CME questions: management of gastroesophageal reflux disease.1. Gastroesophageal reflux disease gastroesophageal reflux disease (GERD) Disorder characterized by frequent passage of gastric contents from the stomach back into the esophagus. Symptoms of GERD may include heartburn, coughing, frequent clearing of the throat, and difficulty in swallowing. has been associated with the following manifestations except: a. Globus b. Chest pain c. Asthma d. Supraventricular tachycardia e. Pneumonia 2. The most common pathophysiologic mechanism of mild gastroesophageal reflux disease is: a. Transient lower esophageal sphincter lower esophageal sphincter n. A ring of smooth muscle fibers at the junction of the esophagus and stomach. Also called cardiac sphincter. relaxation b. Hypotensive hypotensive /hy·po·ten·sive/ (-ten´siv) marked by low blood pressure or serving to reduce blood pressure. hy·po·ten·sive adj. 1. Of or characterized by low blood pressure. 2. lower esophageal sphincter c. Hiatal hernia d. Delayed gastric emptying 3. The following medications can decrease lower esophageal sphincter pressures except: a. [beta]-agonists b. Calcium-channel blockers c. Angiotensin-converting inhibitors d. Estrogens e. Theophylline theophylline /the·oph·yl·line/ (the-of´i-lin) a xanthine derivative found in tea leaves and prepared synthetically; its salts and derivatives act as smooth muscle relaxants, central nervous system and cardiac muscle stimulants, and 4. The most important risk factor for the development of esophageal adenocarcinoma is: a. Gastroesophageal reflux disease b. Obesity c. Alcohol d. Cigarette smoking e. Barrett esophagus 5. If a patient has Barrett's without dysplasia found at the time of an initial screening upper endoscopy and the diagnosis is confirmed at one year by a second upper endoscopy, the patient should undergo another screening upper endoscopy: a. In 3 months b. In one year c. In 3 to 5 years d. Does not need another upper endoscopy 6. An alarm symptom in a patient with gastroesophageal reflux disease that requires further evaluation with an upper endoscopy is: a. Weight loss b. Gastrointestinal bleeding c. Dysphagia d. Anemia e. All of the above 7. The most helpful test in a patient suspected of having atypical gastroesophageal reflux disease symptoms is: a. Barium swallow b. Upper endoscopy c. Ambulatory pH study d. Manometry manometry /ma·nom·e·try/ (-e-tre) the measurement of pressure by means of a manometer. anal manometry e. Abdominal CT scan 8. Lifestyle modifications that should be recommended to patients with gastroesophageal reflux disease include all of the following except: a. Avoid lying down for 2 to 3 hours after a meal b. Lower head of bed by 6 inches c. Stop smoking d. Reduce weight 9. Possible side effects of proton pump inhibitors Proton Pump Inhibitors Definition The proton pump inhibitors are a group of drugs that reduce the secretion of gastric (stomach) acid. They act by binding with the enzyme H+, K(+)-ATPase, hydrogen/potassium adenosine triphosphatase include all of the following except: a. Diarrhea b. Meningitis c. C difficile infection d. Headaches e. Pneumonia 10. Possible complications from laparoscopic Laparoscopic A minimally-invasive surgical or diagnostic procedure that uses a flexible endoscope (laparoscope) to view and operate on structures in the abdomen. Mentioned in: Obstetrical Emergencies antireflux fundoplication surgery include: a. Dysphagia b. Gas-bloat syndrome c. Flatulence d. Diarrhea e. All of the above Answers to CME CME See: Chicago Mercantile Exchange CME See Chicago Mercantile Exchange (CME). Questions 1. D, 2. A, 3. C, 4. E, 5. C, 6. E, 7. C, 8. B, 9. B, 10. E |
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