Gastroenterology: H pylori therapy: practice question

A General Medicine question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Medicine · Gastroenterology: H pylori therapy

Sample item

Which regimen is recommended as first-line therapy for H pylori in areas with high clarithromycin resistance such as India?

AAmoxicillin alone for 14 daysBClarithromycin triple therapy for 7 daysCBismuth-based quadruple therapy for 14 daysDOmeprazole alone

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Bismuth-based quadruple therapy for 14 days

Where clarithromycin resistance exceeds 15 percent, bismuth quadruple therapy of PPI, bismuth, tetracycline and metronidazole for 14 days is preferred. Standard triple therapy has declining eradication rates. Single agents cannot eradicate the organism.

Option by option

A. Amoxicillin alone for 14 days
Amoxicillin alone is ineffective.
B. Clarithromycin triple therapy for 7 days
Clarithromycin triple therapy fails often with resistance.
C. Bismuth-based quadruple therapy for 14 days (correct)
Correct. Bismuth quadruple therapy is advised in high-resistance areas.
D. Omeprazole alone
A PPI alone does not eradicate the bacterium.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is C, Bismuth-based quadruple therapy for 14 days. Where clarithromycin resistance exceeds 15 percent, bismuth quadruple therapy of PPI, bismuth, tetracycline and metronidazole for 14 days is preferred.

Why is "Amoxicillin alone for 14 days" not the answer?

Amoxicillin alone is ineffective.

Why is "Clarithromycin triple therapy for 7 days" not the answer?

Clarithromycin triple therapy fails often with resistance.

Why is "Omeprazole alone" not the answer?

A PPI alone does not eradicate the bacterium.

What concept does this question test?

It tests Gastroenterology: H pylori therapy in General Medicine. Standard triple therapy has declining eradication rates. Single agents cannot eradicate the organism.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Gastroenterology: H pylori therapy?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.