A 45 year-old man comes to the emergency by Dr. Laurence Bailen

Question 7 / 32: A 45 year-old man comes to the emergency room after passing tarry black stool for 3 days. He has had intermittent epigastric pain with nausea but no vomiting. An upper endoscopy is performed and a large ulcer in the duodenal bulb is seen.

Which of the following would you most likely find in this patient’s stomach?

Basal acid production twice below normal

High acid production in response to a meal

Negative rapid urease test for h.pylori

Reduced sensitivity of parietal cells to gastrin

Very high serum gastrin levels

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Explanation:

Duodenal ulcer with GI bleeding. Many duodenal ulcers are h.pylori associated. Duodenal ulcers are associated with above normal acid production. There is an increased sensitivity of parietal cells to gastrin in patients with peptic ulcer. High gastrin levels usually seen in Zollinger-Ellison syndrome and not benign peptic ulcer disease.

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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