A 67-year-old male presented to the gastroenterology outpatient clinic with the new complaint of heartburn. He reports regurgitation on/off multiple times a day, especially before bedtime and after large fatty meals. He does not report melena, dysphagia, or odynophagiano reported symptoms of gastrointestinal bleeding. Which of the following is the best next step:
سؤال مجاني 1 من 10 اليوم · اشترك وكمّل بدون حد
اعرض الإجابة
الإجابة والشرح
ادخل لحسابك عشان نحفظ إجاباتك ونوريك أخطاءك.
المصادر مختلفة. ملفات الدفعة فيها إجابتين، وما نرجّح وحدة على الثانية. سبب كل وحدة في الشرح تحت:
- إجابة: A. Gastroscopy
- إجابة ثانية: B. PPI prescription
Typical GERD (heartburn, regurgitation after fatty meals and at bedtime) can normally be treated with an empiric PPI trial only if there are no alarm features. The UQU GERD lecture explicitly lists advanced age ≥60 as an alarm (red-flag) feature, alongside dysphagia, odynophagia, GI bleeding, anaemia, weight loss and family history of UGI cancer. A 67-year-old with new-onset symptoms therefore needs upper endoscopy (gastroscopy).
- Generic notes (Step Up / OnlineMedEd) list only dysphagia, anaemia and weight loss as triggers for EGD. Read that way, the answer would be a PPI trial, which is the old bank key.
- pH monitoring and barium swallow are not first steps.
- المصدر
- Y4 - MD (GI) GERD.pdf · p. 11
GERD.pdf · p. 14
Step Up To Medicine 6th Edition 2024 (GERD).pdf · p. 1 - المحاضرة
- GERD & Oesophagitis · Gastroenterology & Liver · Module C
- ظهر في
- MED43 ♂ Quiz C · MED43 ♀ Compre