AIIMS Delhi NO - 2017: Most common causative organism of Peptic ulcer?

AIIMS Delhi NO - 2017

Applied Microbiology & Infection control

Easy

Appeared in: AIIMS Delhi NO - 2017

Explanation

Helicobacter pylori is a gram-negative bacterium recognized as the primary cause of peptic ulcer disease.
It colonizes the gastric mucosa, weakening the protective mucous layer through inflammation and enzyme production (e.g., urease).
This damage allows stomach acid to erode the underlying tissue, leading to the formation of ulcers in the stomach or duodenum.
Medical literature confirms that H. pylori is responsible for about 90% of duodenal ulcers and 70% of gastric ulcers.

Option B: Escherichia coli is a bacterium commonly found in the intestines. While certain strains can cause severe diarrhea and gastroenteritis, it is primarily known for causing urinary tract infections and is not a causative agent for peptic ulcers.
Option C: Streptococcus is a genus of bacteria responsible for a wide range of infections, most notably streptococcal pharyngitis (strep throat), pneumonia, and skin infections like cellulitis. It does not cause peptic ulcers.
Option D: Botulism is a rare but serious paralytic illness caused by a neurotoxin produced by the bacterium Clostridium botulinum. It is typically associated with improper food canning and has no connection to the formation of peptic ulcers.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Etiology of Peptic Ulcer Disease as background academic context rather than a clinical decision trigger.
Nurses are crucial in educating patients diagnosed with H. pylori-induced ulcers about the importance of adhering to the prescribed 'triple therapy' (two antibiotics and a proton pump inhibitor) to ensure complete eradication of the bacteria.
Accurate assessment for peptic ulcer disease includes asking about risk factors like chronic NSAID use, smoking, and symptoms such as epigastric pain that may be relieved by food.
Confirming the success of eradication therapy, often through a urea breath test or stool antigen test, is a key nursing consideration to prevent ulcer recurrence and complications like bleeding or perforation.

How to Approach the Question

First, identify the keywords in the question: 'most common', 'causative organism', and 'peptic ulcer'. This is a factual recall question asking for the primary pathogen.
Recall the major causes of peptic ulcer disease. The two most significant are a specific bacterial infection and the use of certain medications.
Evaluate each option based on your medical knowledge.
Helicobacter pylori is widely known as the bacterium strongly linked to peptic ulcers.
E. coli, Streptococcus, and Botulism are pathogens, but they are associated with different conditions (UTIs/diarrhea, throat/skin infections, and paralysis, respectively).
Conclude that H. pylori is the only option that is a common cause of peptic ulcers.

Concept Tested & Keywords

QCo5hUEIc3pgGsuqzpf5r-

E6 Nelson Textbook of Pediatrics(2024) — Volume 2 p. 88-90

E6 Medicine Davidson Principles Practice 24e p. 818-820

E6 Medicine Harrison 22e Part 1 p. 1339-1341