Quiz_02 - nplquiz.net

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Empiric therapy for typical GERD symptoms without alarm features:

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PPI once daily before breakfast

Antibiotics

High-dose steroids

Lactulose

None

NSAID user with epigastric pain; endoscopy shows gastric ulcer. Most important next step:

Stop NSAID + PPI therapy

Start loperamide

Start metformin

No treatment needed

None

Strongest indication for urgent endoscopy in dyspepsia/“acidity”:

Symptoms for 2 months

Belching

Dysphagia or GI bleeding

Mild nausea

None

Functional dyspepsia is diagnosed when:

Dyspeptic symptoms + structural disease identified

Symptoms explained by gallstones

Persistent dyspeptic symptoms with no structural cause on evaluation

Only constipation is present

None

In a young patient with dyspepsia and no alarm features, a common recommended approach:

Immediate ERCP

Test-and-treat for H. pylori (where appropriate) or PPI trial

Start chemotherapy

Routine CT angiogram

None

If symptoms persist despite PPI and H. pylori eradication (if positive), next reasonable option:

Low-dose TCA (e.g., amitriptyline)

High-dose diuretics

Insulin infusion

Antitubercular therapy

None

Best lifestyle advice in functional dyspepsia:

Large high-fat meals

Smaller frequent meals; reduce trigger foods; manage stress/sleep

Stop all carbs completely

Only take antibiotics monthly

None

Most common systemic association:

Diabetes mellitus

Hyperthyroidism

Nephrolithiasis

Asthma

None

Most likely diagnosis suggested by Image A:

Image A (Abdominal X-ray) — Constipation

Small bowel obstruction

Fecal loading/constipation

Pneumoperitoneum

Sigmoid volvulus

None

In the LA classification, Grade A means:

Mucosal break ≥75% circumference

Continuous breaks between folds involving <75% circumference

≥1 mucosal break ≤5 mm that does not extend between tops of two folds

Any Barrett’s mucosa

None

Gastro Quiz: Hyperacidity and Functional Dyspepsia

Reviewed by Asso. Prof. Dr. Md. Naymul Hasan, MD (Gastro), National Gastroliver Institute

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