A 34-year-old female comes to the physician with nausea and abdominal pain. She indicates that the pain is epigastric and it improves with food intake. She also reports recent weight gain. A urease…

Question

Options

• Acatalase positivity
• Bgram negativity
• Cgram positivity
• Doxidase positivity
• Eurease positivity

• A
  10% (5)
• B
  4% (2)
• C
  80% (41)
• D
  4% (2)
• E
  2% (1)

Explanation

This patient most likely has a duodenal ulcer caused by infection with Helicobacter pylori. Duodenal ulcers present with epigastric pain which improves with eating hence patients tend to gain weight. Helicobacter pylori is a urease positive, catalase positive, oxidase positive, curved shaped gram-negative bacterium. The urease it possesses produces ammonia which creates an alkaline environment that promotes the survival of the bacteria in acidic mucosa. It may colonize the antrum of the stomach and cause gastric ulcers or colonize the first part of the duodenum causing duodenal ulcers. Infection with H. pylori increases the risk for gastric adenocarcinomas and MALT lymphomas. The diagnosis can be made with a positive urea breath test or fecal antigen test. Treatment regimens include triply therapy with amoxicillin, clarithromycin and omeprazole or alternatively quadruple therapy with bismuth subsalicylate, metronidazole, tetracycline and omeprazole.

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