Question 1
What time interval do you need to have had stopped PPIs prior to interpreting a urease breath test for the diagnosis of H. pylori?
(A) 3 days
(B) 5 days
(C) 7 days
(D) 10 days
(E) 14 days
E: "For both the breath test and the fecal antigen test, the patient should stop taking proton-pump inhibitors 2 weeks before testing, should stop taking H2 receptor antagonists for 24 hours before testing, and should avoid taking antimicrobial agents for 4 weeks before testing, since these medications may suppress the infection and reduce the sensitivity of testing" N Engl J Med 2010; 362:1597-1604
Question 2
Which of the following is NOT associated with H. pylori?
(A) Atrophic gastritis
(B) Iron refractory Iron deficiency anaemia
(C) GORD
(D) Gastric adenocarcinoma
(E) MALT lymphoma
C: N Engl J Med 2010; 362:1597-1604
Question 3
A 67 year old male presented with 6 weeks of fevers, weight loss and night sweats. There was associated dyspepsia. Upper endoscopy was performed which showed evidence for a duodenal ulcer and the presence of H. pylori on both the CLO test and on biopsy. MALT lymphoma was also confirmed. A 14 day triple therapy course was prescribed. What is the best test to determine recurrence?
(A) Stool antigen testing or Urease breath testing 4 weeks post treatment
(B) Stool antigen testing or Urease breath testing 8 weeks post treatment
(C) H. pylori serology
(D) Upper endoscopy
(E) Urine antigen for H. pylori
A: D is also an option but only if repeat endoscopy is going to be done for other reasons. Option 'B' is too long a wait. H. pylori serology stays positive for many months and should not be used for confirmation of eradication N Engl J Med 2010; 362:1597-1604
What time interval do you need to have had stopped PPIs prior to interpreting a urease breath test for the diagnosis of H. pylori?
(A) 3 days
(B) 5 days
(C) 7 days
(D) 10 days
(E) 14 days
E: "For both the breath test and the fecal antigen test, the patient should stop taking proton-pump inhibitors 2 weeks before testing, should stop taking H2 receptor antagonists for 24 hours before testing, and should avoid taking antimicrobial agents for 4 weeks before testing, since these medications may suppress the infection and reduce the sensitivity of testing" N Engl J Med 2010; 362:1597-1604
Question 2
Which of the following is NOT associated with H. pylori?
(A) Atrophic gastritis
(B) Iron refractory Iron deficiency anaemia
(C) GORD
(D) Gastric adenocarcinoma
(E) MALT lymphoma
C: N Engl J Med 2010; 362:1597-1604
Question 3
A 67 year old male presented with 6 weeks of fevers, weight loss and night sweats. There was associated dyspepsia. Upper endoscopy was performed which showed evidence for a duodenal ulcer and the presence of H. pylori on both the CLO test and on biopsy. MALT lymphoma was also confirmed. A 14 day triple therapy course was prescribed. What is the best test to determine recurrence?
(A) Stool antigen testing or Urease breath testing 4 weeks post treatment
(B) Stool antigen testing or Urease breath testing 8 weeks post treatment
(C) H. pylori serology
(D) Upper endoscopy
(E) Urine antigen for H. pylori
A: D is also an option but only if repeat endoscopy is going to be done for other reasons. Option 'B' is too long a wait. H. pylori serology stays positive for many months and should not be used for confirmation of eradication N Engl J Med 2010; 362:1597-1604