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1. Dyspepsia is chronic or recurrent pain/discomfort in the upper abdomen. Which of the following conditions is not associated with dyspepsia?

A. Asthma

B. Peptic ulcer disease

C. Chronic use of nonsteroidal anti-inflammatory agents

D. Gastroesophageal reflux disease

The correct answer is A. Asthma generally causes airway obstruction without prominent symptoms in the gastrointestinal tract. All of the other choices affect the stomach and the esophagus.

2. Which of the following choices is not true about peptic ulcer disease associated with infection by Helicobacter pylori?

A. Infection with H. pylori is the major cause of peptic ulcer disease.

B. The infection is more common in individuals living in higher socioeconomic conditions.

C. Not all patients with H. pylori infection develop ulcer disease.

D. Infected individuals have an increased risk for gastric adenocarcinoma.

The correct answer is B. Infection with H. pylori is most likely to occur in childhood, more common in low socioeconomic conditions, and its prevalence increases with age.

3. The laboratory tests for H. pylori infection can be divided into the tests that identify exposure to H. pylori and the tests that detect active infection by H. pylori. Which of the following tests indicates exposure without providing information about whether the infection is active?

A. Urea breath test

B. Serologic tests for IgG antibodies to H. pylori

C. Rapid urease test using biopsy material

D. Molecular tests for H. pylori

The correct answer is B. H. pylori is able to split urea, and, therefore, active infection with H. pylori can be detected by metabolism of urea. The urea breath test involves ingestion of a substance containing urea that is labeled with radioactive carbon. Urease splits the urea into ammonia and carbon dioxide, and the radioactivity in the breath correlates with urease activity. Choices A and C are based on urease activity. A molecular test for H. pylori also detects the presence of active H. pylori. Serologic tests can remain positive for years, even if the disease is treated, and therefore active infection is not required for a positive test result.

4. Which of the following is not a commonly used diagnostic test for celiac disease?

A. Tissue transglutaminase IgA antibodies

B. IgA antiendomysial antibodies


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