Epigastric Pain Q 1 - 4 ???????? - mirt

[ArchivalUser]

Sorry. Its
B
B
D
C

[ArchivalUser]

hehe th good thinking

answers plz

[ArchivalUser]

Alrt guys the correct answers are CCDC

Gastritis
Fecal Ag
Amox+Metro+Omeprazole

Pt is not anemic when he presented, the P/E is completely normal except epigastric pain so Gastritis is on top of DDX. Urea breath test is very good test to do but Patient should be off antibiotics, Antacids, bismuth etc for several weeks........Serum H-Pylori Ab does not tell you if this is current infection or previous infection...( remember Pt siad he is not sure if he was treated for H-Pylori........HpSA is considered best when a case like this is in office.....Two antibiotics and PPI are sufficient to begin with.......No improvement by itself is a clue that this Pt needs endoscopy. In addition his sclera now is pale and it was normal when he first presented.

[ArchivalUser]

I always thought that metronidazole is given if patient is allergic to Penicillin (Amoxicillin).
DO you give both together?????? Please correct me if i am wrong. In step 2 CK they just say that the first choice is PPI+Clarithromycin+Amoxicillin and that the other 2 choices are tetracycline and Metronidazole.

[ArchivalUser]

Also, don't most patients with Gastritis present with asymptomatic bleeding?

[ArchivalUser]

Stualis............it is any 2 antibiotics with PPI

[ArchivalUser]

a
a
c
c

[ArchivalUser]

Regarding the initial diagnosis:

Just b/c there was mention of ineffective OTC prilosec does that automatically make the DX for Gastritis?? Should we look past the DX of DU that quickly? also no hx of ETOH etc

I've never seen this... but I'll try to come away with something here.....hmm....

[ArchivalUser]

If you guys still have doubt about Gastritis then plz have a cool look at CCS case 45 in FA and tell me why the final Dx is Gastritis not DU or GU

[ArchivalUser]

hey mirt,

thanks for the reference,, just my view that gastritis usually comes with more convincing history which this Q didn't have and for step3 we may need to search for the more common things first.

Either way thanks for posting this Q ... when I purchase FA I will look for this concept too...