Chapter 78: Peptic Ulcer Disease and Gastritis

Question 1

It protect mucosa by enhancing mucus and bicarbonate production and by enhancing mucosal blood flow, thereby supporting metabolism

Answer 1

Prostagladin

Question 2

Thought to be the causal agents of peptic ulcer disease in most cases

Answer 2

NSAIDS and H. pylori

Question 3

Characteristic of H. pylori

Answer 3

Spiral, gram-negative, urease-producing, flagellated bacterium

Question 4

Continuous or recurrent upper abdominal pain or discomfort and may be caused by a number of diseases or may be functional

Answer 4

Dyspepsia

Question 5

The most classic symptom of peptic ulcer disease

Answer 5

Burning epigastric pain

Question 6

The most common presentation of gastritis is ____

Answer 6

The most common presentation of gastritis is GI bleeding

Question 7

The gold standard for diagnosis of peptic ulcer disease is ____

Answer 7

The gold standard for diagnosis of peptic ulcer disease is visualization of an ulcer by upper GI endoscopy

Question 8

Laboratory test that can be used to determine the presence of infection after eradication therapy

Answer 8

Urea breath test

Question 9

Accurate time to do urea breath test after H. pylori eradication

Answer 9

Testing performed ≥4 weeks after completion of H. pylori eradication therapy is useful as a test of cure

Question 10

When to do testing for H. pylori?

Answer 10

after 2-4 weeks of medications

Question 11

Current literature supports using ____ as first-line noneradication therapy for peptic ulcers

Answer 11

Current literature supports using proton pump inhibitors as first-line noneradication therapy for peptic ulcers

Question 12

Long term side effect of proton pump inhibitors

Answer 12

Clostridium difficile–associated diarrhea, fracture, pneumonia risk, chronic kidney disease, and hypomagnesemia

Question 13

True or False

In H2 receptor antagonists, because of renal excretion, make dosage adjustments in patients with renal failure

Answer 13

True

In H2 receptor antagonists, because of renal excretion, make dosage adjustments in patients with renal failure

Question 14

This H2 receptor antagonist has the most significant drug interactions due to inhibition of cytochrome P450 activity

Answer 14

Cimetidine

Question 15

Drug that appears to protect the ulcer from acid exposure by forming a sticky gel that adheres to the ulcer crater but does not relieve pain

Answer 15

Sucralfate

Question 16

Drug that heal ulcers by buffering gastric acid

Answer 16

Antacids

Question 17

Component of Antacids that may accumulate and cause osteoporosis, encephalopathy and hypermagnesemia

Answer 17

Aluminum in renal failure

Question 18

Drug that may prevent ulcer formation in those concurrently receiving NSAID therapy

Answer 18

Misoprostol

Question 19

Component of triple therapy in eradication of H. pylori

Answer 19

proton pump inhibitor, clarithromycin, and either amoxicillin or metronidazole

Question 20

Most common cause of GI-related hospital admissions

Answer 20

Upper GI bleeding

Question 21

It is given 30 minutes prior to endoscopy to improve visualization of the gastric mucosa

Answer 21

Azithromycin IV

Question 22

It is use for classification of lesion to predict risk of rebleeding

Answer 22

Forrest classification

Question 23

Forrest classification

Answer 23

Active spurting of blood (Ia); Active oozing (Ib); Nonbleeding visible vessel (IIa); Adherent clot (IIb); Flat pigmented spot (IIc); and An ulcer with a clean base (III)

Question 24

“Alarm Features” for Endoscopy

Answer 24

• Age >50 y, with new-onset symptoms
• Unexplained weight loss
• Persistent vomiting
• Dysphagia or odynophagia
• Iron deficiency anemia or GI bleeding
• Abdominal mass or lymphadenopathy
• Family history of upper GI malignancy