<prompt> A patient presents with tachycardia, BP of less than 100 mm systolic and postural hypotension. Diagnosis is: September 2012Vasovagal attackDiabetic neuropathyShy Drager syndromeBleeding peptic ulcer  <response>: Ans: D i.e. Bleeding peptic ulcer GI ulcers from surgery MC site of duodenal ulcer: Duodenal cap Curlings ulcer: GI ulcers in severe burns Site of bleeding in duodenal ulcer: Gastroduodenal aery Treatment of perforated peptic ulcer: - Exploratory laparotomy, Nasogastric suction, - Acid suppression, - Antibiotics etc. Management of duodenal ulcer: - Highly selective vagotomy least chances of diarrhea dumping syndrome - Truncal vagotomy and antrectomy lowest chances of recurrence Cause of early dumping syndrome: Due to rapid emptying of hyperosmolar gastric contents into the small intestine 