Chapter 36

Question 1

Lifestyle changes are the first step in treatment of gastroesophageal reflux disease (GERD). Food or drink that may aggravate GERD include:

Answer 1

Caffeine

Question 1

Gastroesophageal reflux disease may be aggravated by the following medication that affects lower esophageal sphincter (LES) tone:

Answer 1

Estrogen

Question 2

Metoclopramide improves gastroesophageal reflux disease symptoms by:

Answer 2

Increasing lower esophageal tone

Question 3

Antacids treat gastroesophageal reflux disease by:

Answer 3

Increasing gastric pH

Question 4

When treating patients using the “Step-Down” approach the patient with gastroesophageal reflux disease is started _____ on first.

Answer 4

Proton pump inhibitors

Question 5

If a patient with symptoms of gastroesophageal reflux disease states that he has been self-treating at home with OTC ranitidine daily, the appropriate treatment would be:

Answer 5

Proton pump inhibitor (omeprazole) for 12 weeks

Question 6

If a patient with gastroesophageal reflux disease who is taking a proton pump inhibitor daily is not improving, the plan of care would be:

Answer 6

Proton pump inhibitor (omeprazole) twice a day for 4 to 8 weeks

Question 7

The next step in treatment when a patient has been on proton pump inhibitors twice daily for 12 weeks and not improving is:

Answer 7

Referral for endoscopy

Question 8

Infants with reflux are initially treated with:

Answer 8

Anti-reflux maneuvers (elevate head of bed)

Question 9

Long-term use of proton pump inhibitors may lead to:

Answer 9

Hip fractures in at-risk persons

Question 10

An acceptable first-line treatment for peptic ulcer disease with positive H. pylori test is:

Answer 10

Proton pump inhibitor bid plus clarithromycin plus amoxicillin for 14 days

Question 11

Treatment failure in patients with peptic ulcer disease associated with H. pylori may be because of:

Answer 11

Antimicrobial resistance

Question 12

If a patient with H. pylori-positive peptic ulcer disease fails first-line therapy, the second-line treatment is:

Answer 12

Proton pump inhibitor bid plus metronidazole plus tetracycline plus bismuth subsalicylate for 14 days

Question 13

After H. pylori treatment is completed, the next step in peptic ulcer disease therapy is:

Answer 13

A proton pump inhibitor for 8 to 12 weeks until healing is complete