MedU Case 19

Question 1

epigastric abdominal pain that is relieved with meals

Answer 1

peptic ulcer disease

Question 2

use of what causes PUD

Answer 2

NSAIDs
cigarettes
physiological stress
H. pylori

Question 3

epigastric pain that improved immediately after a meal

Answer 3

gastritis

Question 4

use of what causes gastritis

Answer 4

alcohol

NSAIDs

Question 5

epigastric pain radiating to the back and worsens w/ eating

Answer 5

acute pancreatitis

Question 6

complications of PUD

Answer 6

hemorrhage
perforation
gastric outlet syndrome

Question 7

dysphagia to liquids

Answer 7

motility disorder

Question 8

rapidly progressive dysphagia

Answer 8

adenocarcinoma

Question 9

dysphagia to solids

Answer 9

peptic stricture

Question 10

early satiety

Answer 10

gastroparesis

gastric outlet obstruction

Question 11

recurrent vomiting

Answer 11

gastric outlet obstruction

Question 12

trial of PPIs should last how long?

Answer 12

8 wks

Question 13

PPI ADRs

Answer 13

CAP
C. diff
osteoporosis
inhibits anti-platelet meds
defic Fe, Mg, B12

Question 14

best H. pylori test if not getting endoscopy

Answer 14

H. pylori IgG

Question 15

conditions in order to do urease breath test

Answer 15

need to be off PPIs for 2 weeks

Question 16

triple therapy for H. pylori

Answer 16

PPI
amoxicillin (or metronidazole)
clarithromycin

Question 17

quadruple therapy for H. pylori

Answer 17

PPI
metronidazole
tetracycline
bismuth

Question 18

tests to evaluate eradication of H. pylori

Answer 18

urease breath test

fecal antigen test

Question 19

indications for testing if H. pylori was eradicated post treatment

Answer 19

H. pylori-associated ulcer
sxs despite tx for H. pylori
H. pylori-associated MALT lymphoma, 
h/o resection for early gastric cancer, 
plan to resume chronic NSAID therapy