GERD: ABFM practice questions

8 board-style questions on gerd in the PulseMD family medicine question bank, written against current guidelines with the reference cited on each question. Two free samples below; the full set with answers, explanations, and spaced review is free to start.

Sample question 1

A 42-year-old man presents with burning substernal chest pain that worsens after meals and when lying down at night. He reports a sour taste in his mouth most mornings for the past 3 months. He denies dysphagia, odynophagia, weight loss, or vomiting. He does not smoke and drinks alcohol socially. Physical examination is unremarkable. What is the most appropriate initial management?

1. Obtain a barium swallow study
2. Refer for 24-hour esophageal pH monitoring
3. Start an empiric 8-week trial of proton pump inhibitor therapy
4. Order an upper endoscopy to evaluate the esophagus

Sample question 2

A 55-year-old woman has been taking omeprazole 20 mg daily for 8 weeks for GERD symptoms with significant improvement. She asks about continuing the medication long-term. She has no alarm symptoms and takes no other medications. Her symptoms return within a few days whenever she tries to stop the PPI. Which of the following is the most appropriate counseling regarding long-term PPI use?

1. Long-term PPI use has been associated with increased risks including C. difficile infection, hypomagnesemia, and bone fractures, so the lowest effective dose should be used
2. Long-term PPIs should be replaced with H2 receptor antagonists, which are equally effective and have no adverse effects
3. PPIs must be discontinued after 8 weeks because they cause irreversible kidney damage in all long-term users
4. PPIs are completely safe for indefinite use with no monitoring needed

Create a free PulseMD account to answer these, see the explanations, and practice five minutes a day.

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