Epigastric pain

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Epigastric pain

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jean robert
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12/05/07 - 01:39 PM

A 24-year-old medical student complains of midepigastric pain that she describes as a "dull ache" that is relieved by eating. She has awakened from sleep on several occasions at 2 AM because of severe exacerbation of these symptoms, which are relieved with magnesium hydroxide. She takes frequent acetaminophen for menstrual cramping. Which of the following is the most likely cause of her symptoms?

A. Autonomous gastrin secretion
B. Gram-negative organism
C. Gram-positive organism
D. Prostaglandin inhibition
E. Vagal inhibition

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doc_clotaire
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12/05/07 - 03:42 PM

B. Gram-negative organism (H.pylori )

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jean robert
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12/06/07 - 04:35 PM

Hey doc, it s a pleasure that a big time guy like you stop by. Hope that you re doing great in CS.

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SURVIVOR
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12/07/07 - 01:39 AM

D. Prostaglandin inhibition

PGI2alpha
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12/07/07 - 06:12 AM

i think gram negative...whts the answer?

sigmadx
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12/07/07 - 08:27 AM

B. Pretest prob for H. Pylori in DU is roughly 75%

SURVIVOR
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12/11/07 - 12:27 AM

Its D. She's taking acetaminophen for menstrual cramping! Prostaglandin inhibitin is the reason for the tummy complaints! Get it?

There's NOTHING in the question leading 2 duodenal ulceration due to H Pylori! Correct me if i'm wrong plz!

Edited by Aashi on 12/13/07 - 03:41 PM

new_n_lost
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12/13/07 - 02:13 PM

B. Gram-negative organism

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Aashi
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12/13/07 - 03:43 PM

Dr_Kashif wrote:
Its D. She's taking acetaminophen for menstrual cramping! Prostaglandin inhibitin is the reason for the tummy complaints! Get it?

There's NOTHING in the question leading 2 duodenal ulceration due to H Pylori! Correct me if i'm wrong plz!

B. Gram-negative organism ----->H.PYLORI------>Duodenal ULCER---->hx of frequent awakening in the night coz of pain and relived by eating

Acetaminophen doesn't block PGs--->they DO NOT cause or exacerbate GI ulcers or a GI bleed.

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SURVIVOR
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12/14/07 - 01:23 AM

#10

Thanx for the explanation!

Ig F
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02/15/08 - 08:25 AM

#11

pt has symptoms of duodenal ulcers which are pain relieved by eating,frequent awakening at nights...the MCC of duodenal ulcer is H.pylori(gram negative organism)...answer is B.. nod

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pr20
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02/15/08 - 09:53 AM

#12

B.Gram-negative organism.

pari99
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02/15/08 - 11:14 AM

#13

Gram negative organism...90-95% DU cases are associated with h. pylori
In fact even in pts with NSAIDS induced ulcer,h pylori is playing a huge role in pathogenesis.

Tiff
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02/17/08 - 12:55 AM

#14

Aashi wrote:

B. Gram-negative organism ----->H.PYLORI------>Duodenal ULCER---->hx of frequent awakening in the night coz of pain and relived by eating

Acetaminophen doesn't block PGs--->they DO NOT cause or exacerbate GI ulcers or a GI bleed.

Though I agree with B, Acetaminophen is a paraamenophenol derivative that inhibits cyclooxygenase and, therefore, the formation and release of prostaglandin.

pr20
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02/17/08 - 11:46 AM

#15

I think the answer is B.
There is a lot of research going on exact mechanism of action of acetaminophen.For USMLE,just remember that acetaminophen is a reversible inhibitor of cyclooxygenase in CNS(but not in periphery),an enzyme involved in synthesis of prostaglandins.
Most important is acetaminophen,unlike aspirin,does not cause GI side effects.

Amlo99
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02/18/08 - 07:56 PM

#16

95% H pylori definitely

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