What factors may have contributed to the development of PUD? 

1. A 45-year-old male comes to the clinic with a chief complaint of epigastric abdominal pain that has persisted for 2 weeks. He describes the pain as burning, non-radiating and is worse after meals. He denies nausea, vomiting, weight loss or obvious bleeding. He admits to bloating and frequent belching.

 

PMH-+ for osteoarthritis, seasonal allergies with frequent sinusitis infections.

 

Meds-Zyrtec 10 mg po daily and takes it year-round, ibuprofen 400-600 mg po prn pain

 

Family Hx-non contributary

 

Social history-recently divorced and expressed concern at how expensive it is to support 2 homes. Works as a manager at a local tire and auto company. He has 25 pack/year history of smoking, drinks 2-3 beers/day, and drinks 5-6 cups of coffee per day. He denies illicit drug use, vaping or unprotected sexual encounters.

 

Breath test in the office revealed + urease.

 

The healthcare provider suspects the client has peptic ulcer disease.

 

1 of 2 Questions:

 

What factors may have contributed to the development of PUD? 

2 of 2 Questions:

How do these factors contribute to the formation of peptic ulcers? 

 

QUESTION 3

1. A 36-year-old morbidly obese female comes to the office with a chief complaint of “burning in my chest and a funny taste in my mouth”. The symptoms have been present for years but patient states she had been treating the symptoms with antacid tablets which helped until the last 4 or 5 weeks. She never saw a healthcare provider for that. She says the symptoms get worse at night when she is lying down and has had to sleep with 2 pillows. She says she has started coughing at night which has been interfering with her sleep. She denies palpitations, shortness of breath, or nausea.

 

PMH-HTN, venous stasis ulcers, irritable bowel syndrome, osteoarthritis of knees, morbid obesity (BMI 48 kg/m²)

 

Family history-non contributary

 

Medications-amlodipine 10 mg po qd, dicyclomine 20 mg po, ibuprofen 600 mg po q 6 hr prn

 

Social hx- 15 pack/year history of smoking, occasional alcohol use, denies vaping

 

The health care provider diagnoses the patient with gastroesophageal reflux disease (GERD).