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Which of the following is a common side effect of misoprostol?
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Which drug is commonly used in quadruple therapy due to clarithromycin resistance?
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What lifestyle change is recommended for patients suffering from peptic ulcer disease?
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What is the goal of pharmacologic therapy in treating ulcers caused by H.pylori infection?
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Study Notes
Peptic Ulcer Disease (PUD) Treatment
- Focuses on treating the cause of PUD such as H. pylori infection or NSAID-related ulcers.
- Eradicating H. pylori infection and managing NSAID use are crucial.
- Nurses play a vital role in ongoing assessment and patient education.
Diagnostic Tests
- Upper GI series uses barium to detect ulcers via x-ray, effective for 80-90% of cases.
- Gastroscopy allows visualization of the esophagus, stomach, and duodenum, enabling direct ulcer inspection and tissue biopsy for H. pylori detection.
- Rapid urease test is a quick method using urea to indicate the presence of H. pylori within 1-24 hours.
- Microscopic examination and culturing of biopsy samples are alternative methods for H. pylori detection.
- Non-invasive methods for H. pylori detection include serologic testing, fecal antigen immunoassays, and urea breath test.
- Gastric acid analysis through nasogastric tube aspiration helps diagnose Zollinger-Ellison syndrome.
Treatment Options
- Surgery is rarely necessary, with advancements in medical treatment for PUD.
- Pharmacologic Therapy utilizes drugs effective in treating GERD to manage PUD due to hydrochloric acid erosion.
- H2-receptor antagonists (H2 blockers) like cimetidine (Tagamet) reduce acid secretion by blocking histamine.
- Proton pump inhibitors (PPIs) such as omeprazole (Prilosec) inhibit the ATPase pump in stomach mucosa, blocking gastric acid secretion.
- Eradication of H. pylori relies on multiple-drug therapies, including triple therapy (amoxicillin, clarithromycin, and PPI) and quadruple therapy (tetracycline, metronidazole, PPI, and bismuth) for resistant strains.
- Bismuth compounds like Pepto-Bismol promote healing by stimulating mucosal bicarbonate and prostaglandin production, suppressing H. pylori.
- Sucralfate (Carafate) forms a protective barrier against acid in duodenal ulcers, aiding healing.
- NSAID-induced ulcers require discontinuing the NSAID, alternative analgesics, or PPIs, blockers, sucralfate, or prostaglandin analogs for healing.
- Prostaglandin analogs (misoprostol) promote ulcer healing, but are contraindicated in pregnancy due to potential birth defects.
- Complementary Health Approaches include stress reduction (yoga, walking, music), increased dietary fiber, zinc supplementation, and ginger for nausea.
Nursing Considerations
- Patient teaching is critical, focusing on lifestyle modifications like smoking cessation, balanced meals, and avoiding unnecessary dietary restrictions.
- Monitoring patient compliance with medication regimens is essential for successful eradication of H. pylori and ulcer healing.
- Regular assessment and tailored education empower patients to manage their PUD actively.
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Description
This quiz covers the treatment and diagnostic methods for Peptic Ulcer Disease (PUD). It includes details on H. pylori infection management and various tests used to detect ulcers. Understanding the roles of nurses in patient education and ongoing assessment is also integral to the content.