Review Questions

  1. 1.

    Which of the following is a likely cause of duodenal ulceration in patients who are Helicobacter pylori negative?

    1. a.

      Bordetella pertussis infection

    2. b.

      Zollinger-Ellison syndrome

    3. c.

      Pheochromocytoma

    4. d.

      Mercury poisoning

    5. e.

      None of the above

  2. 2.

    An 80-year-old woman with degenerative joint disease involving her fingers presents with a gastric ulcer with smooth edges. She denies being prescribed nonsteroidal anti-inflammatory drugs (NSAIDs), and biopsies and serology for H. pylori are negative. Which of the following is the most likely cause of her ulcer?

    1. a.

      Gastric rheumatoid nodules

    2. b.

      Systemic lupus erythematosus

    3. c.

      Over-the-counter medications containing NSAIDs

    4. d.

      Ankylosing spondylitis

    5. e.

      Surreptitious laxative abuse

  3. 3.

    Which of the following is the major factor contributing to current changes in the incidence of peptic ulcer disease in developed countries?

    1. a.

      The rise in H. pylori−associated gastric ulcers

    2. b.

      The fall in NSAID-associated duodenal ulcers

    3. c.

      The rise in NSAID-related gastric ulcers

    4. d.

      The rise in NSAID-related duodenal ulcers

    5. e.

      The rise in intensive care unit (ICU)-related stress ulcers

  4. 4.

    Which of the following is correct about peptic ulcer disease?

    1. a.

      Risk is greatest in females.

    2. b.

      The highest relative risk is in persons younger than 20 years.

    3. c.

      Treatment of autoimmune diseases with biologic agents (e.g., anti−tumor necrosis factor [TNF]-α agents) has increased risk.

    4. d.

      Most deaths are due to gastric cancer.

    5. e.

      Smoking increases risk.

  5. 5.

    Which of the following involves an increased risk for peptic ulcer disease?

    1. a.

      Scleroderma

    2. b.

      Pernicious anemia

    3. c.

      Celiac disease

    4. d.

      Systemic mastocytosis

    5. e.

      Cryptococcosis

  6. 6.

    The effect of H. pylori eradication therapy always needs to be assessed in patients with which of the following?

    1. a.

      A bleeding peptic ulcer

    2. b.

      Reflux esophagitis

    3. c.

      Nonulcer dyspepsia

    4. d.

      Uncomplicated peptic ulcer

    5. e.

      Chronic active gastritis

  7. 7.

    Which of the following statements is false in patients with peptic ulcer bleeding?

    1. a.

      Endoscopic treatment is the mainstay of therapy.

    2. b.

      Preemptive proton pump inhibitor (PPI) therapy reduces the need for endoscopic treatment.

    3. c.

      High-dose continuous intravenous PPI treatment reduces the risk for rebleeding.

    4. d.

      Patients with a low Blatchford score usually do not require intervention.

    5. e.

      Recurrent bleeding requires surgery.