Peptic Ulcer Disease: NCLEX Priorities
PUD: H. pylori vs NSAID, gastric vs duodenal pain pattern, complications, triple therapy.
PUD is ulceration in stomach or duodenum. NCLEX tests H. pylori treatment and complication recognition.
Gastric vs duodenal
Gastric, pain during or after meals. Weight loss. Risk of cancer. Duodenal, pain 2-3 hours after meals, relieved by food. Weight stable or gain.
Causes
H. pylori (most common). NSAIDs. Stress (ICU patients). Zollinger-Ellison rare.
H. pylori treatment
Triple therapy: PPI + clarithromycin + amoxicillin × 14 days. Or quadruple therapy (PPI + bismuth + metronidazole + tetracycline) in resistant areas.
Complications
GI bleed (melena, hematemesis), perforation (sudden severe pain, rigid abdomen, surgical emergency), obstruction (vomiting, weight loss).
Frequently asked
H. pylori test of cure?
Urea breath test or stool antigen 4 weeks after therapy. Don't use serology (stays positive).
Stop PPI after eradication?
Depends on symptoms. Often taper if asymptomatic.
Quick check
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