Acid Peptic Disorders

Question 1

How do you diagnosed peptic ulcer disease?

Answer 1

Lab: consider H Pylori testing

Endoscopy (SOR A): 90% sensitivity and specificity

Question 2

What is the use of the urea breath test?

Answer 2

initial diagnosis AND test of cure (4-6 weeks post treatment) for H pylori

MOST sensitive and specific

Question 3

What is the use of a stool antigen test for H pylori?

Answer 3

Used to detect active infection
Used as test of cure

may be used in office, but less reliable

Question 4

What is the utility of antibody test for H pylori?

Answer 4

not useful as test of cure

can tell if ever infected

Question 5

What is the diagnostic study of choice in children with persistent or severe upper abdominal symptoms of pUD?

Answer 5

Endoscopy with biopsy and test for H pylori

Question 6

Which tests should be used for initial diagnosis of H pylori?

Answer 6

urea breath test and stool antigen test both test for active infection

Question 7

Which tests can be used to test for eradication of h pylori?

Answer 7

urea breath test and stool antigen test at least 4 weeks post treatment

Question 8

What is standard triple therapy for H pylori?

Answer 8

PPI, amoxicillin, clarithromycin

or

PPI, amoxicillin, metronidazole

Question 9

How long is therapy with PPI for gastric ulcer?

Answer 9

12 weeks

Question 10

How long is therapy with PPI for duodenal ulcer?

Answer 10

4-6 weeks

Question 11

Which treatment of H pylri has highest success rate?

Answer 11

Non-bismuth based quadruple therapy

• 10 days
• PPI, amoxicillin
• clarithromycin
• mtronidazole or tinidazole

Question 12

What cotherapy can be given to pts at high risk for NSAID ulcer who need to take NSAID?

Answer 12

• add PPI or misoprostol (cytotec)

- consider naproxen