H. pylori

Question 1

x

Question 2

x

Question 3

x

Question 4

x

Question 5

x

Question 6

x

Question 7

x

Question 8

x

Question 9

x

Question 10

x

Question 11

x

Question 12

x

Question 13

first line management of H pylori ?

Answer 13

PPI, amoxicillin and clarithromycin or

a PPI, amoxicillin and metronidazole

Question 14

second line mx for H pylori

Answer 14

use a PPI, amoxicillin and either clarithromycin or metronidazole

whichever was not used for first-line treatment.

Question 15

patients who have an inadequate response to second-line treatment, patients should be?

Answer 15

referred for upper GI endoscopy

Question 16

x

Question 17

Helicobacter pylori test

Answer 17

Urea breath test

Rapid urease test (e.g. CLO test)

Serum antibody

Culture of gastric biopsy

Gastric biopsy

Stool antigen test

Question 18

method of urea breath test ?

Answer 18

consume a drink containing carbon isotope 13 (13C) enriched urea

urea is broken down by H. pylori urease

after 30 mins patient exhale into a glass tube

mass spectrometry analysis calculates the amount of 13C CO2

Question 19

urea breath test should not be performed ?

Answer 19

within 4 weeks of treatment with an antibacterial

or within 2 weeks of an antisecretory drug (e.g. a proton pump inhibitor)

Question 20

urea test is most specifically used for ?

Answer 20

to check for H. pylori eradication

Question 21

what remains positive after H pylori eradication

Answer 21

Serum antibody

Question 22

Stool antigen test

Answer 22

sensitivity 90%, specificity 95%

Question 23

before second-line treatment is considered what is suggested ?

Answer 23

recommends re-testing for H. pylori using urea breath test (for eradication)

he carbon-13 urea breath test is the most accurate method of re-testing for H. pylori

should be performed 4 weeks after the eradication therapy

Question 24

before second-line treatment is considered what is suggested ?

Answer 24

recommends re-testing for H. pylori using urea breath test (for eradication)

he carbon-13 urea breath test is the most accurate method of re-testing for H. pylori

should be performed 4 weeks after the eradication therapy