GERD practice questions Flashcards
Which of the following best describes the distinction between GER and GERD?
A) GER is always symptomatic, while GERD is not.
B) GER involves pathologic reflux, while GERD is considered physiologic.
C) GER can be identified by normal regurgitation in infants, whereas GERD presents with troublesome symptoms or complications.
D) GER involves inflammation of the esophagus, whereas GERD does not.
Answer: C) GER can be identified by normal regurgitation in infants, whereas GERD presents with troublesome symptoms or complications.**
Which of the following is a common lifestyle modification recommended for managing GERD in children?
A. Avoid tobacco and alcohol, and ensure meals are consumed shortly before bedtime.
B) Encourage larger and infrequent meals and increase dairy intake.
C) Elevate the head of the bed and avoid eating within two hours of bedtime.
D) Encourage carbonated drink consumption to ease symptoms.
Answer: C) Elevate the head of the bed and avoid eating within two hours of bedtime.**
In infants, which non-pharmacological intervention is appropriate for addressing gastroesophageal reflux (GER)?**
A) Placing infants in a prone position to decrease symptoms.
B) Thickening feeds with 1 teaspoon of cereal per ounce of formula.
C) Immediately placing the child in a car seat after feedings.
D) Encouraging nocturnal feedings to ensure weight gain.
*Answer: B) Thickening feeds with 1 teaspoon of cereal per ounce of formula.**
If pharmacological management is required for GERD in a 1-month-old infant after lifestyle modifications, which medication is considered first-line?**
A) Omeprazole (Prilosec)
B) Ranitidine (Zantac)
C) Lansoprazole (Prevacid)
D) Metoclopramide (Reglan)
*Answer: B) Ranitidine (Zantac)**
Which of the following diagnostic tests is used primarily to rule out anatomic abnormalities in infants with GERD-like symptoms?**
A) Upper GI series
B) Esophageal pH monitoring
C) Abdominal ultrasound
D) MRI of the abdomen
Answer: A) Upper GI series*
What is a principal goal of treatment for infants and children with GERD?**
A) Reduce caloric intake to promote weight loss.
B) Prolong periods between feedings to allow digestive settling.
C) Prevent respiratory and other potential complications.
D) Delay motor development for overall health improvement.
Answer: C) Prevent respiratory and other potential complications.**
Which of the following are common clinical manifestations of GERD in children?**
A) Regurgitation, epigastric pain, and persistent cough
B) Weight gain, increased appetite, and hematuria
C) Shortness of breath, chest pain, and hyperactivity
D) Diarrhea, constipation, and fever
Answer: A) Regurgitation, epigastric pain, and persistent cough**
A 2-month-old infant is brought to the clinic by her parents due to frequent spitting up after feedings. The infant is otherwise playful, gaining weight appropriately, and does not appear distressed during or after episodes of regurgitation.
Questions:
- What is the most likely diagnosis for this infant?A) GERDB) Pyloric stenosisC) GERD) Milk protein allergy
Answer:** C) GER
What non-pharmacological management would you recommend for this infant?**
A) Start a proton pump inhibitor.
B) Increase the volume of feedings to reduce frequency.
C) Thicken feeds with cereal and hold upright after feedings.
D) Place in a prone position after feeding.
Answer:** C) Thicken feeds with cereal and hold upright after feedings.
Under what circumstances should follow-up be advised for this infant?**
A) If regurgitation decreases in frequency.
B) If the infant begins to demonstrate poor weight gain or prolonged fussiness.
C) Regardless of symptom status, follow-up is unnecessary.
D) Only if there are signs of dehydration.
Answer:** B) If the infant begins to demonstrate poor weight gain or prolonged fussiness.
A 6-year-old child presents to the clinic with a history of frequent abdominal pain that worsens after meals, occasional nausea, and a sensation of food “sticking” in the throat. The child’s parents report a decrease in activity level related to discomfort, but weight gain remains stable.
Questions:
- Based on the symptoms described, what condition is most consistent with this clinical picture?A) Celiac diseaseB) AppendicitisC) GERDD) Lactose intolerance
Answer:** C) GERD
Which dietary modifications should you recommend to help alleviate this child’s symptoms?**
A) Encourage consumption of peppermint and avoid dairy products.
B) Avoid caffeine, chocolate, and large meals; do not eat within 2 hours of bedtime.
C) Encourage frequent, large meals containing citrus fruits.
D) Increase intake of carbonated beverages and avoid leafy greens.
Answer:** B) Avoid caffeine, chocolate, and large meals; do not eat within 2 hours of bedtime.
If the child does not demonstrate improvement with dietary modifications alone, what is the next step in management?**
A) Start antibiotic therapy.
B) Initiate H2 blocker therapy, such as famotidine.
C) Recommend surgical intervention.
D) Prescribe opioid analgesics for pain control.
Answer:** B) Initiate H2 blocker therapy, such as famotidine.
A 9-month-old infant who is premature is observed experiencing frequent vomiting, and the parents report decreased feeding enthusiasm with refusal of solid foods. Chronic cough and wheezing are also present.
Questions:
- What is a potential diagnosis for this infant given the symptoms?A) AsthmaB) GERDC) Foreign body aspirationD) Gastroenteritis
Answer:** B) GERD
What diagnostic test might be considered in this case to rule out anatomic abnormalities, despite a lack of definitive tests for GERD?**
A) MRI of the abdomen
B) Upper GI series
C) Esophageal pH monitoring
D) Nasopharyngoscopy
Answer:** B) Upper GI series
