172.2 📚 國考版

172.2.0.1 必背 — 細菌學

• Spiral gram - rod, urease 超強, microaerophilic, 胃黏膜 mucus 層
• CagA + VacA virulence

172.2.0.2 必背 — Diseases

• Chronic gastritis (universal)
• PUD (DU 90%, GU 80%)
• Gastric adenocarcinoma (Class I carcinogen)
• MALT lymphoma (eradication cure early)
• ITP, IDA refractory

172.2.0.3 必背 — Dx

• UBT / Stool antigen preferred (active infection)
• Hold PPI 2 wk before
• Biopsy: CLO + histology + culture (AST)

172.2.0.4 必背 — Treatment 2024

• Bismuth quadruple × 14d (PPI + bismuth + tetra + metro) — preferred globally
• Concomitant quadruple alternative if clari R < 15%
• Vonoprazan-based new option (PCAB)
• Clari triple — 不再 preferred (R 高)
• Test of cure ≥ 4 wk

172.2.0.5 必背 — Indications to Test

• PUD, MALT, post-gastric CA resection
• Dyspepsia < 60 + no alarm: test-and-treat
• 1st-degree relative gastric CA

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