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Gastroesophageal Reflux Disease

Chapter 17. Gastroesophageal Reflux Disease

Student Questions

Which one of the following GERD symptom is considered atypical and requires further diagnostic evaluation?

A. Heartburn

B. Regurgitation

C. Wheezing

D. None of the above symptoms is considered atypical

Answer: C

Option A: Incorrect. Heartburn is a typical symptom.

Option B: Incorrect. Regurgitation is a typical symptom.

Option C: Correct. Wheezing is an atypical symptom and may be a contributing factor in certain patients with asthma.

Option D. Incorrect. Option C is the correct response.

Which of the following PPIs would offer dosing flexibility relative to meal timing?

A. Dexlansoprazole

B. Lansoprazole

C. Omeprazole

D. Pantoprazole

Answer: A

Option A: Correct. Dexlansoprazole can be taken without regard to meals.

Option B: Incorrect. Lansoprazole should be taken 30–60 minutes prior to a meal.

Option C: Incorrect. Omeprazole should be taken 30–60 minutes prior to a meal.

Option D: Incorrect. Pantoprazole should be taken 30–60 minutes prior to a meal.

On-demand therapy would be most appropriate in a patient with:

A. Atypical symptoms

B. Typical intermittent reflux symptoms

C. Barrett esophagus

D. Erosive esophagitis

Answer: B

Option A: Incorrect. Atypical symptoms require further evaluation.

Option B: Correct. Typical intermittent symptoms can be treated with 2–4 week courses of PPIs.

Option C: Incorrect. Barrett esophagus requires further evaluation and treatment.

Option D: Incorrect. Erosive esophagitis should be treated initially with 8 weeks of a twice-daily PPI.

Which one of the following medications may worsen GERD symptoms by decreasing lower esophageal sphincter pressure?

A. Nifedipine

B. Alendronate

C. Naproxen

D. Doxycycline

Answer: A

Option A: Correct. Dihydropyridine calcium channel blockers lower LES pressure.

Option B: Incorrect. Bisphosphonates are direct irritants to esophageal mucosa.

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