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Old 03-08-2012
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GIT Confirmatory test for dyspepsia!

50 y.o. female with increasing digestive discomfort. She gets heartburn following meals and has increased belching. minimal relief from over the counter antacid
which best confirms the diagnosis?

a. breath test
b. culture on specialized medium
c. direct fluorescent antibody
d. DNA probe
e. serology

ans: A
I know its hard to culture but isn't confirmatory (golden) test always culture??? even TB?
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Old 03-09-2012
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I think you could culture H. pylori from asymptomatic individuals as well - the breath test would indirectly measure the level of activity and confirm the diagnosis, hence the breath test (though commonly patients go straight to EGD with biopsy). Culture and sensitivity would theoretically be the gold standard for evaluating serotype and drug selection, though.
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Old 03-09-2012
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Quote:
Originally Posted by Mondoshawan View Post
I think you could culture H. pylori from asymptomatic individuals as well - the breath test would indirectly measure the level of activity and confirm the diagnosis, hence the breath test (though commonly patients go straight to EGD with biopsy). Culture and sensitivity would theoretically be the gold standard for evaluating serotype and drug selection, though.
in the video they tought us that if they are asking for confirmatory test, always go for culture (gold standard)...and they come up with question like this
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Old 03-09-2012
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Originally Posted by kenlee View Post
in the video they tought us that if they are asking for confirmatory test, always go for culture (gold standard)...and they come up with question like this
It's a good "90% rule", but sometimes that's not true - for example, with a pathogen that is part of the normal flora. One could culture c. diff from any stool sample.
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Old 03-09-2012
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Originally Posted by kenlee View Post
in the video they tought us that if they are asking for confirmatory test, always go for culture (gold standard)...and they come up with question like this
Yes, culture is gold standard and definite. But its more costly and invasive.

Breath test is the best initial test, when pts dont have 14Co2 then you go on ordering biopsy.

Just like rapid antigen test vs. throat culture for Strep.
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Originally Posted by patho2012 View Post
Yes, culture is gold standard and definite. But its more costly and invasive.

Breath test is the best initial test, when pts dont have 14Co2 then you go on ordering biopsy.

Just like rapid antigen test vs. throat culture for Strep.
I disagree..
u have to do endoscopy anyways to see if there is a lesion and at the same time u take multiple biopsies to see if there is cell atypia..
urea test is expensive alot of clinics dont really prefer anymore..except for confirming eradication...thats what i learnt in the clinics..and theoretically culture would most likely to confirm..
i think it was a bad question from them..
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Old 03-09-2012
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Default endoscopy is not a choice.

ok, I checked RR (p329). Even if you perform biopsy, you don't culture H pylori. silver stain/urease detection.

Last edited by patho2012; 03-09-2012 at 08:11 AM.
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