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  #1  
Old 10-21-2012
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Default COPD patient

A 76-year-old man with chronic obstructive pulmonary disease presents at his annual clinic visit with complaints of black stools and epigastric pain relieved by meals. He reports a 4.5-kg (10-lb) weight gain over the past 4 months. He has no other medical problems and takes no medications. Physical examination is unremarkable. His plasma calcium and phosphate levels are within the normal ranges. Endoscopy reveals mucosal ulceration in the duodenal bulb. Which of the following is the most likely risk factor for this patient's duodenal ulcer?

A Alcohol use
B Chronic nonsteroidal anti inflammatory use
C Excessive salt intake
D Primary hyperparathyroidism
E Tobacco use
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  #2  
Old 10-21-2012
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B.. NSAIDs ??? After H pylori ?
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  #3  
Old 10-21-2012
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i want say B,but man with chronic pulmonary disease
My answer E Tobacco use, because other risk factors for duodenal ulcers include overuse of alcohol, tobacco.......
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Old 10-21-2012
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Quote:
Originally Posted by MedicalExaminer View Post
A 76-year-old man with chronic obstructive pulmonary disease presents at his annual clinic visit with complaints of black stools and epigastric pain relieved by meals. He reports a 4.5-kg (10-lb) weight gain over the past 4 months. He has no other medical problems and takes no medications. Physical examination is unremarkable. His plasma calcium and phosphate levels are within the normal ranges. Endoscopy reveals mucosal ulceration in the duodenal bulb. Which of the following is the most likely risk factor for this patient's duodenal ulcer?

A Alcohol use
B Chronic nonsteroidal anti inflammatory use
C Excessive salt intake
D Primary hyperparathyroidism
E Tobacco use
I will go with E) most likely
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  #5  
Old 10-21-2012
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Was blind to " COPD " ... Yeah smoking could be the answer .....
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Old 10-21-2012
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E)tobacco....

thanks
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  #7  
Old 10-21-2012
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smoking>>>>>COPD+PUD
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  #8  
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Steroids??

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  #9  
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Oops.. tobacco it shud b..

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Old 10-21-2012
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e - smoking
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Old 10-22-2012
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The correct answer is E. Given this patient's history of chronic obstructive pulmonary disease, the most likely factor contributing to the development of his duodenal ulcer is tobacco use. The incidence of peptic ulcers in smokers is twice as great as in nonsmokers.

Answer A is incorrect. Unlike acute gastritis, alcohol use is not a known risk factor for peptic ulcer development.

Answer B is incorrect. Chronic use of nonsteroidal anti-inflammatory drugs is a known risk factor for peptic ulcer disease. However, in this patient, there is no reason to suspect long-term use of these medications.

Answer C is incorrect. Excessive salt intake is not a risk factor for peptic ulcer disease.

Answer D is incorrect. Primary hyperparathyroidism is associated with peptic ulcer disease. This condition is a possibility in this patient given his increased risk for bronchogenic squamous cell carcinoma; however, his recent weight gain and normal calcium and phosphate plasma levels argue against primary hyperparathyroidism.
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