The Correct Answer is B!

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A 78 year-old African American man presents in the doctor's office 8 weeks after being discharged from the hospital following an upper GI bleed from a duodenal ulcer. He is now totally asymptomatic. He completed a 2 week course of amoxicillin and clarithromycin. He was on omeprazole 20 mg a day (stopped one week earlier).

Lab Results:
CBC- Hemoglobin: 14.2 [13.5-17.5 g/dL]
Hematocrit: 42 [38.8-50.0%]
MCV: 89 [81.2-95.1 fL]
Leukocytes: 5 [3.5-10.5 x10⁹/L]
Platelet Count: 170 [150-450 x10⁹/L]


Which of the following is the most appropriate next step in patient care?

  1. No further testing is needed
  2. Perform a fecal H. pyloriantigen
  3. Repeat upper endoscopy with gastric biopsies
  4. H. pylori serology

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