GERD

Question 1

It is a retrosternal BURNING discomfort

Answer 1

heartburn

Question 2

What is the primary barrier from reflux?

Answer 2

LES

Question 3

What are the 3 mechanism of EGJ incompetence?

Answer 3

1) Transient LES relaxation= gastric distension>vasovagal reflex>LES relaxation.
2) LES hypotension
3) anatomic distortion.

Question 4

It is the feeling of “having a lump on the throat”

Answer 4

Globus sensation

Question 5

What are the causes of prolonged acid clearance?

Answer 5

1) impaired peristalsis

2) reduced salivation

Question 6

What is the gold standard exam in the diagnosis of GERD?

Answer 6

24hr pH monitoring

Question 7

TRUE or FALSE: emperical management with acid inhibitors is the dominant clinical strategy in the treatment of GERD

Answer 7

TRUE. with exception of patients suffering of chest pain or chronic dysphagia.

Question 8

Persistent dysphagia should be careful assessed because chronic reflux can lead to the development of?

Answer 8

peptic strictures or adenocarcinoma.

Question 9

What management is more effective in the treatment in relieving heartburns in patients with GERD?

Answer 9

h2 receptor antagonist.

Question 10

Indication/s of endoscopy use is/are:

Answer 10

1) patients with alarm signs/symptoms
2) patients who failed a medication trial
3) patients who require long term treatment

Question 11

What is Gold standard treatment for patients presenting high-grade dysplasia?

Answer 11

Esophagectomy

Question 12

What is the most severe histologic consequence of GERD?

Answer 12

Barret’s metaplasia

Question 13

Surgical management of chronic GERD?

Answer 13

Nissen fundoplication

Question 14

Give 3 alarm symptoms:

Answer 14

dysphagia, early satiety, GI bleeding, odynophagia, vomiting, weight loss, IDA

Question 15

it is the over production of saliva as a response from regurgitation of acd in the esophagus

Answer 15

Water brash