I HUMAN CASE STUDY NEWEST 2025 ACTUAL EXAM
QUESTIONS AND VERIFIED CORRECT ANSWERS
ALREADY RATED A+
Gastrointestinal Case History - Case 19
ANSWER-A 26-year-old business executive
complained of a dull pain (heartburn) behind
the sternum. The pain was postprandial
(occurred after meals) and disappeared within
a few minutes to an hour. It was often
associated with belching and often was worse
on lying down or on exertion after heavy meals.
Sometimes it radiated to the back, jaws,
shoulders, and down the inner aspects of the
arms, simulating angina pectoris. X-rays
revealed a small portion of the stomach above
the diaphragm, and an endoscopic biopsy
revealed mucosal inflammation. Esophageal
manometry (determining pressures at the
,lower esophageal sphincter, LES) revealed
decreased LES pressure. Esophageal pH
monitoring showed reflux of gastric contents
into the esophagus and provided direct
evidence of gastroesophageal reflux.
Recommended treatment for this individual is
avoidance of strong stimulants of gastric acid
secretion (e.g., coffee, alcohol) and avoidance
of certain drugs (e.g., anticholinergics), and
specific foods (fats, chocolates, whole milk, and
orange juice), and smoking, all of which reduce
LES competence. Elevation of the head of the
bed by about six inches is also recommended.
Suggested treatments also include the use of
cholinergic agonists (e.g., bethanechol) and the
use of histamine (H2) antagonists (cimetidine).
, What is the disorder of this 26-year-old
business executive?
ANSWER-a hiatal hernia, which is a structural
defect in which a weakened diaphragm allows a
portion of the stomach to pass through the
esophageal opening into the chest, where
pressure increases
What mechanisms normally prevent gastric
reflux into the esophagus when lying down or
bending over?
ANSWER-adequate lower esophageal pressure
at the lower esophageal sphincter
QUESTIONS AND VERIFIED CORRECT ANSWERS
ALREADY RATED A+
Gastrointestinal Case History - Case 19
ANSWER-A 26-year-old business executive
complained of a dull pain (heartburn) behind
the sternum. The pain was postprandial
(occurred after meals) and disappeared within
a few minutes to an hour. It was often
associated with belching and often was worse
on lying down or on exertion after heavy meals.
Sometimes it radiated to the back, jaws,
shoulders, and down the inner aspects of the
arms, simulating angina pectoris. X-rays
revealed a small portion of the stomach above
the diaphragm, and an endoscopic biopsy
revealed mucosal inflammation. Esophageal
manometry (determining pressures at the
,lower esophageal sphincter, LES) revealed
decreased LES pressure. Esophageal pH
monitoring showed reflux of gastric contents
into the esophagus and provided direct
evidence of gastroesophageal reflux.
Recommended treatment for this individual is
avoidance of strong stimulants of gastric acid
secretion (e.g., coffee, alcohol) and avoidance
of certain drugs (e.g., anticholinergics), and
specific foods (fats, chocolates, whole milk, and
orange juice), and smoking, all of which reduce
LES competence. Elevation of the head of the
bed by about six inches is also recommended.
Suggested treatments also include the use of
cholinergic agonists (e.g., bethanechol) and the
use of histamine (H2) antagonists (cimetidine).
, What is the disorder of this 26-year-old
business executive?
ANSWER-a hiatal hernia, which is a structural
defect in which a weakened diaphragm allows a
portion of the stomach to pass through the
esophageal opening into the chest, where
pressure increases
What mechanisms normally prevent gastric
reflux into the esophagus when lying down or
bending over?
ANSWER-adequate lower esophageal pressure
at the lower esophageal sphincter
