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Self Assessment Quiz - Peptic Ulcer Disease
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NSAID-induced ulcers differ from H. pylori-associated ulcers in that patients with an NSAID-induced ulcer are more likely to have
A)a duodenal ulcer.
B)more severe upper gastrointestinal bleeding.
C)ulcer-related epigastric pain.
D)gastric cancer.

The preferred noninvasive test to confirm H. pylori eradication is
A)a stool antigen test.
B)a whole-blood antibody-detection test.
C)a serologic antibody detection test.
D)a urea breath test.

The following statements best characterize the current status of H. pylori testing and treating except
A)asymptomatic patients with a documented history of PUD should be tested for H. pylori, and if positive, should receive eradication therapy.
B)symptomatic patients with uninvestigated dyspepsia should be tested for H. pylori, and if positive, should receive eradication therapy.
C)symptomatic patients with an active peptic ulcer should be tested for H. pylori, and if positive, should receive eradication therapy.
D)asymptomatic patients who do not have an active ulcer or a documented history of an ulcer but who were tested for H. pylori and found to be positive should be offered eradication therapy.

Antimicrobial resistance to H. pylori is most likely to occur with which of the following agents?
A)Metronidazole and clarithromycin
B)Clarithromycin and tetracycline
C)Metronidazole and amoxicillin
D)Amoxicillin and tetracycline

The preferred drug treatment regimen for a penicillin-allergic H. pylori-positive 35-year-old man with epigastric pain and a duodenal ulcer documented by radiography is
A)lansoprazole + metronidazole.
B)ranitidine bismuth citrate + clarithromycin.
C)omeprazole + metronidazole + clarithromycin.
D)bismuth subsalicylate + metronidazole + tetracycline.

The most important parameter to monitor to assess ulcer healing in an H. pylori-positive 25-year-old man who has just completed eradication therapy for his first ulcer is
A)symptom relief 1 to 2 weeks after completion of drug treatment.
B)upper endoscopy on completion of drug treatment.
C)a urea breath test 4 to 6 weeks after completion of drug treatment.
D)a serology antibody detection 4 weeks after completion of drug treatment.

The preferred H. pylori eradication regimen for a patient with an active ulcer who is admittedly noncompliant is
A)amoxicillin + omeprazole ( 14 days.
B)bismuth subsalicylate + metronidazole + tetracycline + ranitidine ( 7 days.
C)lansoprazole + amoxicillin + clarithromycin ( 10 days.
D)ranitidine bismuth citrate + clarithromycin + metronidazole ( 10 days.

The most important counseling information to convey to a patient prescribed an H. pylori eradication regimen containing ranitidine bismuth citrate (RBC) is
A)RBC may cause ringing in the ears.
B)RBC may cause your urine to turn orange.
C)RBC may cause dry mouth.
D)RBC may cause your stool to turn dark brown or black.

The preferred management of a 70-year-old woman with rheumatoid arthritis who is at risk of developing an NSAID-induced ulcer or ulcer-related complication is
A)misoprostol 100 µg twice daily.
B)famotidine 40 mg twice daily.
C)pantoprazole 40 mg daily.
D)omeprazole 40 mg twice daily.

The preferred management of an H. pylori-negative 60-year-old woman with a documented NSAID-induced ulcer is
A)misoprostol 100 µg four times a day.
B)ranitidine 150 mg twice daily.
C)famotidine 20 mg twice daily + sucralfate 1 g four times a day.
D)lansoprazole 30 mg twice daily.

The most important parameter to monitor to assess the effectiveness of misoprostol cotherapy in a 70-year-old woman taking ibuprofen is
A)prothrombin time.
B)absence of blood in the stool.
C)absence of epigastric pain.
D)stool consistency.

The most important parameter to monitor in an ulcer patient receiving long-term maintenance therapy with a PPI is
A)fasting serum gastrin concentrations.
B)recurrence of ulcer symptoms.
C)vitamin B12 concentrations.
D)hemoglobin and hematocrit.

A 30-year-old woman prescribed misoprostol cotherapy for the prevention of an NSAID-induced ulcer should be counseled to do all the following except
A)discontinue the NSAID before beginning the misoprostol.
B)use adequate contraceptive measures.
C)have a serum pregnancy test within 2 weeks of starting treatment.
D)avoid magnesium-containing antacids.

The most important counseling information to convey to a 40-year-old man taking omeprazole for an NSAID-induced ulcer is
A)take the omeprazole at the same time you take the NSAID.
B)take the omeprazole 15 to 30 minutes before breakfast.
C)take the omeprazole 1 hour before or 2 hours after a meal.
D)take omeprazole at bedtime.

Which of the following statement best characterizes the current status of drug therapy in the prevention of stress-related mucosal bleeding?
A)Large randomized, controlled trials confirm that an intravenous proton pump inhibitor is superior to an intravenous H2-receptor antagonist.
B)Antacids are the drugs of choice because they are effective and least costly.
C)Continuous infusion of an H2-receptor antagonist provides similar efficacy as intermittent intravenous administration.
D)Sucralfate is not effective.

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