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urea breath test

Practice targeted AMC-style multiple-choice questions on urea breath test.

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A 45-year-old woman presents to her general practitioner with a 3-month history of epigastric pain that is worse at night and occasionally wakes her from sleep. She describes the pain as a burning sensation that improves with food intake but returns a few hours later. She denies any weight loss, vomiting, or changes in bowel habits. She has a history of intermittent use of ibuprofen for chronic back pain. On examination, she appears well-nourished, with normal vital signs and mild epigastric tenderness on palpation. A urea breath test is positive. What is the most appropriate initial management for this patient?

A. Prescribe an H2 receptor antagonist and advise dietary modifications
B. Recommend discontinuation of ibuprofen and start antacids
C. Advise lifestyle modifications and monitor symptoms
D. Refer for an upper gastrointestinal endoscopy
E. Initiate a proton pump inhibitor and test for Helicobacter pylori eradication
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A 45-year-old woman presents to her general practitioner with a 3-month history of epigastric pain that is worse at night and occasionally wakes her from sleep. She describes the pain as a burning sensation that improves with food intake but worsens a few hours after eating. She denies any weight loss, vomiting, or changes in bowel habits. She has a history of intermittent use of ibuprofen for chronic back pain. On examination, she appears well-nourished, with normal vital signs and mild epigastric tenderness on palpation. A urea breath test is positive. What is the most appropriate initial management for this patient?

A. Start a proton pump inhibitor and schedule a follow-up in 4 weeks
B. Initiate a proton pump inhibitor and eradicate Helicobacter pylori with a combination antibiotic therapy
C. Prescribe a histamine-2 receptor antagonist and advise discontinuation of ibuprofen
D. Refer for an upper gastrointestinal endoscopy to confirm the diagnosis
E. Recommend dietary modifications and prescribe antacids as needed
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