Several Months in Medicine / Internal Medicine — 34yo Woman | Gastroenterology | SMLE Q#18189

SMLE Question #18189

Medicine / Internal Medicine Gastroenterology

Objective: OBJ-PEP-001

Last updated: February 2026
A 34-year-old woman has 3 weeks of burning epigastric pain worse 1–2 hours after meals and sometimes at night. She has taken ibuprofen 600 mg three times daily for several months for knee pain. She denies hematemesis, melena, syncope, or unintentional weight loss. Upper endoscopy shows a 1 cm clean-based ulcer in the first part of the duodenum without active bleeding. Rapid urease testing is positive for Helicobacter pylori. What is the most appropriate next step in management?

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