A 56-Year-Old Man Comes to the Office for Upper Abdominal

A 56-year-old man comes to the office for upper abdominal pain occurring with meals for the last month.  His symptoms improve when fasting.  The patient's other medical problems are coronary artery disease and osteoarthritis.  His medications include aspirin, simvastatin, and acetaminophen as needed.  The patient drinks 1 or 2 beers daily but does not use tobacco or illicit drugs.  Upper endoscopy is performed and reveals a gastric ulcer with a smooth, rounded border and an exudative base.  A biopsy of the ulcer is taken and placed into a urea-containing solution that includes phenol red, a pH indicator.  Thirty minutes later, the solution has turned pink, indicating a pH increase.  This test result suggests that which of the following processes is occurring?

A) Clonal proliferation of glandular cells
B) Cyclooxygenase inhibition leading to mucosal damage
C) Enzymatic production of ammonia
D) Gastrin hypersecretion leading to acid overproduction
E) Parietal cell destruction due to autoimmune disease

Correct Answer:

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