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Clinical Review Quiz

  Helicobacter pylori: Review and Update:
Review Questions

Frederick J. Hardin, MD, and Richard A. Wright, MD

Dr. Hardin is a Fellow and Dr. Wright is a Professor and Chief, Division of Gastroenterology/Hepatology, Department of Medicine, University of Louisville, Louisville, KY.

The questions below are based on the May 2002 cover article,
Helicobacter pylori: Review and Update.”

Choose the single best answer for each question.

1. Increased prevalence of H. pylori infection is NOT associated with which of the following characteristics?
  1. Fecal-oral exposure during childhood
  2. Female sex
  3. Increasing age
  4. Low socioeconomic status during childhood
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2. Which of the following terms accurately describes the H. pylori organism?

  1. Cytotoxic protein­associated
  2. Gram-positive
  3. Intracellular
  4. Nonmotile
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3. Which of the following is NOT a histologic change associated with H. pylori infection?

  1. Atrophy of mucosal glands in longstanding infection
  2. Intense eosinophilic aggregation
  3. Lymphocytic proliferation in the stroma
  4. Neutrophilic infiltration of mucosal glands
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4. Which of the following characterizations does NOT pertain to nonulcer dyspepsia?

  1. Altered gastric emptying and fundic compliance may cause the disorder
  2. The disorder is associated with altered visceral sensation
  3. Eradication of H. pylori infection is usually curative of the disorder
  4. Increased levels of serotonin may play a role in the disorder
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5. Which of the following statements is NOT accurate regarding the diagnosis of H. pylori infection?
  1. Breath tests and stool tests can aid in diagnosis
  2. Culture can be problematic and unreliable as a diagnostic tool
  3. Histology is the “gold standard” of diagnosis
  4. Serology should be a first-line diagnostic tool in low-prevalence areas
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6. Which of the following statements regarding management of H. pylori infection is most accurate?

  1. Cure rates of 60% to 70% are acceptable
  2. Monotherapy is comparable to multidrug therapy
  3. Multiple acceptable treatment regimens exist
  4. Proton pump inhibitors administered to infected patients work by inhibiting the action of antibiotics
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7. Which of the following statements is NOT accurate regarding development of a vaccine for H. pylori infection?

  1. Antibiotic agents are likely to provide primary protective immunity
  2. Interleukins 4 and 10 are key to providing protective immunity
  3. The optimal route of administration has yet to be identified
  4. Oral vaccines can induce postimmunization gastritis
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8. Which of the following disorders does NOT yet have an established, accepted association with H. pylori infection?

  1. Gastric adenocarcinoma
  2. Gastric mucosa-associated lymphoid tissue lymphoma
  3. Gastritis
  4. Iron-deficiency anemia
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