DDSEP® 8 Quick Quiz

February 2017 Quiz 1

Publish date: February 1, 2017

Testing for Helicobacter pylori infection is recommended for the following patient who has never previously been tested, EXCEPT:

55-year-old asymptomatic man with one episode of upper GI bleeding due to an uncomplicated duodenal ulcer seen on esophagogastroduodenoscopy 6 years ago

60-year-old asymptomatic woman who is status-post recent mucosal resection of early gastric adenocarcinoma

25-year-old healthy Hispanic woman who presents with mild, intermittent epigastric discomfort without other symptoms

45-year-old asymptomatic man of Irish decent whose son was recently diagnosed with H. pylori infection

48-year-old woman with cirrhosis who was found to have a small, clean-based gastric ulcer incidentally during EGD for variceal screening

Q1: Answer: D

Current recommendations suggest H. pylori testing for patients with active or a documented history of peptic ulcer disease, gastric MALT lymphoma, or gastric carcinoma. The H. pylori test-and-treat strategy is also recommended for patients less than 55 years of age who present with dyspepsia symptoms without “alarm features.”

There is currently no recommendation for asymptomatic family members of patients diagnosed with H. pylori infection to be tested, unless there are known factors that may increase the patient’s risk for gastric malignancy (e.g., family history of gastric carcinoma, and ethnic background from areas with high prevalence of H. pylori and gastric cancer such as East Asia, Latin America, and Eastern Europe).

References

1. Chey W.D., Wong B.C. Practice Parameters Committee of the American College of Gastroenterology. American College of Gastroenterology guideline on the management of Helicobacter pylori infection. Am J Gastroenterol. 2007;102:1808-25.

2. Talley N.J., Vakil N.B., Moayyedi P. American Gastroenterological Association technical review on the evaluation of dyspepsia. Gastroenterology 2005;129:1756-80.

3. Suerbaum S., Michetti P. Helicobacter pylori infection. N Engl J Med. 2002;347:1175-86.

4. Everhart J.E., Kruszon-Moran D., Perez-Perez G.I., et al. Seroprevalence and ethnic differences in Helicobacter pylori infection among adults in the United States. J Infect Dis. 2000;181:1359-63.

Next Article:

AGA Guideline: Acute liver failure