Peptic Ulcer Disease (PUD)
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Questions and Answers

Which gender is more commonly affected by gastric ulcers?

  • Males (correct)
  • Both genders are equally affected
  • It is not mentioned in the text
  • Females

    • Where are duodenal ulcers most commonly located?

  • It is not mentioned in the text
  • First portion of the duodenum (correct)
  • Second portion of the duodenum
  • Third portion of the duodenum

    • What is the typical size of duodenal ulcers?

  • It is not mentioned in the text
  • 1-3 cm in diameter
  • 3-6 cm in diameter
  • ≤1 cm in diameter (correct)

    • Which type of ulcers can represent a malignancy?

    <p>Gastric ulcers</p> Signup and view all the answers

    Where are benign gastric ulcers most often found?

    <p>Distal to the junction between the antrum and the acid secretory mucosa</p> Signup and view all the answers

    What is the most common cause of duodenal ulcers?

    <p>Both H. pylori infection and NSAID use</p> Signup and view all the answers

    What is the typical gastric acid output in patients with gastric ulcers?

    <p>Normal or decreased</p> Signup and view all the answers

    What is the role of H. pylori in the development of gastric ulcers?

    <p>Both A and B</p> Signup and view all the answers

    Where is H. pylori commonly found in the stomach?

    <p>Between the mucous layer and the gastric epithelium</p> Signup and view all the answers

    Where does H. pylori initially reside in the stomach?

    <p>Antrum</p> Signup and view all the answers

    Which of the following is a common risk factor for peptic ulcer disease (PUD)?

    <p>Frequent use of over-the-counter pain relievers</p> Signup and view all the answers

    What is the estimated incidence of duodenal ulcers (DUs) in the Western population?

    <p>6-15%</p> Signup and view all the answers

    What is the size criterion for ulcers to be defined as breaks in the mucosal surface?

    <blockquote> <p>5 mm</p> </blockquote> Signup and view all the answers

    Which of the following factors has contributed to the reduction in the frequency of duodenal ulcers (DUs)?

    <p>Decreasing frequency of H. pylori</p> Signup and view all the answers

    Which of the following is NOT associated with an increased incidence of PUD?

    <p>Chronic obstructive lung disease</p> Signup and view all the answers

    What is the estimated odds ratio for H. pylori as a risk factor for PUD in the United States?

    <p>3.3</p> Signup and view all the answers

    What is the most common type of peptic ulcer?

    <p>Duodenal ulcer</p> Signup and view all the answers

    What is the main factor that distinguishes gastric ulcers (GUs) from duodenal ulcers (DUs)?

    <p>Location of the ulcers</p> Signup and view all the answers

    Which of the following is associated with an increased incidence of PUD?

    <p>Former alcohol use</p> Signup and view all the answers

    What has eradication of H. pylori resulted in?

    <p>Decrease in the frequency of DUs</p> Signup and view all the answers

    Which of the following proteins is NOT mentioned as an essential determinant of H. pylori-mediated pathogenesis and colonization?

    <p>Hop proteins</p> Signup and view all the answers

    What is the function of Cag A once it is translocated into host cells?

    <p>Activates a series of cellular events important in cell growth and cytokine production</p> Signup and view all the answers

    What is the prevalence of H. pylori infection in developing parts of the world?

    <p>80% by the age of 20</p> Signup and view all the answers

    What is the overall prevalence of H. pylori infection in the United States?

    <p>30%</p> Signup and view all the answers

    What percentage of infected individuals develop frank peptic ulceration?

    <p>10-15%</p> Signup and view all the answers

    What is the prevalence of H. pylori in individuals born before 1950 compared to those born later in the United States?

    <p>Higher rate of infection</p> Signup and view all the answers

    What is the basis for the difference in the development of peptic ulceration in infected individuals?

    <p>Combination of host and bacterial factors</p> Signup and view all the answers

    What factors determine the particular end result of H. pylori infection?

    <p>Complex interplay between bacterial and host factors</p> Signup and view all the answers

    What is the function of γ-glutamyl transpeptidase (GGT) in H. pylori infection?

    <p>Not mentioned in the text</p> Signup and view all the answers

    What is the function of vacuolating toxin (Vac A) in H. pylori infection?

    <p>Induces mucosal injury</p> Signup and view all the answers

    What is the most common location for duodenal ulcers (DUs)?

    <p>Within 3 cm of the pylorus</p> Signup and view all the answers

    What is the typical size of gastric ulcers (GUs)?

    <p>≤1 cm in diameter</p> Signup and view all the answers

    What is the most common cause of gastric ulcers (GUs)?

    <p>H. pylori infection</p> Signup and view all the answers

    What is the most common gender affected by gastric ulcers (GUs)?

    <p>Males</p> Signup and view all the answers

    What is the prevalence of H. pylori infection in the United States?

    <p>Higher in individuals born before 1950</p> Signup and view all the answers

    Which of the following risk factors for peptic ulcer disease (PUD) has the highest estimated odds ratio in the United States?

    <p>H. pylori</p> Signup and view all the answers

    What is the estimated incidence of duodenal ulcers (DUs) in the Western population?

    <p>6-15%</p> Signup and view all the answers

    What has been the trend in the incidence of DUs since 1980?

    <p>Remained stable</p> Signup and view all the answers

    What has been the trend in death rates, need for surgery, and physician visits related to DUs over the past 30 years?

    <p>Decreased by &gt;50%</p> Signup and view all the answers

    What has eradication of H. pylori resulted in?

    <p>Decreased recurrence rates of DUs</p> Signup and view all the answers

    Which of the following is NOT a risk factor for NSAID-induced GI bleeding?

    <p>Advanced age</p> Signup and view all the answers

    What is the estimated incidence of NSAID-induced GI bleeding in patients taking low-dose aspirin?

    <p>45-60%</p> Signup and view all the answers

    Which of the following is NOT a possible risk factor for NSAID-induced GI bleeding?

    <p>Concomitant use of clopidogrel</p> Signup and view all the answers

    What is the prevalence of dyspepsia in patients with serious NSAID-related complications?

    <p>More than 80%</p> Signup and view all the answers

    What is the estimated number of hospital admissions per year due to NSAID-induced GI bleeding?

    <p>60,000-90,000</p> Signup and view all the answers

    Which of the following is a mechanism by which H. pylori causes epithelial cell injury?

    <p>Activation of cellular pathways involved in cytokine production</p> Signup and view all the answers

    What is the impact of H. pylori infection on the gastric microbiota?

    <p>It decreases the diversity of commensal organisms</p> Signup and view all the answers

    How does H. pylori contribute to the development of gastric cancer?

    <p>By promoting the formation of 8-nitroguanine</p> Signup and view all the answers

    What is the reason for H. pylori–mediated duodenal ulceration?

    <p>Increased acid production</p> Signup and view all the answers

    How does H. pylori infection affect gastric acid secretion?

    <p>It decreases gastric acid secretion</p> Signup and view all the answers

    Which of the following is NOT a factor that contributes to the pathogenicity of H. pylori?

    <p>γ-glutamyl transpeptidase (GGT)</p> Signup and view all the answers

    What is the function of pathogen-associated molecular patterns (PAMPs) in H. pylori infection?

    <p>Facilitate gastric residence</p> Signup and view all the answers

    Which strain of H. pylori is associated with a higher risk of peptic ulcer disease (PUD), premalignant gastric lesions, and gastric cancer?

    <p>cag-PAI positive strains</p> Signup and view all the answers

    What is the prevalence of H. pylori infection in industrialized countries?

    <p>20%</p> Signup and view all the answers

    What is the prevalence of H. pylori infection in the United States?

    <p>30%</p> Signup and view all the answers

    Which of the following is NOT a potential genetic risk factor for peptic diathesis?

    <p>CYP2C9 polymorphism</p> Signup and view all the answers

    Which of the following is NOT a potential pathogenetic factor unrelated to H. pylori and NSAIDs in acid peptic disease?

    <p>Diet</p> Signup and view all the answers

    Which of the following is NOT a disorder strongly associated with peptic ulcer disease (PUD)?

    <p>Hyperparathyroidism</p> Signup and view all the answers

    Which of the following is NOT a potential risk factor for peptic ulcer disease (PUD)?

    <p>Three or more doctor visits in a year</p> Signup and view all the answers

    Which of the following is NOT a potential cause of injury to the mucosa as a result of topical use of NSAIDs?

    <p>Decreased proximal duodenal bicarbonate production</p> Signup and view all the answers

    Which of the following H2 receptor antagonists is associated with weak antiandrogenic side effects?

    <p>Cimetidine</p> Signup and view all the answers

    Which of the following is the main form of therapy for peptic ulcers?

    <p>Eradication of H. pylori</p> Signup and view all the answers

    Which H2 receptor antagonist is NOT associated with binding to hepatic cytochrome P450?

    <p>Nizatidine</p> Signup and view all the answers

    Which of the following is a potential side effect of using aluminum hydroxide as an antacid?

    <p>Constipation</p> Signup and view all the answers

    Which proton pump inhibitor is available as a parenteral formulation for intravenous use?

    <p>Rabeprazole</p> Signup and view all the answers

    Which of the following antacids should be avoided in patients with chronic renal failure?

    <p>Magnesium hydroxide</p> Signup and view all the answers

    Which of the following is NOT a substituted benzimidazole derivative that irreversibly inhibits H+,K+-ATPase?

    <p>Ranitidine</p> Signup and view all the answers

    Which of the following antacids can lead to milk-alkali syndrome with long-term use?

    <p>Calcium carbonate</p> Signup and view all the answers

    Which proton pump inhibitor is available in an orally disintegrating tablet form?

    <p>Lansoprazole</p> Signup and view all the answers

    Which of the following can induce systemic alkalosis?

    <p>Sodium bicarbonate</p> Signup and view all the answers

    Which of the following is a potential side effect of long-term use of proton pump inhibitors (PPIs)?

    <p>Increased risk of gastric carcinoid tumor development</p> Signup and view all the answers

    What is the mechanism behind rebound gastric acid hypersecretion after discontinuation of PPIs?

    <p>Gastrin-induced hyperplasia and hypertrophy of histamine-secreting ECL cells</p> Signup and view all the answers

    Which of the following is NOT a potential drug interaction with PPIs?

    <p>Rabeprazole</p> Signup and view all the answers

    What is the association between long-term PPI use and community-acquired pneumonia?

    <p>Higher incidence of community-acquired pneumonia</p> Signup and view all the answers

    What is the potential side effect of PPI use that has been associated with the development of collagenous colitis?

    <p>Diarrhea</p> Signup and view all the answers

    Which of the following is NOT a potential side effect of the widespread use of antibiotics for H. pylori therapy?

    <p>Decreased efficacy</p> Signup and view all the answers

    Which of the following is the most effective duration for H. pylori therapy?

    <p>14 days</p> Signup and view all the answers

    Which of the following antibiotics is NOT commonly used in the therapy of H. pylori?

    <p>Azithromycin</p> Signup and view all the answers

    Which of the following factors does NOT influence the choice of H. pylori therapy regimen?

    <p>Existing antibiotic resistance</p> Signup and view all the answers

    Which of the following dual therapy regimens is NOT recommended for H. pylori eradication?

    <p>PPI plus metronidazole</p> Signup and view all the answers

    What is the mechanism of action of potassium-competitive acid pump antagonists (P-CAPs)?

    <p>They inhibit gastric acid secretion by binding to the H+,K+-ATPase</p> Signup and view all the answers

    Which drug acts as a physicochemical barrier and enhances mucosal defense and repair in the stomach and duodenum?

    <p>Sucralfate</p> Signup and view all the answers

    Which drug is considered the drug of choice for treating peptic ulcer disease (PUD) and has a resurgence in use due to its effect against H. pylori?

    <p>Bismuth-containing preparations</p> Signup and view all the answers

    What is the most common toxicity associated with prostaglandin analogues used for the treatment of PUD?

    <p>Diarrhea</p> Signup and view all the answers

    Which group of drugs is rarely, if ever, used today for treating acid peptic disorders due to their toxicity and the development of potent antisecretory agents?

    <p>Anticholinergic agents and tricyclic antidepressants</p> Signup and view all the answers

    Which of the following is a potential side effect of long-term use of proton pump inhibitors (PPIs)?

    <p>Increased risk of iron deficiency</p> Signup and view all the answers

    What is the recommended approach to consider in patients needing to take PPIs long term?

    <p>Check complete blood count, vitamin B12 level, and magnesium level after 1-2 years of PPI use</p> Signup and view all the answers

    What is the potential drug interaction between PPIs and clopidogrel?

    <p>Competition with the same cytochrome P450 (CYP2C19)</p> Signup and view all the answers

    What is the theoretical advantage of pantoprazole over other PPIs?

    <p>At least a theoretical advantage, but not confirmed</p> Signup and view all the answers

    What additional concerning side effects are associated with long-term PPI use?

    <p>Increased cardiac risks, dementia, and acute and chronic kidney injury</p> Signup and view all the answers

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