H. pylori: ABFM practice questions

5 board-style questions on h. pylori in the PulseMD family medicine question bank — physician-reviewed, written against current guidelines with the reference cited on each question. Two free samples below; the full set with answers, explanations, and spaced review is free to start.

Sample question 1

A 35-year-old woman presents with a 3-month history of gnawing epigastric pain that improves with eating but recurs 2 to 3 hours after meals. She has no alarm symptoms, takes no NSAIDs, and has no history of peptic ulcer disease. She has never been tested for H. pylori. A urea breath test is positive. What is the most appropriate next step in management?

1. Start a proton pump inhibitor alone and retest for H. pylori in 8 weeks
2. Bismuth quadruple therapy (PPI, bismuth, metronidazole, tetracycline) for 14 days
3. Perform upper endoscopy with biopsy before initiating any treatment
4. No treatment is needed since H. pylori is a normal commensal organism

Sample question 2

A 48-year-old man was treated for H. pylori infection 6 weeks ago with clarithromycin-based triple therapy (omeprazole, clarithromycin, and amoxicillin for 14 days). A follow-up urea breath test performed 4 weeks after completing all medications remains positive. He has a documented penicillin allergy (anaphylaxis). Which of the following is the most appropriate salvage regimen?

1. PPI and amoxicillin dual high-dose therapy for 14 days
2. Repeat the same clarithromycin-based triple therapy for an additional 14 days
3. Discontinue treatment and monitor symptoms only since one treatment failure is acceptable
4. Bismuth quadruple therapy: PPI, bismuth subsalicylate, metronidazole, and tetracycline for 14 days

Create a free PulseMD account to answer these, see the explanations, and practice five minutes a day.

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