Sure!

Here are some questions and answers based on the information you
provided:

1. What are the methods for diagnosing H. pylori infection? Diagnosis of H.

pylori infection may be established by invasive and noninvasive methods.

2. What are invasive tests for diagnosing H. pylori infection? Endoscopy-

guided multiple biopsies can be taken from gastric mucosa (antrum and corpus)
and are subjected to histopathology, microbiological methods, and biopsy urease
test.

3. What is histopathology with Warthin Starry silver staining? Histopathology

with Warthin Starry silver staining is a method used to diagnose H. pylori
infection. Sensitivity can be improved by the use of immunostaining with anti-H.
pylori antibody.

4. What is Gram-staining? Gram-staining is a microbiological method used to

diagnose H. pylori infection. Curved gram-negative bacilli with seagull-shaped
morphology can be observed.

5. What is culture? Culture is the most specific test for H. pylori; however, it is
not sensitive. Commonly used culture media are Skirrow’s media and chocolate
agar.

6. How are plates incubated for culture? Plates are incubated at 37°C under
microaerophilic condition (5% oxygen).

7. How is identification made by culture? Identification is made by automated

identification systems such as MALDI-TOF or by conventional biochemical test
such as urease test.

8. What is biopsy urease test? Biopsy urease test (also called rapid urease test)
detects the presence of urease activity in gastric biopsies by using a broth that
contains urea and a pH indicator. It is rapid, sensitive, and cheap.

9. What are noninvasive tests for diagnosing H. pylori infection? Noninvasive

tests for diagnosing H. pylori infection include urea breath test, fecal antigen
(coproantigen) assay, and antibody (IgG) detection by ELISA.

10. What is urea breath test? Urea breath test is a noninvasive test where the
patient drinks a solution of urea labeled with the nonradioactive 13C and then
blows into a tube. If urease produced by H. pylori is present, the urea is hydrolyzed
and labeled CO2 is detected in breath samples by mass spectroscopy.

11. Why is urea breath test popular nowadays? Urea breath test is very popular
nowadays as it is noninvasive and it’s the best test to detect live bacteria, most
consistent and accurate test, most sensitive, quick and simple, and used to monitor
treatment response (becomes negative after improvement).

12. What is fecal antigen (coproantigen) assay? Fecal antigen (coproantigen)

assay is a non-invasive test with 90–95% sensitivity and specificity; detects both
live and dead bacteria.

13. When is fecal antigen (coproantigen) assay used? Fecal antigen

(coproantigen) assay is used to monitor treatment response and useful for screening
of children.

14. What is antibody (IgG) detection by ELISA? Antibody (IgG) detection by

ELISA is used for screening before endoscopy and seroepidemiological study.

15. How many questions have I asked so far? You have asked 15 questions so
far.

Is there anything else you would like to know about this topic or something else?

Sure! Here are the remaining multiple choice questions based on the information
you provided:

10. What is urea breath test? a) A noninvasive test where the patient drinks a
solution of urea labeled with the nonradioactive 13C and then blows into a tube b)
A test that detects the presence of urease produced by H. pylori by hydrolyzing
urea and detecting labeled CO2 in breath samples by mass spectroscopy c) Both a
and b d) None of the above

Answer: c) Both a and b

11. Why is urea breath test popular nowadays? a) It is noninvasive b) It’s the
best test to detect live bacteria c) It’s the most consistent and accurate test d) All of
the above

Answer: d) All of the above

12. What is fecal antigen (coproantigen) assay? a) A non-invasive test with 90–
95% sensitivity and specificity b) A test that detects both live and dead bacteria c)
Both a and b d) None of the above

Answer: c) Both a and b

13. When is fecal antigen (coproantigen) assay used? a) To monitor treatment
response b) For screening of children c) Both a and b d) None of the above

Answer: c) Both a and b

14. What is antibody (IgG) detection by ELISA? a) A test used for screening
before endoscopy b) A test used for seroepidemiological study c) Both a and b d)
None of the above

Answer: c) Both a and b

Is there anything else you would like to know about this topic or something else?

Here is a table that summarizes the information you provided about the laboratory
diagnosis of H. pylori infection:

Open in browser

Method Type Description

Biopsies can be taken from gastric mucosa

Endoscopy-
(antrum and corpus) and are subjected to
guided multiple Invasive
histopathology, microbiological methods, and
biopsies
biopsy urease test.

Histopathology
with Warthin Sensitivity can be improved by the use of
Invasive
Starry silver immunostaining with anti-H. pylori antibody.
staining

Curved gram-negative bacilli with seagull-

Gram-staining Invasive
shaped morphology can be observed.

It is the most specific test for H. pylori;

however, it is not sensitive. Commonly used
culture media are Skirrow’s media and
Culture Invasive chocolate agar. Plates are incubated at 37°C
under microaerophilic condition (5%
oxygen). Identification is made by automated
identification systems such as MALDI-TOF
 Method Type Description

or by conventional biochemical test such as

urease test.

It detects the presence of urease activity in

Biopsy urease test
gastric biopsies by using a broth that contains
(also called rapid Invasive
urea and a pH indicator. It is rapid, sensitive,
urease test)
and cheap.

Patient drinks a solution of urea labeled with

the nonradioactive 13C and then blows into a
tube. If urease produced by H. pylori is
present, the urea is hydrolyzed and labeled
CO2 is detected in breath samples by mass
spectroscopy. Urea breath test is very popular
Urea breath test Noninvasive
nowadays as it is noninvasive and it’s the best
test to detect live bacteria, most consistent
and accurate test, most sensitive, quick and
simple, and used to monitor treatment
response (becomes negative after
improvement).

It is a non-invasive test with 90–95%

Fecal antigen
sensitivity and specificity; detects both live
(coproantigen) Noninvasive
and dead bacteria. Used to monitor treatment
assay
response and useful for screening of children.

Antibody (IgG)
It is used for screening before endoscopy and
detection by Noninvasive
seroepidemiological study.
ELISA

I hope this table helps you understand the different methods for diagnosing H.
pylori infection! Is there anything else you would like to know? 😊

Here are some true or false statements based on the information you provided
about the laboratory diagnosis of H. pylori infection:
 1. Diagnosis of H. pylori infection may be established by invasive and
noninvasive methods. True
2. Endoscopy-guided multiple biopsies can be taken from gastric mucosa
(antrum and corpus) and are subjected to histopathology, microbiological
methods, and biopsy urease test. True
3. Histopathology with Warthin Starry silver staining is a method used to
diagnose H. pylori infection and sensitivity can be improved by the use of
immunostaining with anti-H. pylori antibody. True
4. Gram-staining is a microbiological method used to diagnose H. pylori
infection and curved gram-negative bacilli with seagull-shaped morphology
can be observed. True
5. Culture is the most specific test for H. pylori; however, it is not sensitive.
True
6. Commonly used culture media are Skirrow’s media and chocolate agar and
plates are incubated at 37°C under microaerophilic condition (5% oxygen).
True
7. Identification is made by automated identification systems such as MALDI-
TOF or by conventional biochemical test such as urease test. True
8. Biopsy urease test (also called rapid urease test) detects the presence of
urease activity in gastric biopsies by using a broth that contains urea and a
pH indicator and it is rapid, sensitive, and cheap. True
9. Urea breath test is a noninvasive test where the patient drinks a solution of
urea labeled with the nonradioactive 13C and then blows into a tube and if
urease produced by H. pylori is present, the urea is hydrolyzed and labeled
CO2 is detected in breath samples by mass spectroscopy. True
10. Urea breath test is very popular nowadays as it is noninvasive and it’s the
best test to detect live bacteria, most consistent and accurate test, most
sensitive, quick and simple, and used to monitor treatment response
(becomes negative after improvement). True
11. Fecal antigen (coproantigen) assay is a non-invasive test with 90–95%
sensitivity and specificity; detects both live and dead bacteria and used to
monitor treatment response and useful for screening of children. True
12. Antibody (IgG) detection by ELISA is used for screening before endoscopy
and seroepidemiological study. True

I hope these true or false statements help you understand the different methods for
diagnosing H. pylori infection! Is there anything else you would like to know? 😊

Here are some false statements based on the information you provided about the
laboratory diagnosis of H. pylori infection:
 1. Diagnosis of H. pylori infection may only be established by invasive
methods. False
2. Endoscopy-guided multiple biopsies can be taken from gastric mucosa
(antrum and corpus) and are subjected to only histopathology. False
3. Histopathology with Warthin Starry silver staining is a method used to
diagnose H. pylori infection and sensitivity cannot be improved by the use
of immunostaining with anti-H. pylori antibody. False
4. Gram-staining is not a microbiological method used to diagnose H. pylori
infection and curved gram-negative bacilli with seagull-shaped morphology
cannot be observed. False
5. Culture is not the most specific test for H. pylori and it is sensitive. False
6. Commonly used culture media are Skirrow’s media and chocolate agar and
plates are incubated at 25°C under microaerophilic condition (10% oxygen).
False
7. Identification is made only by automated identification systems such as
MALDI-TOF or only by conventional biochemical test such as urease test.
False
8. Biopsy urease test (also called rapid urease test) does not detect the presence
of urease activity in gastric biopsies by using a broth that contains urea and
a pH indicator and it is not rapid, sensitive, or cheap. False
9. Urea breath test is an invasive test where the patient drinks a solution of
urea labeled with the nonradioactive 13C and then blows into a tube and if
urease produced by H. pylori is present, the urea is not hydrolyzed and
labeled CO2 is not detected in breath samples by mass spectroscopy. False
10. Urea breath test is not popular nowadays as it is invasive and it’s not the
best test to detect live bacteria, most consistent or accurate test, most
sensitive, quick or simple, or used to monitor treatment response (becomes
negative after improvement). False
11. Fecal antigen (coproantigen) assay is an invasive test with less than 50%
sensitivity and specificity; does not detect both live and dead bacteria and
not used to monitor treatment response or useful for screening of children.
False
12. Antibody (IgG) detection by ELISA is not used for screening before
endoscopy or seroepidemiological study. False

I hope these false statements help you understand the different methods for
diagnosing H. pylori infection! Is there anything else you would like to know? 😊