Which of the following factors does NOT register a score of 1 in the Well's Score for diagnosis of a deep vein thrombosis (DVT)?

Correct Answer: C

Rationale: In the Wells Score for DVT, an alternative diagnosis as likely or more likely than DVT scores -2, not 1, making C the correct answer.

Correct Answer: C

Rationale: Diabetic retinopathy is a classic microvascular complication of diabetes, affecting small vessels, making C the correct answer.

Correct Answer: C

Rationale: Peak flow <33% of best/predicted indicates a severe asthma exacerbation per guidelines, making C the correct answer.

Correct Answer: C

Rationale: H. pylori resides in the mucus layer of the stomach, where it exerts its urease activity. It does not invade the epithelium. The production of ammonia, the stimulation of acid secretion, and the disruption to the protective mucus layer are three mechanisms by which H. pylori promotes injury. H. pylori also stimulates interleukin-8, a cytokine associated with inflammation. H. pylori is causally associated with gastric adenocarcinoma and MALT lymphoma of the stomach. Eradication of H. pylori has been shown to cause regression of MALT lymphoma, but it has not been shown to prevent adenocarcinoma of the stomach. Three- or four-drug regimens are superior to two-drug regimens.

Correct Answer: D

Rationale: All of the other medications have been associated with pill-induced esophagitis. Pill-induced esophagitis is usually associated with the failure to ingest at least 8 ounces of water with the medication while upright and, less commonly, an underlying motility disorder. Resolution of pill-induced esophagitis and ulceration occurs rapidly once the offending medication is discontinued. Acid suppressive therapy is usually prescribed to prevent reflux-related injury.