plz can any one explain - marwa

[ArchivalUser]

how to dignose pu?how to detect H pylorai? what is the urease test
thanks in advance

[ArchivalUser]

AT ANY CASE ENDOSCOPIC BIOPSY IS THE MOST ACCURATE TEST (MOST SENSITIVE AND MOST SPECIFIC).IT LL DETECT THE PRESENCE OF GASTRIC CANCER TOO.
SECOND THING IS TO SEE WETHER PATIENT HAS H PYLORI OR NOT.
THAT U CAN DO BY THE MEANS OF BREATH UREA TEST OR H PYLORI SEROLOGY(STOOL ANTIGEN TEST)
serology is highly sensitive but not specific.(doesnt differentiate old/new disease)
same with urea breath test.
but most important use of above test is they both become negetive afte treatment so they ll be good to do for assessment of treatment.
BOTTOM LINE:non invasive test are sensitive but not specific and invasive test diagnose everything.
so high risk patient would go for endoscopy and low risk should give trial of PPI initially.

[ArchivalUser]

Is it difficult to find in the book (Kaplan note)?

[ArchivalUser]

thank panther 4780..but do you know how do we do urea breath test..? another thing if some one has the symtoms for pu we foun h pylori test(serology) negative is this exclude pu? or should we go to endoscopy?

[ArchivalUser]

Patients swallow urea labelled with an uncommon isotope, either radioactive carbon-14 or non-radioactive carbon-13. In the subsequent 10-30 minutes, the detection of isotope-labelled carbon dioxide in exhaled breath indicates that the urea was split; this indicates that urease (the enzyme that H. pylori uses to metabolize urea) is present in the stomach, and hence that H. pylori bacteria are present.

as i have said before negetive serology wont rule out h.pylori as its not tht much specific but definate diagnosis most acurately predicted by endoscopic biopsy.

[ArchivalUser]

thanks alot panther 4780