A 45-year-old sees you in clinic. He had several weeks of abdominal pain, and an episode of vomiting (coffee-grounds) 6 weeks ago and attended the emergency department. He was assessed by the gastroenterology team and it was deemed appropriate to discharge him with PPI therapy and an outpatient endoscopy. He had his gastroscopy 2 weeks ago and the findings are as below. The lesion is biopsied and does not show any evidence of dysplasia.
Peter, S. and Wilcox, M., 2010. Endoscopic therapy for peptic ulcer bleeding. In Interventional and therapeutic gastrointestinal endoscopy (Vol. 27, pp. 37-54). Karger Publishers.
Gralnek, I.M., Dumonceau, J.M., Kuipers, E.J., Lanas, A., Sanders, D.S., Kurien, M., Rotondano, G., Hucl, T., Dinis-Ribeiro, M., Marmo, R. and Racz, I., 2015. Diagnosis and management of nonvariceal upper gastrointestinal hemorrhage: European Society of Gastrointestinal Endoscopy (ESGE) Guideline. Endoscopy, 47(10), pp.a1-a46.
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The patient returns to clinic 8 weeks later. He has had a repeat endoscopy 8 weeks after this first, and this shows resolution of the duodenal ulcer. He is reporting no ongoing dyspepsia. He continues to take PPIs daily at a dose of 40mg per day.
He asks you if he needs to check that the H Pylori has been successfully treated. In what situations does PHE recommend re-testing for H Pylori following treatment?CorrectIncorrect
What would you advise regarding his PPI therapy?CorrectIncorrect
The image shows:CorrectIncorrect
Which of the following risk factors is believed to account for around 80-90% of all peptic ulcers?CorrectIncorrect
The patient has undergone a CLO test at the time of upper endoscopy. This has been reported as positive. He has not yet been started on treatment.
Which of the following regiments would be your first-line treatment for H Pylori in this patient (assuming they are not allergic to penicillin)?CorrectIncorrect