• Card 9 / 34: 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?
    1.) Basal acid production twice below normal
    2.) High acid production in response to a meal
    3.) Negative rapid urease test for h.pylori
    4.) Reduced sensitivity of parietal cells to gastrin
    5.) Very high serum gastrin levels

    Answer:
    2.) High acid production in response to a meal

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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.

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Gastrointestinal Pathophysiology Self-Assessment

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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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