Correct Answer: A

Rationale: Helicobacter pylori (H. pylori) is a type of bacteria that infects the stomach lining and is the most common cause of chronic gastritis. Aspirin and other NSAIDs can cause gastritis but are not the most common cause. Chronic alcohol consumption can lead to gastritis but is less common than H. pylori. Smoking exacerbates gastric conditions but is not a direct cause.

Correct Answer: D

Rationale: Abdominal cramping can occur with various gastrointestinal conditions, including peritonitis. However, it is not specific to peritonitis and may also be present in conditions like gastroenteritis or bowel obstruction. Profuse diarrhea is typically associated with gastrointestinal infections or inflammatory bowel diseases rather than peritonitis. In fact, peritonitis often leads to reduced bowel activity, potentially resulting in constipation rather than diarrhea. Hyperactive bowel sounds can occur in early stages of peritonitis but are not a classic finding. In many cases of peritonitis, bowel sounds may be diminished or absent due to the body’s response to inflammation. A hard, rigid abdomen indicates muscle guarding, which is the body’s response to inflammation and irritation of the peritoneum. This rigidity is often referred to as 'board-like' and is a key indicator of peritonitis.

Correct Answer: C

Rationale: Elevating the head of the bed is a recommended practice for individuals with GERD, as it helps prevent stomach acid from flowing back into the esophagus during sleep. This shows the patient is taking proactive steps to manage their condition. Using antacids can provide symptomatic relief from heartburn and discomfort associated with GERD. Taking them between meals and at bedtime can help neutralize stomach acid, which is a common practice for managing GERD symptoms. Eating large meals, especially rich or fatty foods, and snacking before bedtime can exacerbate GERD symptoms by increasing stomach pressure and acid production. Patients with GERD are typically advised to eat smaller meals and avoid eating close to bedtime to reduce reflux episodes. Chewing gum can actually be beneficial for some GERD patients as it stimulates saliva production, which can help neutralize stomach acid.

Correct Answer: C

Rationale: A vagotomy does not repair a perforation. It does not involve removing ulcerated tissue. It cuts the vagus nerve to decrease acid production, promoting ulcer healing. It is unrelated to preventing stomach sliding, which is addressed by fundoplication.

Correct Answer: D

Rationale: Urine retention is not typically associated with appendicitis. Increased bowel motility is not specific to appendicitis, which may cause decreased motility. Gastric hyperacidity is related to gastritis or ulcers, not appendicitis. Rebound tenderness is a classic sign of appendicitis, indicating peritoneal irritation.