Aashi
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A 44-year-old man undergoes an upper endoscopy for chronic heartburn. He has had no nausea, vomiting, dysphagia, fever, chills, or weight loss. The heartburn occurs three to four times per week. He has a long history of tobacco but no alcohol use. An upper endoscopy shows erosive esophagitis and 4 cm of Barrett's-appearing mucosa. Biopsies are taken. Which of the following statements concerning this patient is false?
(A) H2 blockers at standard doses are minimally effective in treating GERD
(B) The risk of developing esophageal cancer is related to the histology on biopsy
(C) The risk of developing esophageal cancer is approximately 0.5% per year
(D) There is clear evidence that an endoscopy every year for surveillance will decrease morbidity and mortality
(E) A proton-pump inhibitor daily should be prescribed
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| nadiabarati
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D
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| ling
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d
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| robin082006
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D
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| Mahwish Mushtaq
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D
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| dr_jojo
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why all agree for D
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| dr_jojo
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doctor AASHI , EXPLAIN please
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| Aashi
Forum Moderator
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Answer:
(D) There is clear evidence that an endoscopy every year for surveillance will decrease morbidity and mortality
Explanation:
Barrett's esophagus is defined by the metaplastic change of the squamous esophageal mucosa to columnar mucosa. The risk of developing cancer is dependent upon the length of the mucosa, the age of the patient, and the histology. The finding of intestinal metaplasia and/or dysplasia increases the risk of developing cancer. However, the risk of the average patient with Barrett's esophagus is approximately 0.5% per year. Patients without dysplasia (the typical patient) should be treated with a proton-pump inhibitor. A repeat, surveillance endoscopy at 1- to 3-year intervals should be performed; however, there are no data to demonstrate a decrease in morbidity or mortality by such a practice.
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"Obstacles are those frightful things you see when you take your EYES off your goal."
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| dr_jojo
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good Q
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