Page 252 - 2021 IDMT Digital

PEPTIC ULCER DISEASE (PUD)
Introduction:
• 3HSWLF XOFHU EUHDN LQ JDVWULF RU GXRGHQDO PXFRVD
o $ULVHV ZKHQ PXFRVDO GHIHQVH IDFWRUV DUH LPSDLUHG RU RYHUZKHOPHG E\
DJJUHVVLYH OXPLQDO IDFWRUV DFLG
• [ PRUH FRPPRQ LQ GXRGHQXP
• 0RUH FRPPRQ LQ VPRNHUV
• (WLRORJ\
o H pylori SUHYDOHQFH
o 16$,' iQGXFHG SUHYDOHQFH
• )RU GLDJQRVLV PXVW QRWH OHVLRQV RQ XSSHU HQGRVFRS\
Subjective:
• 6LJQV DQG 6\PSWRPV
o (SLJDVWULF SDLQ G\VSHSVLD LV WKH KDOOPDUN RI 38' SUHVHQW LQ RI SDWLHQWV
ƒ 3DLQ LV XVXDOO\ QRW VHYHUH DQG GHVFULEHG DV JQDZLQJ GXOO DFKLQJ
³KXQJHU OLNH´
ƒ RI SDWLHQWV UHSRUW UHVROXWLRQ RI V\PSWRPV ZLWK DQWDFLG
ƒ 0D\ FDXVH QRFWXUQDO SDLQ WKDW DZDNHQV SDWLHQW
o 0D\ EH DV\PSWRPDWLF
• )RFXVHG +LVWRU\
o 7LPLQJ RI V\PSWRPV W\SHV RI IRRG PHGLFDWLRQ XVH
Objective:
• 3K\VLFDO ([DP
o 2IWHQ QRUPDO LQ XQFRPSOLFDWHG 38'
o 0D\ KDYH PLOG ORFDOL]HG HSLJDVWULF WHQGHUQHVV WR GHHS SDOSDWLRQ
• 7RROV
o H pylori WHVWLQJ
o 8SSHU HQGRVFRS\ PXVW KDYH IRU GLDJQRVLV
Assessment:
• 'LIIHUHQWLDO
o '\VSHSVLD SDLQ DQG disFRPIRUW FHQWHUHG LQ WKH XSSHU DEGRPHQ GRHV QRW
LQYROYH UHIOX[ V\PSWRPV
o *(5' UHIOX[ RI VWRPDFK FRQWHQWV FDXVLQJ KHDUWEXUQ V\PSWRPV
o *DVWULWLV LQIODPPDWLRQ RI WKH JDVWULF PXFRVD
o $FXWH SDQFUHDWLWLV DEUXSW RQVHW RI GHHS HSLJDVWULF SDLQ RIWHQ ZLWK UDGLDWLRQ WR WKH
EDFN ODEV ZLOO VKRZ HOHYDWHG SDQFUHDWLF HQ]\PHV
o 3HUIRUDWHG SHSWLF XOFHU VXGGHQ LQWHQVH SDLQ RYHU HSLJDVWULXP

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