Chief Complaint: A 23 years old male presents with complaints of upper abdominal pain, nausea and occasional vomiting over the last 5 days. History of Present illness: The pain worsens at night and after meals, especially fried and spicy food. The use of a nonsteroidal anti-infammatory drug (NSAIDI, Naproxe n failed to relieve his pain over the past 2 days. Past Medical History: none Social History: Never smoked tobacco, Alcohol: 1 drink per week Family History: non-contributory Physical Examination: Weight: 58 kg. 128 lb: Height: 5 feet, 8 inches; BM: 19.44 kg/m2 : Temperature: 98*F; BP: 120/70 mmHg: upper abdominal tenderness Laboratory Tests. Normal Blood Hemoglobin (Hb) level (13.5g/di); Absent blood in stools; Positive Urea Breath Test (UBT) Endoscopy. whitish crater measuring 1 x0.5 cm seen in the gastric pylorus Blopsy: Curved rods seen on gastric epithelium; loss of gastric mucosa with chronic inflammation and fibrin seen in the underlying ulcer floor Treatment: Combination therapy with a proton pump inhibitor, plus a macrolide ancibiotic and a beta-lactam antibiotic v DIAGNOSIS 1. Amoxicilin INFECTIOUS AGENT 2 Peptic Ulcer Diseases (PUD) 3. Clarythromycin 1. PATHOGENESIS 4. Urease 2. ENZYME ACTIVITY DETECTED 5. Cancer arising in the ulcer 3. PROTON PUMP INHIBITOR 6. Blocks Acid INCREASED RISK for patient 7. Comma-shaped rod with multiple flagellae 8. Microaerophilic 4. 5. MICROSCOPY 6. GROWTH CONDTIONS 9. Helicobocter pylori 7. MACROUDE ANTIBIOTIC 10. Chronic gastritis, Hyperacidity, Erosion 8. Beta-LACTAM ANTIBIOTIC 9. 10.