Chapter 78: Peptic ulcer Disease and Gastritis

Question 1

“Alarm Features” for Endoscopy

Answer 1

• 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

Question 2

The gold standard for diagnosis of peptic ulcer disease

Answer 2

upper GI endoscopy

Question 3

drug that may prevent ulcer formation in those concurrently receiving NSAID therapy but has not been proven to heal ulcers.

Answer 3

Misoprostol

Question 4

“Triple Therapy”

Answer 4

proton pump inhibitor, clarithromycin, and either amoxicillin or metronidazole

10 to 14 day regimens

Question 5

Forrest classification

Answer 5

• active spurting of blood (Ia)
• active oozing (Ib)
• nonbleeding visible vessel (IIa)
• adherent clot (IIb)
• flat pigmented spot (IIc)
• an ulcer with a clean base (III)

injection therapy (epinephrine, sclerosing agents), thermal therapy (electrocoagulation, heater probe, argon plasma coagulation), and mechanical clipping and banding