Peptic Ulcer Disease: ABFM practice questions

4 board-style questions on peptic ulcer disease in the PulseMD family medicine question bank — physician-reviewed, written against current guidelines with the reference cited on each question. Two free samples below; the full set with answers, explanations, and spaced review is free to start.

Sample question 1

A 60-year-old man presents to the emergency department with melena and coffee-ground emesis. He has been taking ibuprofen 800 mg three times daily for 6 weeks for chronic knee osteoarthritis. His blood pressure is 110/70 mmHg, heart rate is 100 bpm, and hemoglobin is 9.2 g/dL. After resuscitation, upper endoscopy reveals a 1.5 cm clean-based gastric ulcer with no active bleeding or visible vessel. Rapid urease test for H. pylori is negative. What is the most important management step?

1. Start misoprostol 200 mcg four times daily and continue ibuprofen at a lower dose
2. Surgical consultation for ulcer excision to rule out malignancy
3. Begin empiric H. pylori eradication therapy despite the negative rapid urease test
4. Discontinue NSAIDs and start high-dose PPI therapy for 8 weeks

Sample question 2

A 45-year-old woman is diagnosed with a duodenal ulcer and tests positive for H. pylori via urea breath test. She has no penicillin allergy and no prior H. pylori treatment. Local clarithromycin resistance rates are below 15%. Which of the following is the most appropriate first-line treatment regimen?

1. Bismuth plus metronidazole plus tetracycline plus PPI for 14 days
2. PPI plus amoxicillin for 14 days (dual therapy)
3. PPI plus clarithromycin plus metronidazole for 7 days
4. PPI plus amoxicillin plus clarithromycin for 14 days

Create a free PulseMD account to answer these, see the explanations, and practice five minutes a day.

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