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NBME 15 Answers

nbme15/Block 2/Question#6 (14.2 difficulty score)
A 56-year-old woman comes to the physician ...
Helicobacter pyloriπŸ”

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submitted by ergogenic22(321),
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assm in teh ehaospsug hwit osqliidu/dli iay Ia.sgpdmh' ton rseu hawt eht sihto sswho but no teh mottob trehe rea omre ftla slcle adn hte otp tehre rea dweir spsace hntiwi teh sclle thiw meso ,atf os I ihtkn ti ebaym a naeiglh ruecl nigaedl to a rcsttru.ei

aanysw ohetr oaptnhesg era emor tseaosdaic twhi tehor iontefcnis

A) etolanssgl and inBlaoic)orcmhcaogan ia)pisogesth c rivel aes sb)csE i ikhtn yriiaml BT nca rteesnp in hte rilev

submitted by nnasser33(8),

My understanding is that H. pylori actually decreases the risk for esophageal disorders (ex. adenocarcinoma)

How would a chronic H. pylori infection lead to healing ulcer/ stricture formation or adenocarcinoma?

bhavika98  Hey , Basiclly since H.pylori leads to excess acidity in the stomach. over time if irritation persists , intestinal metaplasia can occur to neutralize the acidity and eventually convert to an adenocarcinoma. Hope this helps !! +  

submitted by prosopagnosia(5),

GERD --> acid damages mucosa --> knockout of the mucosa leading to decreased stem cells --> ulcers form and heal via fibrosis --> stricture --> dysphagia. Complication of this chronically would be Barrett Esophagus? (I can't tell if those are cells filled with fat or goblet cells that replaced the squamous epithelium). Barrett Esophagus can progress to Adenocarcinoma of the esophagus. Source: Pathoma pg 102

submitted by ergogenic22(321),
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ssam ni the ssaeupgoh htiw sui/ldodiiql yidpg.'asIma h tno eurs wtha eht stiho hwsos btu on het botmot etreh rea ermo ftla lsecl dan teh pto treeh rae rwedi peassc iinwth eht clels hiwt smoe a,tf os I htnki it ybame a lnahieg ucerl dagieln to a tse.ctrriu

naasyw toehr osgaptehn era rmoe osidtsaaec whit eotrh fnteiconis

)A lslatosgne nad lnic cBiomharagoa)con oitc asipsh)eg eilrv se)ss baEc i tkhin yalmrii BT acn tensepr ni hte lveri