no more a loser
Forum Guru
Topics: 140
Posts: 580
|
what is the most cost effective test to dx Hpylori?
|
| zaki
Forum Guru
Topics: 92
Posts: 398
|
serology
___________________
Maverick
|
| no more a loser
Forum Guru
Topics: 140
Posts: 580
|
yup
|
| s_braga
Forum Junior
Topics: 6
Posts: 53
|
*** Whenever I've a patient with gastric symptoms, what should I order first: serology or endoscopy? I've read that sometimes the inital step is serology but in another book it says the first step is endoscopy! On the other hand, if the patients shows up with general (non-classic) dyspepsia, should I start with ENDOSCOPY or H.py?.
* The idea that I have is the one below and I would like to know if it is correct?:
* CLASSIC symptoms of GASTRITIS => do SEROLOGY first!
If POSITIVE => TREAT IT and NO ENDOSCOPY is needed. Just treat it b/c it's Type B (H.pylori) gastritis.
If NEGATIVE (but still classic symptoms, or not) => ENDOSCOPY + BIOPSY + SEROLOGY.
Diagnosis confirmed?
YES => TREAT, it's gastritis!
NO => It could be PUDs (gastric or duodenal) or CANCER.
If it's GU => TREAT IT same way as gastritis.
If it's DU => TREAT IT same way as gastritis.
NON-SPECIFIC DYSPEPSIA OR CLASSICAL GASTRIC ULCER Sx's
Start with ENDOSCOPY + BIOPSY + Serology.
It shows Inflammation => Treat!
It shows Gastric Ulcer => Treat! If patient does not improve, EGD+BIOPSY AGAIN!!!
It shows Duodenal Ulcer => Treat!
It shows Cancer => CANCER Treatment!!!
Well, this is what I understood from Kaplan notes. Another thing that messed me up was that in class, Dr Faselis said "You donīt have to do an EGD if it (Duodenal Ulcer) has a classic presentation". And, according with Appleton & Lange CMDT, this is correct - at least this is my understanding. I just want to make sure.
Does anyone have a clearer explanation or a PUD & Gastritis diagram that would help me understand with this stuff?
Thanks!
|
|
| |
| | | | |
