Peptic ulcers, gastritis, and duodenitis (pediatrics) Quiz: Ace Your Exams
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A 10-year-old girl presents with a 3-month history of intermittent epigastric pain that worsens at night and is partially relieved by eating. There is no history of vomiting or weight loss, and the patient has not been taking nonsteroidal anti-inflammatory drugs (NSAIDs). The patient was started on omeprazole but has had no improvement in symptoms despite four weeks of treatment. Temperature is 36.7°C (98.1°F), heart rate is 94/min, blood pressure is 110/70 mmHg, respiratory rate is 20/min, and oxygen saturation is 99% on room air. The patient appears comfortable on the examination table. Abdominal palpation reveals mild tenderness in the epigastric region without guarding or rebound. Laboratory testing is notable for a hemoglobin of 10 g/dL and mean corpuscular volume (MCV) of 75 fL. An esophagogastroduodenoscopy (EGD) reveals mucosal erythema and multiple erosions in the stomach, and rapid urease testing is positive. What is the best next step in management?
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