Peptic Ulcer Disease Treatment and Diagnosis

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Questions and Answers

What is the primary goal of treatment for peptic ulcer disease (PUD)?

Relieve symptoms

Increase gastric acid production

Promote digestion

Eradicate H.pylori infection (correct)

Which diagnostic procedure is often chosen first for detecting peptic ulcers?

Urea breath test

Fecal antigen immunoassay

Upper GI series using barium (correct)

Gastroscopy

What is the primary limitation of biopsy tests for H.pylori detection?

They are highly invasive and costly. (correct)

They are not specific to H.pylori.

They are ineffective in detecting ulcers.

They provide results too quickly.

How does the rapid urease test for H.pylori work?

It converts urea to ammonia and carbon dioxide indicating the presence of H.pylori. Signup and view all the answers

What preparations should be made before performing a urea breath test?

Discontinue proton pump inhibitors for 14 days. Signup and view all the answers

In which condition is gastric analysis primarily performed?

Zollinger-Ellison syndrome Signup and view all the answers

What can non-invasive methods to detect H.pylori infection include?

Serologic testing Signup and view all the answers

Which method can be used to measure the effectiveness of treatment to eradicate H.pylori?

Fecal antigen testing Signup and view all the answers

What is the purpose of proton pump inhibitors in the treatment of peptic ulcer disease?

To block the secretion of gastric acid Signup and view all the answers

Which treatment regimen is considered 'triple therapy' for eradicating H.pylori?

Two antibiotics and a proton pump inhibitor Signup and view all the answers

What is a primary long-term complication of gastric resection surgery for peptic ulcer disease?

Nutritional deficiencies Signup and view all the answers

What is one reason why misoprostol is contraindicated in pregnant women?

It can cause birth anomalies and premature birth. Signup and view all the answers

How does sucralfate aid in the healing of duodenal ulcers?

By forming a protective barrier over the ulcer Signup and view all the answers

What dietary recommendation can help prevent further ulcers in patients with a history of PUD?

Increase fiber intake Signup and view all the answers

Which of the following is a common side effect of misoprostol?

Diarrhea Signup and view all the answers

Which drug is commonly used in quadruple therapy due to clarithromycin resistance?

Tetracycline Signup and view all the answers

What lifestyle change is recommended for patients suffering from peptic ulcer disease?

Mild alcohol intake is acceptable Signup and view all the answers

What is the goal of pharmacologic therapy in treating ulcers caused by H.pylori infection?

To eradicate H.pylori and allow the ulcer to heal Signup and view all the answers

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.