Patient case: Peptic Ulcer
A 38-year-old male presents to the clinic with complaints of persistent epigastric pain for the last three weeks. He describes the pain as a burning sensation that starts about 30 minutes after eating, often worsening after consuming acidic foods or spicy meals. He notes that the discomfort is relieved temporarily by taking antacids. The patient also mentions that he wakes up several times during the night with pain, which is alleviated by drinking water or eating something small. He denies any significant weight loss, vomiting, or changes in his bowel habits.
His medical history is significant for mild hypertension, for which he takes an antihypertensive medication, and occasional back pain, for which he has been using ibuprofen. He admits to consuming alcohol on weekends (around 4-5 drinks per week) and has been smoking half a pack of cigarettes daily for the last 10 years.
On physical examination, he appears well, with stable vital signs. Abdominal examination reveals mild tenderness in the epigastric region without guarding or rebound tenderness. No other abnormalities are noted on examination.
Given his history of NSAID use, alcohol consumption, and smoking, along with his characteristic symptoms, the physician suspects peptic ulcer disease and orders a test for H. pylori infection, as well as an upper gastrointestinal endoscopy for further evaluation.
Diagnosis: Peptic Ulcer Disease, likely secondary to H. pylori infection and/or NSAID use.
A) Gallbladder disease
B) Irritable bowel syndrome
C) Peptic ulcer disease
D) Pancreatitis
A) Smoking and alcohol consumption
B) Helicobacter pylori infection
C) Stress
D) Autoimmune diseases
A) Hypertension
B) NSAID use
C) High-fiber diet
D) Lack of sleep
A) Abdominal ultrasound
B) Colonoscopy
C) Upper gastrointestinal endoscopy
D) X-ray of the abdomen
Answers
1. C) Peptic ulcer disease
2. B) Helicobacter pylori infection
3. B) NSAID use
4. C) Upper gastrointestinal endosc
opy
