A 34-Year-Old Man Is Evaluated for Several Months of Epigastric

question 276

Multiple Choice

A 34-year-old man is evaluated for several months of epigastric pain that is worse at night and is relieved by eating.  The patient has no significant medical history and takes no medications.  He does not use tobacco, alcohol, or illicit drugs.  The patient immigrated to the United States from China 4 years ago.  Vital signs are within normal limits.  Physical examination shows mild epigastric tenderness to deep palpation.  Upper gastrointestinal endoscopy reveals a 1-cm ulcer in the first portion of the duodenum.  Additional testing is pending.  In addition to proton pump inhibitor therapy, which of the following therapies would most likely prevent ulcer recurrence in this patient?

• A)Antibiotics
• B)Gastric cytoprotectants
• C)Glucocorticoids
• D)Histamine 2 receptor blockers
• E)Prokinetic agents
• F)Prostaglandin analogues

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