Which risk factor is the most likely cause of a patient's peptic ulcer disease (PUD)?
Alcohol.
Helicobacter pylori.
Smoking.
Stress.
The Correct Answer is B
Choice A rationale
While alcohol is a known irritant to the gastric lining, it is not the primary cause of peptic ulcer disease. Excessive alcohol consumption contributes to mucosal damage but lacks the direct causative action of Helicobacter pylori, which colonizes the stomach lining and interferes with protective mechanisms, leading to ulcer formation. Alcohol merely exacerbates existing risk factors rather than initiating disease.
Choice B rationale
Helicobacter pylori is the most common cause of peptic ulcer disease globally. Its mechanism involves producing urease, neutralizing stomach acid and enabling bacterial survival. It induces inflammation and mucosal damage, compromising the stomach's protective lining. Persistent infection leads to ulcer formation. This bacterial colonization is implicated in up to 90% of duodenal ulcers, making it the key pathogenic factor in PUD.
Choice C rationale
Smoking is a risk factor for peptic ulcer disease but functions more as an aggravating agent than the primary cause. Tobacco use increases gastric acid secretion and decreases bicarbonate production, weakening mucosal defenses. It also reduces the efficacy of Helicobacter pylori eradication therapy, prolonging ulcer disease. However, it does not directly induce the condition independently, highlighting its secondary role in PUD pathology.
Choice D rationale
Stress is associated with peptic ulcer disease but is not a primary causative factor. Psychological stress can lead to hypersecretion of gastric acid, aggravating mucosal vulnerability in susceptible individuals. However, its role is predominantly indirect, amplifying existing risk factors like Helicobacter pylori infection. Stress-induced ulcers are typically seen in critical illnesses or severe physiological stress conditions, differing from PUD pathogenesis.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
Chewing gum can increase salivary production, and while saliva may neutralize some stomach acid, the act of chewing can stimulate swallowing and possibly exacerbate symptoms by introducing excess air into the stomach. For GERD patients, avoiding gum may help reduce bloating and gas discomfort.
Choice B rationale
Elevating the head of the bed reduces the likelihood of acid reflux during sleep by using gravity to prevent stomach contents from flowing backward into the esophagus. This strategy aligns with GERD management guidelines and reduces nighttime symptoms.
Choice C rationale
Taking antacids between meals and at bedtime helps neutralize stomach acid temporarily, providing short-term relief of GERD symptoms. While effective, long-term use without addressing dietary and lifestyle factors is not ideal for managing GERD.
Choice D rationale
Eating small meals is beneficial for GERD, as it prevents overdistension of the stomach, but having a bedtime snack contradicts GERD management principles. Late-night eating may increase the risk of acid reflux when lying down, thus requiring more teaching.
Correct Answer is A
Explanation
Choice A rationale
Fractures caused by disease processes are termed pathological fractures. Diseases like osteoporosis weaken bones, increasing susceptibility to fractures. Conditions like cancer can invade bone tissue, causing structural fragility. Pathological fractures occur without significant trauma, distinguishing them from those caused by external injuries, which require high-impact forces to break otherwise healthy bones. By definition, trauma fractures arise from external forces, while pathological ones involve internal conditions compromising bone integrity.
Choice B rationale
Traumatic fractures stem from external forces, not from disease processes. This assertion neglects the reality of pathological fractures, which result from diseases undermining the bone's natural strength. Healthy bones typically endure significant stress before fracturing, and the absence of disease makes fractures from minimal trauma highly unlikely. This reasoning excludes pathological fractures caused by internal illnesses or conditions weakening bone structures.
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