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Chapter 18. Peptic Ulcer Disease

Student Questions

Which of the following is not a cause of peptic ulcers?

A. Chronic alcohol ingestion

B. Nonsteroidal anti-inflammatory drugs (NSAIDs)

C. Helicobacter pylori infection

D. Stress-related mucosal damage

Answer: A

Option A: Correct. Although some lifestyle factors such as alcohol use may aggravate dyspepsia symptoms, they are not the primary cause for an ulcer in the absence of other risk factors.

Options B, C, and D: Incorrect. NSAIDs, H. pylori infection, and stress-related mucosal damage (usually in a critically ill, hospitalized patient) are all causes of peptic ulcer.

Which of the following is not a complication of PUD?

A. GI bleeding

B. Perforation

C. Obstruction

D. Colon cancer

Answer: D

Options A, B, and C: Incorrect. GI bleeding, perforation, and bowel obstruction are all possible complications of peptic ulcer disease.

Option D: Correct. Although a small percentage of patients with H. pylori infection may develop gastric cancer, colon cancer is not expected to be a complication of PUD.

Which of the following is an indication for stress ulcer prophylaxis (SUP) in critically-ill patients according to the 1999 American Society of Health-System Pharmacists (ASHP) published guidelines?

A. Mechanical ventilation for longer than 48 hours

C. Platelet count greater than 50,000/mm3 (50 × 109/L) but less than 150,000/mm3 (150 × 109/L)

D. Thermal injuries to more than 15% of body surface area

E. Admission to ICU on enteral feedings

Answer: A

Option A: Correct. Mechanical ventilation for longer than 48 hours is an indication for stress ulcer prophylaxis per the ASHP guidance.

Option B: Incorrect. This is not an indication for stress ulcer prophylaxis per the ASHP guidance. Platelet count would need to be less than 50 × 103/mm3 (50 × 109/L) for this answer to be correct.

Option C: Incorrect. This is not an indication for stress ulcer prophylaxis per the ASHP guidance. Thermal injury to more than 35% of body surface area would make this answer correct.

Option D: Incorrect. This is not an indication for stress ...

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