Chapter 34. Gastroesophageal Reflux and Peptic Ulcer Disease

____ 1. An acceptable first-line treatment for peptic ulcer disease with positive H. pylori test is:

1. Histamine2 receptor antagonists for 4 to 8 weeks

2. Proton pump inhibitor bid for 12 weeks until healing is complete

3. Proton pump inhibitor bid plus clarithromycin plus amoxicillin for 14 days

4. Proton pump inhibitor bid and levofloxacin for 14 days

____ 2. Treatment failure in patients with peptic ulcer disease associated with H. pylori may be because of:

1. Antimicrobial resistance

2. An ineffective antacid

3. Overuse of proton pump inhibitors

4. All of the above

____ 3. If a patient with H. pylori-positive peptic ulcer disease fails first-line therapy, the second-line treatment is:

1. Proton pump inhibitor bid plus metronidazole plus tetracycline plus bismuth subsalicylate for 14 days

2. Test H. pylori for resistance to common treatment regimens

3. Proton pump inhibitor plus clarithromycin plus amoxicillin for 14 days

4. Proton pump inhibitor and levofloxacin for 14 days

____ 4. After H. pylori treatment is completed, the next step in peptic ulcer disease therapy is:

1. Testing for H. pylori eradication with a serum ELISA test

2. Endoscopy by a specialist

3. A proton pump inhibitor for 8 to 12 weeks until healing is complete

4. All of the above

____ 5. Gastroesophageal reflux disease may be aggravated by the following medication that affects lower esophageal sphincter (LES) tone:

1. Calcium carbonate

2. Estrogen

3. Furosemide

4. Metoclopramide

____ 6. Lifestyle changes are the first step in treatment of gastroesophageal reflux disease (GERD). Food or drink that may aggravate GERD include:

1. Eggs

2. Caffeine

3. Chocolate

4. Soda pop

____ 7. Metoclopramide improves gastroesophageal reflux disease symptoms by:

1. Reducing acid secretion

2. Increasing gastric pH

3. Increasing lower esophageal tone

4. Decreasing lower esophageal tone