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1. Helicobacter pylori infection has to be treated only if the patient is having symptoms.

A. True B. False

2. The prevalence of H pylori in the United States (U.S.) is_____.

A. 5% to 15% B. 16% to 25% C. 30% to 40% D. 50% to 70%

3. Many prescribers will remember to test patients with long-term symptoms of gastritis for H pylori.

A. True B. False

4. Which of the following are complications of H pylori:

A. Gastritis B. Peptic ulcer disease C. Lymphoma D. All of the above

5. The primary goal of anti-H pylori therapy is

A. Reduced gastritis B. Eradication of H pylori C. Reduction in gastrointestinal bleed D. None of the above

6. Clarithromycin kills H pylori by

A. Disrupting cell wall formation B. Decreasing protein synthesis C. Increasing bacterial cell free radicals D. None of the above

7. Triple-drug therapy with amoxicillin, clarithromycin, and a proton pump inhibitor (PPI) is considered first-line therapy when________________.

A. Clarithromycin resistance is < 20% B. Patient has never taken metronidazole C. Patient has a penicillin allergy D. All of the above

8. The duration of PPI-based triple-drug therapy should be_______.

A. 7 days B. 10 days C. 14 days D. 21 days

9. Which of the following agents interacts with alcohol:

A. Metronidazole B. Clarithromycin C. Bismuth D. PPI

10. Choose the correct statement.

A. Clarithromycin resistance does not decrease the effectiveness of triple-drug therapy B. Clarithromycin resistance does decrease the effectiveness of triple-drug therapy C. Metronidazole resistance does not decrease the effectiveness of quadruple-drug therapy D. Amoxicillin resistance is caused by an efflux pump

11. Antimicrobial susceptibility should be done when the patient has ________________.

A. Evidence of gastrointestinal bleed B. Been previously exposed to amoxicillin C. Failed first- and second-line therapy D. All of the above

12. Which of the following agents is not used in sequential therapy:

A. Amoxicillin B. Clarithromycin C. Tetracycline D. Metronidazole

13. Levofloxacin is not recommended as first-line H pylori therapy because

A. High rate of tendinitis B. Risk of rapid development of resistance C. It has not be shown to be effective D. All of the above

14. Probiotics________.

A. Are effective monotherapy B. May increase the efficacy of triple- or quadruple-drug therapy C. May reduce side effects from combination therapy D. Both B and C

15. Which of the following triple-drug therapies should be used as first-line treatments when clarithromycin resistance is > 15% to 20%?

A. Lansoprazole, amoxicillin, clarithromycin B. Bismuth, tetracycline, metronidazole, and lansoprazole C. Lansoprazole, amoxicillin, levofloxacin D. None of the above

16. Pharmacist should__________.

A. Recommend that long-term PPI users get tested for H pylori B. Stress the importance of adherence C. Review side effects of H pylori therapy with patients D. All of the above

17. In a clinical trial examining adherence to H pylori therapy, the primary reason patients were nonadherent was which of the following:

A. Gastrointestinal (GI) upset B. Cost of therapy C. Patients had a hard time swallowing the tablets D. Patients changed their minds about taking the medications

18. Sequential therapy has been shown to be equally effective to clarithromycin-based triple-drug therapy in the U.S.

A. True B. False

19. In the U.S., _____ of H pylori isolates are resistant to clarithromycin.

A. 5% to 9% B. 10% to 20% C. 25% to 35% D. 40% to 50%