PAEA Surgery End Of Rotation (EOR) Practice Exam

What measurement helps differentiate gastric from duodenal ulcers?

1. Severity of pain scale

2. Timing of pain related to meals

3. Presence of nausea

4. Blood work results

The correct answer is: Timing of pain related to meals

The timing of pain related to meals is a crucial factor in distinguishing between gastric and duodenal ulcers. Gastric ulcers typically cause pain that is exacerbated by eating, often occurring shortly after a meal, which can lead to avoidance of food in those affected. This is because the presence of food in the stomach increases gastric acid production, worsening the ulcer's irritation. On the other hand, duodenal ulcers generally present with pain that occurs a few hours after eating and often is relieved by eating. The mechanism here involves the ulcer's location and the dynamics of gastric acid secretions; food in the stomach influences gastric emptying into the duodenum, temporarily increasing the discomfort related to the ulcer. Understanding this timing relationship helps healthcare providers make more accurate assessments when diagnosing the type of ulcer a patient might have. In clinical practice, these differences in pain timing can be pivotal in guiding treatment and management effectively.