PUD 2.pptx it ia very importnat for nedical

Medical

1. Conference: PUD Mentor: Prof Salam Jan Shams Presented by: Hekmatullah A hmazai Number of Slide: 16

2. Components, Definition. Causes. Risk factors types. Specific Chronic Disorders. Signs.Symptoms . Diagnostic Examination. DDX. Treatment. Complications.

3. Definition Peptic ulcer is a break in the gastric and duodenal mucosa that arises when the normal mucosal defensive factors are impaired.

4. Causes H pylori A ssociated Ulcers. NSAID Induced Ulcers. Genetic. Smoking. Diet. Resistance to Pepsin and acids .

5. Risk Factors Age >60 years. Past Hx of PUD. Com of Steroid@NSAID. High Dose of NSAID. Com of Two NSAID Advance Age. Chronic pulmonary disease. Chronic Renal Failure. Liver cirrhosis. Obesity. CAD. Alchol use. Chronic pancreatitis

6. Symptoms. Epigastric pain (80 -90%). Silent Ulcers (20%). Rhythmicity and Peridiocity. Nausia and Vomiting. Weight Loss

7. Symptoms and Signs Epigastric pain (80 -90%). Silent Ulcers (20%). Rhythmicity and Peridiocity. Nausia and Vomiting. Weight Loss Epigastric tenderness. Bleeding and Perforation. Perforation and Peritonitis. Penetration. Succussion splash

8. Diagnostic Examinations. Un complicated PUD lab inves is normal. Anemia. Leucocytosis. Serum Amylase. Serum Gastrin. Endoscopy. Biopsy. H pylori.

9. DDX Other Cause of Dyspepsia. GERD. Bile Disease. Acute Pancreatitis. Gastric Valvulus. Esophageal rupture. Choledocholithiasis.

10. Treatment Acid Antisecretory Agents. Mucosal Protective Agents. H.pylori Eradication Therapy.

11. H Pylori Eradication Therapy. PPI BID . Bismoth Subcitrate 120 mg BID . Tetracycline 500mg QID . Metronidazole 500 mg TID. (tinidazole) PPI BID . Amoxicillin 1000mg BID. Metronidazole500mg BID. Clarithromycin 500mg BID. Standard _B_Q_ Therapy Standard N B Q Therapy

12. Con …….. Standard triple therapy PPI BID. Clarithromycin 500 mg BID. Amoxicillin 1000mg BID. (Metronidazole 500 BID) Levofloxacin Triple therapy PPI BID. Levofloxacin 500mg BID. Amoxicillin 1000 mg BID.

13. CON…… Rifabutin Based Triple Therapy Omeprazol40 mg QID. Rifabutin50mg QID. Amoxil 1000 mg QID. Potassium competitive acid pump antagonisy. Vonoprazon + Amoxil or. Vonoprazon. Amoxil. Clarithromycin

14. Complications. GI Bleeding. Ulcer perforation. Ulcer penetration. Gastric outlet Obstruction. Gastrinoma.

15. References. CMDT 2024 Gastroenterology Prof Saifullah Hadi 1403. Myo Net.com. Harrison.