Card 19 / 33: A 48 year old man is seen by his primary care physician because of persistent epigastric pain and nausea for the past month. He has had no vomiting or signs of gastrointestinal bleeding. He denies heartburn. He takes 8 ibuprofen daily for arthritic complaints. A urea breath test is negative. An upper endoscopy reveals multiple small ulcers in the gastric antrum. Biopsies are negative for malignancy. The patient is placed on omeprazole and his symptoms resolve. A repeat upper endoscopy 6 weeks later shows healing of the ulcers. Which of the following best explains the pathophysiologic mechanism behind the development of ulcers in this patient?
A) H.pylori colonization of the gastric antrum
B) Reduced blood supply to the stomach
C) Inhibition of prostaglandin synthesis
D) Absent gastric acid secretion
E) Markedly elevated gastrin levels

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