A 34-year-old man is seen over multiple visits for complaints of “ulcers,” despite the use of famotidine. Further studies, finding elevated levels of gastrin and evidence of ulcers involving the jejunum. Which of the following agents would be most useful in the management of this patient?Question 3Answera.Misoprostolb.Propanthelinec.Ranitidined.Lansoprazolee.Bismetrol
Question
A 34-year-old man is seen over multiple visits for complaints of “ulcers,” despite the use of famotidine. Further studies, finding elevated levels of gastrin and evidence of ulcers involving the jejunum. Which of the following agents would be most useful in the management of this patient?Question 3Answera.Misoprostolb.Propanthelinec.Ranitidined.Lansoprazolee.Bismetrol
Solution
The patient's symptoms and test results suggest a diagnosis of Zollinger-Ellison syndrome, a condition characterized by gastrin-secreting tumors (gastrinomas) in the pancreas and duodenum. These tumors lead to the overproduction of gastric acid, resulting in recurrent peptic ulcers.
Famotidine and ranitidine are H2 blockers that reduce the production of stomach acid, but they may not be sufficient to manage the high levels of gastrin in Zollinger-Ellison syndrome. Misoprostol is a prostaglandin analogue used to prevent NSAID-induced ulcers, and propantheline is an anticholinergic medication used to treat conditions like peptic ulcer disease. Bismetrol is not a recognized medication.
Lansoprazole, on the other hand, is a proton pump inhibitor (PPI). PPIs like lansoprazole are the treatment of choice for Zollinger-Ellison syndrome because they effectively inhibit gastric acid secretion. Therefore, the most useful agent in the management of this patient would be lansoprazole (option d).
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