Paraesophageal and hiatal hernia 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 65-year-old man comes to the clinic for evaluation of moderate postprandial discomfort. The patient previously experienced similar symptoms and at that time was diagnosed with a type II paraesophageal hernia. He states that he has not kept up with the lifestyle and dietary modifications that initially helped relieve the symptoms. He has a past medical history of hypertension and hyperlipidemia that are well-controlled with lisinopril and atorvastatin. Lifestyle and dietary modifications are recommended again, and a low-dose H2-receptor antagonist is prescribed as needed. Four weeks later, the patient has not had relief from the reflux symptoms. Which of the following is the most appropriate next step in management?

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Prescribe low-dose proton pump inhibitor daily

Continue low-dose H2 receptor agonist as needed for four more weeks and reassess

Emergent surgical management

Refer for elective surgical management

Prescribe an H2-receptor antagonist twice daily and reassess in two weeks