PATHOPHYSIOLOGY 101
What causes PUD?
An imbalance between gastric acid and the protective mucosal barrier, often due to Helicobacter pylori infection or NSAID use.
What kind of pain is typical in PUD?
Burning or gnawing pain, typically in the epigastric region, often occurring between meals.
What is perforation in PUD?
A hole in the stomach or duodenum wall caused by an untreated ulcer, leading to leakage of stomach contents into the abdominal cavity.
What physical area is typically tender in PUD?
The epigastric region of the abdomen, where ulcers are most commonly located.
T/F Does stress cause ulcers?
False! While stress may exacerbate symptoms, the primary causes of ulcers are H. pylori infection and NSAID use.
What is Helicobacter pylori?
A bacterium that infects the stomach lining, weakening the protective mucus and leading to ulcers.
What symptom is relieved by food or antacids?
Epigastric pain—eating temporarily neutralizes stomach acid and relieves discomfort.
What is gastrointestinal bleeding in PUD?
Vomiting blood (hematemesis) or passing black tarry stools (melena) due to ulcers bleeding.
What vital signs should be monitored in a patient with suspected PUD complications?
Tachycardia (increased heart rate) and hypotension (low blood pressure) may indicate significant blood loss.
T/F: Do spicy foods cause ulcers?
False! Spicy foods can irritate existing ulcers but are not a direct cause.
How do NSAIDs cause ulcers?
NSAIDs inhibit prostaglandin synthesis, reducing mucosal protection in the stomach and increasing acid damage.
What are signs of severe PUD?
Severe pain, nausea, vomiting, hematemesis (vomiting blood), and melena (black stools indicating bleeding).
What is gastric outlet obstruction in PUD?
A blockage in the stomach or duodenum that prevents food from passing through, leading to vomiting and weight loss.
What does pallor or jaundice indicate in a patient with PUD?
Pallor could indicate anemia, while jaundice might suggest liver involvement or significant bleeding.
T/F: Can ulcers happen without pain?
True! Some ulcers, especially in the elderly, may not cause noticeable pain but can still lead to complications like bleeding.
What is the role of the mucosal barrier in PUD?
It protects the stomach lining from gastric acid and digestive enzymes, preventing ulcer formation.
What causes nausea and bloating in PUD?
The ulcer irritation and delayed gastric emptying can cause discomfort and distension in the stomach.
What happens when an ulcer spreads to another organ?
The ulcer may cause inflammation, infection, or damage to adjacent organs, leading to more severe complications like pancreatitis or peritonitis.
What does rebound tenderness suggest during a physical exam?
It suggests peritonitis, a sign of serious complications like perforation, requiring immediate medical attention.
T/F: Is it okay to keep taking NSAIDs if you have ulcers?
False! NSAIDs should be avoided, as they can worsen ulcers by reducing stomach protection.
What’s the full pathophysiology of Peptic Ulcer Disease (PUD)?
PUD occurs when aggressive factors like gastric acid and pepsin overwhelm the defensive factors, such as the mucosal barrier and bicarbonate secretion, often triggered by H. pylori or NSAIDs.
What symptom indicates esophageal involvement in PUD?
Pain or discomfort when swallowing, known as dysphagia, often suggests ulcers in the esophagus.
What is ulcer-related anemia?
Chronic blood loss from ulcers can lead to iron deficiency anemia, resulting in fatigue and pallor.
What does epigastric tenderness indicate in a PUD assessment?
Tenderness in the upper abdomen may suggest the presence of an ulcer or inflammation in the stomach lining.
T/F: Can ulcers heal without treatment?
False! Untreated ulcers can lead to serious complications like perforation, bleeding, or obstruction. Proper treatment is necessary.