update
A 35-year-old woman complains of a 6-month his-
tory of periodic "heartburn" primarily after eating
tomato-based sauces. Her weight is unchanged
and examination reveals a single altered finding of
epigastric tenderness without rebound. As first-line
therapy, you advise:
A. avoiding trigger foods.
B. the use of a prokinetic agent.
C. addition of sucralfate with meals.
D. increased fluid intake with food intake.
A. avoiding trigger foods.
Initial therapy for patients with GERD includes identifying trigger foods and reducing
their intake. Most commonly mentioned food
includes alcohol, tomato-based products, chocolate, peppermint, colas, citrus juices,
and food high in fat content.
A 38-year-old nonsmoking man presents with signs
and symptoms consistent of GERD. He has self-treated
with over-the-counter antacids and acid suppression
therapy with effect. His weight is stable, and he denies
nausea, vomiting, diarrhea, or melena. Which of the
following represents the most appropriate diagnostic
plan for this patient?
A. fecal testing for H. pylori antigen
B. upper GI endoscopy
C. barium swallow
D. no specific diagnostic testing is needed
D. no specific diagnostic testing is needed
In caring for a patient with symptomatic gastroesophageal reflux, you prescribe a
PPI to:
A. enhance motility.
B. increase the pH of the stomach.
C. reduce lower esophageal pressure.
D. help limit H. pylori growth.
B. increase the pH of the stomach.
Why is use of Omeprazole or Esomeprzole contraindicated in patients taking
Clopigogrel?
It can decrease the effect of Clopidogrel
Which patients should maintenance PPI therapy be given in? (Select all that
apply)
A. All patients with GERD
B. Patients who continue to have symptoms after an 8 week PPI therapy