GERD and Peptic Ulcer Disease USMLE Step 1 Practice Question
A 38-year-old man presents with burning epigastric pain that improves shortly after meals but recurs a few hours later. He has no weight loss. Upper endoscopy shows an ulcer in the proximal duodenum. Infection with Helicobacter pylori is confirmed. Which of the following mechanisms most directly contributes to this patient's ulcer?
Answer choices
- AGranulomatous transmural inflammation of the bowel wall
- BIncreased gastric acid load reaching the duodenumCorrect answer
- CAutoimmune destruction of gastric parietal cells
- DFailure of pancreatic bicarbonate secretion due to CFTR mutation
- EImpaired lower esophageal sphincter tone
- FNSAID-induced prostaglandin suppression
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