Question 209

Question:

A 46-year-old man has a 4-week history of epigastric pain; test of stool is positive for occult blood. Examination of tissue obtained on biopsy of the gastric antrum shows curved bacterial rods. Which of the following additional findings is most likely?

Correct Answer: E.  Increased urease activity in the antrum

Given this patient’s presentation and the finding of curved bacterial rods, the patient is most likely infected with Helicobacter pylori. H. pylori is a major cause of peptic ulcer disease as well as gastritis, both which can cause epigastric pain with a positive fecal occult blood test. H. pylori tests positive for oxidase, catalase, and urease. Therefore, there would most likely be increased urease activity in the antrum (choice E) of this patient.
Achlorhydria (choice A) and antiparietal cell antibodies (choice B) both describe changes seen in pernicious anemia.
Infection with H. pylori would most likely not cause cholecystitis (choice C) or an immunodeficient state (choice D).