Question 1

Which of the following is the American College of Gastroenterology treatment recommendation for H. pylori-related peptic ulcer disease? A) H₂RA and clarithromycin for 14 days B) H₂RA, bismuth, metronidazole, and tetracycline for 10 to 14 days C) Proton pump inhibitor (PPI) and clarithromycin for 14 days D) Proton pump inhibitor (PPI), amoxicillin, and clarithromycin for 10 days

Accepted Answer

The American College of Gastroenterology recommends a triple therapy regimen consisting of a proton pump inhibitor (PPI), amoxicillin, and clarithromycin for 10 to 14 days as a first-line treatment for H. pylori-related peptic ulcer disease.

Question 2

A patient who has been taking an NSAID for osteoarthritis pain has been diagnoses with peptic ulcer disease (PUD). What is the initial step in treating this patient? A) Discontinue the NSAID. B) Order prostaglandin therapy. C) Prescribe a proton pump inhibitor. D) Recommend an H₂ receptor antagonist.

Accepted Answer

The initial step in treating a patient with PUD who has been taking an NSAID is to discontinue the NSAID. NSAIDs are known to cause and exacerbate PUD, and continuing to take them could lead to further damage to the gastrointestinal tract. Once the NSAID has been discontinued, other treatments can be considered to manage the PUD.

Question 3

A patient has persistent epigastric pain occurring 2 to 3 hours after a meal. Which test is definitive for diagnosis peptic ulcer disease (PUD) in this patient?&#10;A) Barium swallow with radiography&#10;B) Breath test or stool antigen testing for H. pylori&#10;C) Endoscopy with biopsy of gastric mucosa&#10;D) Physical exam with percussion of the upper abdomen

Accepted Answer

Endoscopy with biopsy of gastric mucosa is the definitive test for diagnosing peptic ulcer disease (PUD) as it allows for direct visualization of the ulcer and biopsy of gastric mucosa can confirm the presence of H. pylori infection, which is a common cause of PUD. Barium swallow and radiography can only detect the presence of an ulcer, but cannot confirm the diagnosis. Breath test or stool antigen testing for H. pylori can only confirm the presence of H. pylori infection, but cannot diagnose PUD. Physical exam with percussion of the upper abdomen may reveal tenderness, but it is not definitive for diagnosing PUD.

Deck 126: Peptic Ulcer Disease