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1. Which of the following tests can you
access easily? (Multiple) 1. Routine upper GI endoscopy 2. Narrow band imaging endoscopy 3. Esophageal pH monitoring 4. Esophageal impedance monitoring 5. Esophageal manometry 2. The symptoms of GERD include (Multiple): 1. Heartburn 2. Upper abdominal pain 3. Chest pain 4. Upper abdominal burning 5. Cough 6. Regurgitation 7. Difficulty swallowing 8. Wheezing 9. Sleep disturbance 10. Nausea 11. Ear ache 12. Hoarse voice 13. Pain on swallowing 3. A 46-year old man who presents with heartburn should be considered to have GERD if he says that his symptoms are: (Select one only) 1. Mild, occurring one or more days per week 2. Mild, occurring two or more days per week 3. Moderate to severe, occurring one or more days per week 4. Moderate to severe, occurring two or more days per week 5. Troublesome 4. Heartburn and regurgitation are the characteristic symptoms of the typical reflux syndrome (Select one only): 1. Agree strongly 2. Agree with reservation 3. Neither agree nor disagree 4. Disagree with reservation 5. Disagree strongly 5. The diagnosis of GERD in a 38-year old woman who presents with heartburn (4-5 times per week) and associated night time waking (1-2 times per week) requires (Select one only): 1. Upper GI endoscopy 2. Upper GI endoscopy with esophageal biopsy 3. Upper GI series (barium study) 4. Esophageal pH monitoring 5. An 8-week course of acid suppression therapy with an H2-RA 6. A 4-week to 8-week course of acid suppression therapy with a PPI 7. No formal testing 6. Heartburn and regurgitation are diagnostic of GERD (Select one only): 1. Agree strongly 2. Agree with reservation 3. Neither agree nor disagree 4. Disagree with reservation 5. Disagree strongly 7. Esophageal complications of gastroesophageal reflux disease are reflux esophagitis, hemorrhage, stricture, Barrett’s esophagus and adenocarcinoma. (Select one only): 1. Agree strongly 2. Agree with reservation 3. Neither agree nor disagree 4. Disagree with reservation 5. Disagree strongly 8. The frequency and intensity of heartburn predict accurately, the severity of esophageal complications of GERD (Select one only): 1. Agree strongly 2. Agree with reservation 3. Neither agree nor disagree 4. Disagree with reservation 5. Disagree strongly 9. Sleep disturbance occurs in more than 20% of patients with GERD (Select one only): 1. Agree strongly 2. Agree with reservation 3. Neither agree nor disagree 4. Disagree with reservation 5. Disagree strongly 10. For patients with chest pain, symptom characteristics can be used to differentiate accurately between patients with cardiac pain and those with non-cardiac chest pain due to GERD or esophageal dysmotility (Select one only): 1. Agree strongly 2. Agree with reservation 3. Neither agree nor disagree 4. Disagree with reservation 5. Disagree strongly 11. The most common cause of non-cardiac chest pain is an esophageal motor disorder (Select one only): 1. Agree strongly 2. Agree with reservation 3. Neither agree nor disagree 4. Disagree with reservation 5. Disagree strongly 12. Dysphagia is diagnostic of serious esophageal pathology such as stricture or malignancy (Select one only): 1. Agree strongly 2. Agree with reservation 3. Neither agree nor disagree 4. Disagree with reservation 5. Disagree strongly 13. A 54-year old man with chronic heartburn, 1-2 times per week, for 20 years is found, at endoscopy, to have an irregular squamocolumnar junction, located 1-2 cm proximal to the gastroesophageal junction and the hiatus. Should the endoscopic report indicate (Select one only): 1. He has a small hiatus hernia 2. He does not have Barrett’s esophagus 3. He has short-segment Barrett’s esophagus 4. He has endoscopically-suspected esophageal metaplasia 5. He has endoscopy negative reflux disease 14. A 52-year old lady presents with a chronic cough and a diagnosis of chronic laryngitis from her ENT specialist; she has no heartburn or regurgitation. Her ENT specialist asks for advice regarding the management of her reflux laryngopharyngitis. Would you (Multiple): 1. Arrange for an upper GI endoscopy to confirm GERD 2. Arrange for a 24-hour esophageal pH recording, off all therapy 3. Treat her for 4 weeks with a once-daily PPI 4. Treat her for 12 weeks with a twice-daily PPI 5. Refer her for antireflux surgery 6. Advise her and her specialist that she does not have reflux-related respiratory symptoms 15. Gastroesophageal reflux (GER) is a common cause of sinusitis, pulmonary fibrosis, pharyngitis and recurrent otitis media (Select one only): 1. Agree strongly 2. Agree with reservation 3. Neither agree nor disagree 4. Disagree with reservation 5. Disagree strongly 16. GER is clearly associated with the pathogenesis of obstructive sleep apnoea. (Select one only): 1. Agree strongly 2. Agree with reservation 3. Neither agree nor disagree 4. Disagree with reservation 5. Disagree strongly 17. A 23-year old man with lingual and palatal dental erosions is referred by his dentist for management of his GERD. He has heartburn 1-2 times per week. Would you (Multiple): 1. Arrange for an upper GI endoscopy to confirm GERD 2. Arrange for a 24-hour esophageal pH recording, off all therapy 3. Treat him for 8 weeks with a once-daily PPI to assess symptom response 4. Treat long-term with a PPI at a dose and frequency to keep him symptom-free 5. Advise him and his dentist that his dental erosions are not due to GER |