Stomach and duodenal DO

Question 1

Which type of ulcer is more common: Duodenal or gastric?

Answer 1

Duodenal

Question 2

What is a major risk factor for all ulcers?

Answer 2

Smoking

Question 3

What causes 75-90% of duodenal/gastric ulcers?

Answer 3

H. Pylori

Question 4

What is the best diagnostic tool for evaluating PUD?

Answer 4

EGD

Question 5

Which type of ulcer is more likely to be malignant: Gastric or duodenal?

Answer 5

Gastric

Question 6

What are the first and second line drug classes for PUD?

Answer 6

1. Antisecretory agents (PPI, H2 blockers)

2. Mucosal defense agents

Question 7

What is the quadruple Rx for H. pylori eradication? (90% effective)

Answer 7

PPI, bismuth, tetracycline, metronidazole

Question 8

What is the triple Rx for H. pylori eradication?

Answer 8

PPI, clarithromycin (metronidazole), amoxicillin

Question 9

How do you confirm eradication of H. pylori?

Answer 9

C-urea breath test or fecal antigen test after 4 weeks post completion of antibiotic regimen and 2 weeks after discontinuation of PPI

Question 10

If someone has a recurrent ulcer, what do you need to do?

Answer 10

R/O H. pylori infection and/or NSAID use

Question 11

What is the preferred Rx for prevention of an NSAID ulcer?

Answer 11

PPI

Question 12

Hematemesis or melon should concern you for??

Answer 12

Bleeding ulcer

Question 13

What is the best way to prevent a patient from getting stress gastritis?

Answer 13

PPI orally or through an NG tube

Question 14

Do you need to do any testing to diagnose/treat NSAID gastritis?

Answer 14

No, if they are on NSAIDs and they are having symptoms empiric Rx is reasonable

Question 15

How do you diagnose Zollinger-Ellison syndrome?

Answer 15

Increased serum gastrin, and gastric pH below 3