Helicobacter pylori — MCQs

A 45-year-old woman has a history of mild epigastric pain, which seems to have gotten worse over the last month. Her pain is most severe several hours after a meal and is somewhat relieved with over-the-counter antacids. The patient denies abnormal tastes in her mouth or radiating pain. She does not take any other over-the-counter medications. She denies bleeding, anemia, or unexplained weight loss, and denies a family history of gastrointestinal malignancy. Which of the following is the best next step in the management of this patient?

A 30-year-old man who recently emigrated from Southeast Asia presents with heartburn and a bad taste in his mouth. He says the symptoms have been present for the last 6 months and are much worse at night. He describes the pain as moderate to severe, burning in character, and localized to the epigastric region. He mentions that 1 month ago, he was tested for Helicobacter pylori back in his country and completed a course of multiple antibiotics, but there has been no improvement in his symptoms. Which of the following is the most likely diagnosis in this patient?

A 28-year-old graduate student visits the university health clinic for 3-weeks of epigastric pain that worsens with meals, associated with retrosternal pain, early satiety, and bloating. She denies vomiting blood or blood in her stool. She has been consuming large volumes of caffeinated-drinks and fast-food for a month, as she has been studying for her tests. Her family and personal history are unremarkable with no history of gastrointestinal cancer. Her vital signs are within normal limits. Physical examination is only positive for a mild epigastric tenderness. Which of the following is the most appropriate approach in this case?

A 49-year-old male complains of abdominal discomfort that worsens following meals. A gastric biopsy reveals a 2 cm gastric ulcer, and immunohistochemical staining demonstrates the presence of a rod-shaped bacterium in the gastric mucosa. Which of the following is used by the infiltrating pathogen to neutralize gastric acidity?

A 52-year-old man comes to the physician because of a 3-month history of upper abdominal pain and nausea that occurs about 3 hours after eating and at night. These symptoms improve with eating. After eating, he often has a feeling of fullness and bloating. He has had several episodes of dark stools over the past month. He has smoked one pack of cigarettes daily for 40 years and drinks 2 alcoholic beverages daily. He takes no medications. His temperature is 36.4°C (97.5°F), pulse is 80/min, and blood pressure is 110/70 mm Hg. Abdominal examination shows epigastric tenderness with no guarding or rebound. Bowel sounds are normal. Which of the following treatments is most appropriate to prevent further complications of the disease in this patient?

A previously healthy 37-year-old man comes to the physician for the evaluation of an 8-week history of intermittent burning epigastric pain. During this period, he has also felt bloated and uncomfortable after meals. He has not had weight loss or a change in bowel habits. He has no personal or family history of serious illness. He takes no medications. He does not smoke. He drinks 1–3 beers per week. Vital signs are within normal limits. Abdominal examination shows mild epigastric tenderness on palpation without guarding or rebound tenderness. Bowel sounds are normal. The remainder of the examination shows no abnormalities. Which of the following is the most appropriate next step in management?

A 28-year-old male presents to his primary care physician with complaints of intermittent abdominal pain and alternating bouts of constipation and diarrhea. His medical chart is not significant for any past medical problems or prior surgeries. He is not prescribed any current medications. Which of the following questions would be the most useful next question in eliciting further history from this patient?

A 30-year-old woman who is 24-weeks pregnant presents to the emergency department with fever, painful urination, and headache. The patient's blood pressure is 111/67 mm Hg, the pulse is 95/min, the respiratory rate is 16/min, and the temperature is 38.3°C (101.1°F). Physical examination reveals bilateral tender inguinal lymphadenopathy and painful genital lesions. On closer inspection, the patient’s genital lesions contain clear fluid and measure 5–6 mm in diameter. What is the appropriate description of these lesions?

A 27-year-old previously healthy man presents to the clinic complaining of bloody diarrhea and abdominal pain. Sexual history reveals that he has sex with men and women and uses protection most of the time. He is febrile with all other vital signs within normal limits. Physical exam demonstrates tenderness to palpation of the right upper quadrant. Subsequent ultrasound shows a uniform cyst in the liver. In addition to draining the potential abscess and sending it for culture, appropriate medical therapy would involve which of the following?

A researcher is studying the interactions between foreign antigens and human immune cells. She has isolated a line of lymphocytes that is known to bind antigen-presenting cells. From this cell line, she has isolated a cell surface protein that binds to class I major histocompatibility complex molecules. The continued activation, proliferation and survival of this specific cell line requires which of the following signaling molecules?