【2011苗圃执考笔记】消化系统第四讲（[2011 nursery exam notes] fourth digestive system）.docVIP

【2011苗圃执考笔记】消化系统第四讲（[2011 nursery exam notes] fourth digestive system） Practitioner examination Forum Http:// peptic ulcer (lower) Seven. Diagnosis and differential diagnosis According to the chronic course, periodic attack and rhythmic pain, it is an important clue for the diagnosis of peptic ulcer. The diagnosis was confirmed by gastroscopy Differential diagnosis between benign gastric ulcer and malignant ulcer: Benign ulcer; malignant ulcer Age, age, mostly middle-aged and middle-aged, mostly middle-aged The medical history is longer and shorter The clinical manifestation is obvious, the abdominal pain is obvious, there is no upper abdominal mass, the whole body is light, and the acid can relieve the pain. The medical treatment has a good effect. Progressive development, may have the upper abdominal mass, the whole body performance (such as emaciation) obvious, the general effect of the acid is poor, medical treatment is invalid or only temporary effective. Fecal occult blood temporarily sustained positive positive Gastric juice analysis of normal or low gastric acid, but not true, lack of acid, lack of acid more X ray examination in diameter 25mm, smooth wall. In gastric cavity contour, niche around soft gastric wall, a star shaped polymerization syndrome. Often 25mm. the niche, located within the luminal contour of the stomach; gastric niche around ankylosis, nodular, ulcer to aggregation phenomenon fusion folds interrupt Gastroscope examination ulcer round or oval, smooth bottom, smooth edges, white or gray white moss, ulcer surrounding soft mucosa, visible wrinkles wall to ulcer concentration. Ulcer shape irregular, uneven bottom, edge nodules uplift, filthy moss, ulcers around because of cancer infiltration, thickening, stiffness, texture crisp, nodules, erosion, easy bleeding. Another attention should be paid to the meaning of a few points: 1. complex ulcers of the stomach and duodenum. They mean gastric ulcer and duodenal ulcer. Duodenal ulcer occurs first