Card 7 / 34: An 85 year-old woman is taking aspirin after recently suffering a myocardial infarction. She is admitted to the hospital from the nursing home with coffee ground emesis and several days of black stool. She is found to be hypotensive in the emergency room and severely anemic. She receives intravenous fluid, packed red blood cell transfusions, and pantoprazole intravenously. Once she is stabilized, an upper endoscopy is performed. Multiple small gastric ulcers are seen in the gastric antrum. They are all superficial and not actively bleeding. Which of the following is the most likely cause for this patient’s ulcers?
1.) h.pylori infection
2.) Lack of gastric mucus
3.) Exuberant blood supply to stomach
4.) Inhibition of cyclooxygenase
5.) Very high gastric acid production

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