Gastroenterology: Helicobacter pylori eradication testing: 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: Helicobacter pylori eradication testing

Sample item

A 45-year-old man with an H. pylori-associated duodenal ulcer has just completed 14 days of bismuth-based quadruple therapy and is still taking omeprazole. His physician wants to confirm that the organism has been eradicated. Which approach is correct?

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

The answer and the reasoning

C. Urea breath test at least 4 weeks after antibiotics and 2 weeks after stopping the proton pump inhibitor

Eradication is confirmed with a non-invasive test of active infection, either the urea breath test or the stool antigen test. Both give false-negative results if done too soon after antibiotics (less than 4 weeks) or while on a proton pump inhibitor (stop 2 weeks before), because bacterial load is suppressed.

Option by option

  • A. Rapid urease test on a repeat biopsy one week after finishing antibiotics

    Testing one week after antibiotics is too early and a repeat endoscopy is an unnecessary invasive step.

  • B. Serum H. pylori IgG antibody measured 4 weeks after treatment

    IgG antibody stays positive for months to years after cure, so serology cannot confirm eradication.

  • C. Urea breath test at least 4 weeks after antibiotics and 2 weeks after stopping the proton pump inhibitor (correct)

    Correct. The delay after antibiotics and the PPI-free interval avoid suppression-related false negatives.

  • D. Urea breath test tomorrow while he continues the proton pump inhibitor

    Continuing the PPI lowers bacterial urease activity and gives a falsely negative breath test.

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.

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Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is C, Urea breath test at least 4 weeks after antibiotics and 2 weeks after stopping the proton pump inhibitor. Eradication is confirmed with a non-invasive test of active infection, either the urea breath test or the stool antigen test.

Why is "Rapid urease test on a repeat biopsy one week after finishing antibio…" not the answer?

Testing one week after antibiotics is too early and a repeat endoscopy is an unnecessary invasive step.

Why is "Serum H. pylori IgG antibody measured 4 weeks after treatment" not the answer?

IgG antibody stays positive for months to years after cure, so serology cannot confirm eradication.

Why is "Urea breath test tomorrow while he continues the proton pump inhibitor" not the answer?

Continuing the PPI lowers bacterial urease activity and gives a falsely negative breath test.

What concept does this question test?

It tests Gastroenterology: Helicobacter pylori eradication testing in General Medicine. Both give false-negative results if done too soon after antibiotics (less than 4 weeks) or while on a proton pump inhibitor (stop 2 weeks before), because bacterial load is suppressed.

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: Helicobacter pylori eradication testing?

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.