A 48 year-old man is seen by his primary Dr. Laurence Bailen @Tufts

Question 9 / 32: A 48 year-old man is seen by his primary care physician for evaluation of epigastric abdominal pain and nausea of 3 months duration. There has been no vomiting, hematemesis, or melena (gastrointestinal bleeding). He does not use aspirin or other non-steroidal anti-inflammatory medications. His primary care doctor recommends beginning over the counter prilosec, one tablet in the morning, and she checks H.pylori serology which returns positive.

Which of the following would you most likely expect to see in this patient?

Positive urea breath test

Type A gastritis

Gastrin level greater than 1000

Pernicious anemia

Numerous ulcers in the 3rd and 4th portion of the duodenum

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Explanation:

Positive H.pylori. The urea breath test is a non-invasive way of diagnosing h.pylori. H.pylori is associated with type B gastritis. Type A gastritis is autoimmune gastritis which is associated with pernicious anemia due to antibodies to parietal cells. A gastrin level greater than 1000 and ulcers in the 3rd and 4th portions of the duodenum are findings seen in the rare disorder, Zollinger-Ellison syndrome due to tumor (gastrinoma) secreting gastrin.

Assessment Home Page

https://www.jobilize.com/gastrointestinal-pathophysiology-mcq-assessment-by-dr-laurence-bailen

Gastrointestinal Pathophysiology Self-Assessment

Author:

Dr.Laurence BailenProfessor

Tufts University School of Medicine

USA

Access: Public

Attribution: Laurence Scott Bailen, Tamsin Knox, Paul Abourjaily, Fredric D. Gordon,Marshall Kaplan,Andrew G. Plaut. PPY 222 Gastrointestinal Pathophysiology, Spring 2007. (Tufts University OpenCourseWare), http://ocw.tufts.edu/Course/47 (Accessed 3 May, 2014). License: Creative Commons BY-NC-SA

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