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170759 Medicine

A 57-year-old woman experiences frequent symptoms of heartburn. She reports no weight loss, diarrhea, or dysphagia symptoms. Past medical history is significant for vitamin B12 deficiency treated with monthly injections. She appears well, and the examination is normal, except for some patches on her arms where she has lost all the skin pigmentation. Her upper endoscopy is normal, except for gastric biopsies commenting on gastritis.For the above patient with gastritis, select the most likely mechanism of injury.

Abile acid reflux implicated in pathogenesis
Bimmune or autoimmune pathogenesis suspected
Cischemia of the gastric mucosa implicated in the pathogenesis
Dassociated with Helicobacter pylori infection
Medicine
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