American Board of Internal Medicine (ABIM) Certification Practice Exam

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After how many weeks of PPI therapy can repeat endoscopy be considered for persistent gastric ulcers?

4 to 6 weeks
8 to 12 weeks
12 to 16 weeks
24 weeks

The correct answer is: 8 to 12 weeks

The recommended timeframe for repeat endoscopy in cases of persistent gastric ulcers after initiating proton pump inhibitor (PPI) therapy is typically 8 to 12 weeks. This duration allows sufficient time for healing, as PPIs significantly reduce gastric acid secretion, enhancing the healing process of gastric ulcers. If ulcer healing has not occurred within this timeframe, the repeat endoscopy can help assess the ulcer's status and rule out malignancy or other underlying conditions that could be affecting healing. The other options do not align as well with clinical guidelines. A shorter period like 4 to 6 weeks might not provide enough time for the ulcer to heal effectively in the presence of ongoing risk factors or inadequate treatment. In contrast, waiting 12 to 16 weeks or longer may unnecessarily prolong patient discomfort and delay the investigation of potential complications. Therefore, the 8 to 12 weeks recommendation strikes a balance between allowing healing and being proactive about persistent issues.