Peptic Ulcer Disease (PUD) Fitz and Leik Flashcards
1
Q
55. The gastric parietal cells produce: A. hydrochloric acid. B. a protective mucosal layer. C. prostaglandins. D. prokinetic hormones.
A
A. hydrochloric acid.
2
Q
- Antiprostaglandin drugs cause stomach mucosal injury primarily by:
A. a direct irritative effect.
B. altering the thickness of the protective mucosal layer.
C. decreasing peristalsis.
D. modifying stomach pH level.
A
B. altering the thickness of the protective mucosal layer.
3
Q
- A 24-year-old man presents with a 3-month history of upper abdominal pain. He describes it as an intermittent,
centrally located “burning” feeling in his upper abdomen, most often occurring 2 to 3 hours after meals. His presentation is most consistent with the clinical presentation of:
A. acute gastritis.
B. gastric ulcer.
C. duodenal ulcer.
D. cholecystitis
A
C. duodenal ulcer.
4
Q
- When choosing pharmacological intervention to prevent recurrence of duodenal ulcer in a middle-aged
man, you prescribe:
A. a proton pump inhibitor (PPI).
B. timed antacid use.
C. antimicrobial therapy.
D. a histamine2-receptor antagonist (H2RA).
A
C. antimicrobial therapy.
5
Q
- The H2RA most likely to cause drug interactions with phenytoin and theophylline is:
A. cimetidine.
B. famotidine.
C. nizatidine.
D. ranitidine.
A
A. cimetidine
6
Q
60. Which of the following is least likely to be found in a patient with gastric ulcer? A. history of long-term naproxen use B. age younger than 50 years C. previous use of H2RA or antacids D. cigarette smoking
A
B. age younger than 50 years
7
Q
61. Nonsteroidal anti-inflammatory drug (NSAID)-induced peptic ulcer can be best limited by the use of: A. timed antacid doses. B. an H2RA. C. an appropriate antimicrobial. D. misoprostol.
A
D. misoprostol.
8
Q
- Cyclooxygenase-1 (COX-1) contributes to:
A. the inflammatory response.
B. pain transmission.
C. maintenance of gastric protective mucosal layer.
D. renal arteriole constriction.
A
C. maintenance of gastric protective mucosal layer.
9
Q
- Cyclooxygenase-2 (COX-2) contributes to:
A. the inflammatory response.
B. pain transmission inhibition.
C. maintenance of gastric protective mucosal layer.
D. renal arteriole dilation.
A
A. the inflammatory response.
10
Q
- You see a 48-year-old woman who has been taking a COX-2 inhibitor for the past 3 years. In counseling her,
you mention that long-term use of COX-2 inhibitors is associated with all of the following except:
A. hepatic dysfunction.
B. gastropathy.
C. cardiovascular events.
D. cerebrovascular events.
A
A. hepatic dysfunction.
11
Q
- A 64-year-old woman presents with a 3-month history of upper abdominal pain. She describes the discomfort
as an intermittent, centrally located “burning” feeling in the upper abdomen, most often with meals and
often accompanied by mild nausea. Use of an over-thecounter H2RA affords partial symptom relief. She also uses diclofenac on a regular basis for the control of osteoarthritis pain. Her clinical presentation is most consistent with:
A. acute gastroenteritis.
B. gastric ulcer.
C. duodenal ulcer.
D. chronic cholecystitis.
A
B. gastric ulcer.
12
Q
- Which of the following statements about Helicobacter pylori is false?
A. H. pylori is a gram-negative, spiral-shaped
bacterium.
B. Infection with H. pylori is the most potent risk factor
for duodenal ulcer.
C. The organism is often resistant due to the production of beta-lactamase.
D. H. pylori is transmitted via the oral-fecal or oral-oral
route.
A
C. The organism is often resistant due to the production of beta-lactamase.
13
Q
- The most sensitive and specific test for H. pylori infection from the following list is:
A. stool Gram stain, looking for the offending organism.
B. serological testing for antigen related to the infection.
C. organism-specific stool antigen testing.
D. fecal DNA testing.
A
C. organism-specific stool antigen testing.
14
Q
68. Which of the following medications is a PPI? A. loperamide B. metoclopramide C. nizatidine D. lansoprazole
A
D. lansoprazole
15
Q
69. Peptic ulcer disease can occur in any of the following locations except: A. duodenum. B. stomach. C. esophagus. D. large intestine.
A
D. large intestine.
16
Q
- An ulcer that is noted to be located in the region below the lower esophageal sphincter and before the pylorus
is usually referred to as a(n) ________ ulcer.
A. duodenal
B. esophageal
C. gastric
D. stomach
A
C. gastric
17
Q
- A 56-year-old man with a 60 pack-year cigarette smoking history, recent 5-lb unintended weight loss, and a
3-month history of new-onset symptoms of peptic disease presents for care. He is taking no medications on a regular basis and reports drinking approximately
six 12-oz beers per week with no more than three beers per day. Physical examination is unremarkable except
for mild pharyngeal erythema and moderate epigastric
tenderness without rebound. The most helpful diagnostic
test at this point in his evaluation is:
A. an upper endoscopy.
B. a barium swallow.
C. an evaluation of H. pylori status.
D. an esophageal pH monitoring.
A
A. an upper endoscopy.
18
Q
72. Which of the following medications is a prostaglandin analogue? A. sucralfate B. misoprostol C. esomeprazole D. metoclopramide
A
B. misoprostol
19
Q
- Long-term PPI use is associated with all of the following except:
A. increased risk of pneumonia in hospitalized patients.
B. increased risk of C. difficile colitis in hospitalized
patients.
C. reduced absorption of calcium and magnesium.
D. reduced absorption of dietary carbohydrates.
A
D. reduced absorption of dietary carbohydrates.
