daira
Forum Senior
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Male, 38 yr old, comes with a complaint of indigestion and heart burn. His symptoms of heart burn and indigestion increases after eating. Pt. says that he is having symptoms for last one year. No wt loss, no dysphagia. PE is normal. What is the most appropriate next step:
a. upper barium
b. upper GI endoscopy
c. pH testing
d. serology for H Pylori
e. Prescribe omeprazole
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| lucky
Forum Guru
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i think c
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| son64
Forum Elite
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Is that E?
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| mdwannabe
Forum Guru
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C...
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| jil
Forum Elite
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E???
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| son64
Forum Elite
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ph testing is reserved for patients who present with symptoms of GERD but the Dx cant be made on clinical grounds owing to lack of classic presentation.
In patients presenting with clear cut features of GERD(like this patient) the Dx is made clinically and confirmed by responce to therapy.
so I think it is E
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| dimps
Forum Guru
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i think answer is B
there is 1 year history of GERD ,it may have damage lower esophagus
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| daira
Forum Senior
Topics: 29
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The answer is D. Serology for H.Pylori.
As GERD is a clinical dx and there is no test needed before starting therapy, there are few recommendations for management:
1. In pts above 50, go for EGD.
2. In pts below 50, no need for EGD, but do serology for H. Pylori. Treat if present.
3. Treat with H2-antagonists before starting PPI.
___________________
Roz barhta hoon jahan se aagey
lout kar phir waheen aa jata hoon
baaraha tor chuka hoon jinko
phir unhin dewaroon se takrata hoon...
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| jil
Forum Elite
Topics: 46
Posts: 185
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hi daira,
where did u get these recomendations??
dont rem reading them in kaplan??
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| asmi
Forum Hero
Topics: 1043
Posts: 4,609
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Hi diara,
I cam across same q in q bank..it said omez is the answer. :roll:
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| son64
Forum Elite
Topics: 34
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What was the explanation Asmi?
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| asmi
Forum Hero
Topics: 1043
Posts: 4,609
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it was that pt has long standing GERD with heartburn,indigestion ,no H/o wt loss or dysphagia . :roll:
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