Which of the following statements is true?

Correct Answer: D

Rationale: The correct answer is D because hepatitis A infection can have a relapsing course. This is due to the natural course of the infection, where patients can initially recover but then experience a recurrence of symptoms. This is different from hepatitis B or C, which typically do not have a relapsing course. A is incorrect because in alcoholic hepatitis, the AST/ALT ratio is usually greater than 2. B is incorrect because Alpha-1 Antitrypsin deficiency is associated with liver and lung diseases, not arteriovenous malformations of the brain. C is incorrect because although serum A1AT levels are used to diagnose A1AT deficiency, they are not solely diagnostic as genetic testing is also required for confirmation.

Correct Answer: C

Rationale: The correct answer is C: NSAIDs are known to irritate the gastric mucosa. NSAIDs can lead to gastric mucosal injury by inhibiting prostaglandin synthesis, which plays a protective role in maintaining the integrity of the gastric mucosa. This can result in the development or exacerbation of peptic ulcers. A: NSAIDs actually inhibit prostaglandin synthesis, leading to decreased gastric acid secretion. B: NSAIDs do not delay gastric emptying; rather, they can cause dyspepsia and increase the risk of ulcers. D: NSAIDs do not interfere with proton pump inhibitors; instead, they can reduce the efficacy of these drugs in treating ulcers.

Correct Answer: B

Rationale: The correct answer is B: Constipation. Antacids containing aluminum or calcium can cause constipation due to their ability to slow down digestion. This is a common side effect observed in patients using antacids for peptic ulcer disease (PUD). Rationale: 1. Aluminum and calcium-based antacids can reduce bowel motility, leading to constipation. 2. Diarrhea is not a common side effect of antacids in the management of PUD. 3. Weight gain is not a direct side effect of antacids but may occur indirectly due to overeating to alleviate symptoms. 4. Dizziness is not a typical side effect of antacids in the management of PUD.

Correct Answer: B

Rationale: The correct answer is B because histamine-2 receptor antagonists (H2RAs) work by blocking the action of histamine on the H2 receptors of the stomach, which then leads to a decrease in gastric acid secretion. This helps in reducing the acidity level in the stomach, promoting ulcer healing in peptic ulcer disease (PUD). A: Neutralizing gastric acid is the action of antacids, not H2RAs. C: Coating the stomach lining is the mechanism of action of cytoprotective agents like sucralfate, not H2RAs. D: Eradicating H. pylori is a treatment approach for PUD caused by this bacterium, but H2RAs do not directly target H. pylori.

Correct Answer: D

Rationale: The correct answer is D (Both B and C). NSAIDs and aspirin are known to irritate the stomach lining and increase the risk of developing peptic ulcers. Acetaminophen, on the other hand, does not have the same effect on the stomach lining and is considered safer for patients with PUD. Therefore, advising a patient with PUD to avoid NSAIDs and aspirin is crucial to prevent exacerbation of the condition. Additionally, selecting option D is appropriate as it covers both medications that should be avoided, providing a comprehensive approach to managing PUD.