Chapter 17. Gastroesophageal Reflux Disease
Which one of the following GERD symptom is considered atypical and requires further diagnostic evaluation?
D. None of the above symptoms is considered atypical
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?
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:
B. Typical intermittent reflux symptoms
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?
Option A: Correct. Dihydropyridine calcium channel blockers lower LES pressure.
Option B: Incorrect. Bisphosphonates are direct irritants to esophageal mucosa.
Option C: Incorrect. NSAIDs are direct ...