Peptic Ulcer Disease: ABFM practice questions

4 board-style questions on peptic ulcer disease in the PulseMD family medicine question bank, 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?

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

Sample question 2

A 40-year-old man presents with 6 weeks of epigastric burning pain that is relieved by eating and worsens 2-3 hours after meals. He does not take NSAIDs and drinks alcohol only occasionally. He has never been tested for Helicobacter pylori. There are no alarm symptoms. His physician plans a non-invasive test-and-treat strategy. Which of the following is the most appropriate initial diagnostic test for H. pylori?

Rapid urease test (CLO test) on gastric biopsy
Serum H. pylori IgG antibody
Serum pepsinogen I/II ratio
Urea breath test or stool antigen test

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

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