Gastroesophageal reflux disease Quiz: Ace Your Exams

Get ready to dominate your medical and nursing exams by using our dynamic quizzes to elevate your knowledge and increase your confidence. Whether you're gearing up for the USMLE®, COMLEX®, or your next in-class assessment, Osmosis quizzes tackle key topics in pathology, diagnostics, and treatment approaches. By honing in on clinical readiness and decision-making, we make sure the knowledge you gain empowers you both in the classroom and in real-world practice. Jump in and supercharge your exam prep!

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A 36-year-old woman with a history of epigastric burning and regurgitation presents to the primary care clinic for follow-up evaluation. The patient just finished an eight-week trial of standard-dose proton pump inhibitor (PPI), which has been unsuccessful at alleviating symptoms. There is no associated chest pain, difficulty swallowing, vomiting, melena, hematemesis, or unintentional weight loss. Past medical history is unremarkable. Vital signs are within normal limits. Physical examination is unremarkable. After withholding PPI for 14 days, an EGD with biopsies is performed and is non-diagnostic. Histopathology shows no evidence of erosive esophagitis, esophageal stricture, Barrett esophagus, malignancy, or other complications. Which of the following is the most appropriate next step in the evaluation and management of this patient?

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Start a different PPI and reevaluate in four weeks

Increase the dose of PPI and reevaluate in four weeks

Perform a 24-hour esophageal impedance study with pH monitoring

Repeat EGD with biopsy in eight weeks

Perform esophageal manometry