Q 23 -- GERD

Prep for USMLE Forum

» Log in | Register

Forum

Step 1

Match

Prep4USMLE Forum » USMLE STEP 3 Forum » USMLE Step 3 CCS Forum

Q 23 -- GERD

Author

7 Posts

dochope
Forum Junior

Topics: 26
Posts: 37

04/27/05 - 01:08 PM

A 42y Caucasion man comes to see you in the office with symptoms of dyspepsia and heartburn for the last two years. His symtoms are progressively getting worse. He has tried lifestyle changes, over the counter antacids, and ranitidine earlier, but these have not significantly relieved his symptoms. He denies any history of dysphagia, odynophagia, weight loss, or GI bleeding. He has no other medical problems. His PE is unremarkble. WOF is most appropriate next step?

a. start him on a trial of a proton pump inhibitor
b. obtain esophgeal manometry
c. schedule him for an ambulatory pH monitoring
d. reger to a gastroenterologiest
e. refer to a surgeon for antireflux surgery

faith
Forum Newbie

Topics: 4
Posts: 25

04/27/05 - 07:32 PM

:roll:

dochope
Forum Junior

Topics: 26
Posts: 37

04/28/05 - 06:50 AM

I think so too because the patient needs esophageal endoscopy at this point. But the answer is A.
How do you think? Thanks.

hadavidi
Forum Newbie

Topics: 0
Posts: 1

07/05/05 - 12:44 PM

My .02 cents:

Just going by the case Hx, it appears initially to be a case of heart burn and so was started with life style changes, then on antacid therapy, which apparently didn't provide relief. Going further, PPI are the standard of case for reflux. If the patient doesn't respond to this, or continues to have similar complaints on and off, then you may want to investigate for epithelial changes via endoscopy. I couldn't see what the previous post suggested was the answer. My browser was displaying it as :roll:. Am not sure what that meant. Let me know if this is the correct line of thinking or am I way off base here.

wrote:
I think so too because the patient needs esophageal endoscopy at this point. But the answer is A.
How do you think? Thanks.

sumie
Forum Elite

Topics: 33
Posts: 178

12/06/05 - 10:53 AM

i agree with you

___________________
sumie

bill
Forum Newbie

Topics: 8
Posts: 14

12/06/05 - 01:33 PM

Is there a role for endoscopy in the diagnosis of GERD?

___________________
Sexually transmitted and 100% fatal... life.

bill
Forum Newbie

Topics: 8
Posts: 14

12/06/05 - 01:35 PM

Is the diagnosis of GERD uncertain here in this case?

___________________
Sexually transmitted and 100% fatal... life.

You don't have permission to post.