Internal Medicine_Infectious Diseases_5

Question 2

What type of bacteria is Helicobacter pylori?

Answer 2

Gram-negative gastric spiral-shaped bacillus

Question 3

Helicobacter pylori is associated with what major diseases?

Answer 3

associated with gastritis and peptic ulcer disease (PUD).

Question 4

What makes Helicobacter pylori motile?

Answer 4

It has a curved shape and a flagellar rotor enabling motility.

Question 5

What enzyme does Helicobacter pylori produce, and what is its significance?

Answer 5

Urease, which converts urea into ammonia and carbon dioxide to neutralize stomach acidity. (Basis for the urea breath test)

Question 6

What are the key virulence factors of Helicobacter pylori?

Answer 6

Urease production and motility, allowing survival in acidic gastric environments.

Question 7

Which enzymes are produced by Helicobacter pylori that play roles in respiration?

Answer 7

Oxidase, aiding aerobic respiration.

Question 8

What gastric conditions are strongly associated with Helicobacter pylori infection?

Answer 8

Gastric ulcers and duodenal ulcers.

90%+ of duodenal ulcers are caused by H. pylori.

Question 9

What cancers are linked to chronic Helicobacter pylori infection?

Answer 9

Gastric adenocarcinoma and mucosa-associated lymphoid tissue (MALT) lymphomas.

Question 10

What are the two main noninvasive tests used to diagnose Helicobacter pylori?

Answer 10

Stool antigen assay and the urea breath test.

Serology is typically avoided (low specificity and sensitivity and does not differentiate active from past infections).

Question 11

How is Helicobacter pylori diagnosed invasively?

Answer 11

Upper endoscopy with biopsy, urease testing, and culture.

Question 12

What would warrant invasive testing of H. pylori?

Answer 12

Age > 60
weight loss
GI bleeding
difficulty swallowing
persistent vomiting
palpable mass
lymphadenopathy
family history of GI cancer

Question 13

If invasive testing is not warranted, the lab tests are negative, and the patient is suffering from epigastric pain or burning, what is the way in which one manages these patients?

Answer 13

Trial PPI

Question 14

What is the first-line treatment for Helicobacter pylori infection?

Answer 14

Triple therapy:

Proton pump inhibitor (PPI)

Clarithromycin

Amoxicillin or metronidazole.

Question 15

When is quadruple therapy used for Helicobacter pylori treatment?

Answer 15

When local macrolide resistance is high.
It includes metronidazole, tetracycline, PPI, and bismuth.

Question 16

How is eradication of Helicobacter pylori confirmed after treatment?

Answer 16

Using the same diagnostic tests as those used initially
(stool antigen or urea breath test).

Question 17

What is the first-line treatment for MALToma?

Answer 17

Triple therapy:

Proton pump inhibitor (PPI)

Clarithromycin

Amoxicillin or metronidazole.