GERD

1. Concerning esophagus which of these is FALSE?

a) It's 15 Inches in length
b) Anatomically divided into 3 parts
c) Histologically divided into 4 parts
d) Mucosal lining is non-keratinized squamous epithelium
e) All of the above

2. All of the following about aphthous ulcer is true EXCEPT:

a) Superficial oral ulcers
b) Painless
c) Recurrent
d) Affects 30% of population
e) Can be managed by oral steroids

3. Differential diagnosis of aphthous ulcer includes infection by all of

the following EXCEPT:
a) HIV
b) Mumps
c) CMV
d) Histoplasmosis
e) Syphilis

4. Differential diagnosis of aphthous ulcer includes all of the

following EXCEPT:
a) Squamous cell carcinoma
b) Crohn's disease
c) Methotrexate consumption
d) SLE
e) None of the above

5. Salivary duct obstruction by calculus mainly detected by:

a) X-ray
b) PET/CT
c) MRI
d) None of the above
6. Concerning GERD which of the following is FALSE?
a) A chronic disease
b) Characterized by retrograde flow of gastro duodenal contents into
the esophagus
c) It can be associated with erosions or non-erosive
d) It frequently affect people > 40 yrs.
e) Barret’s esophagus has a higher incidence in adult females

7. The primary barrier to GERD is:

a) Mucous secreted by the mucous secreting glands
b) Bicarbonate neutralize the acidic refluxate in the esophagus
c) Lower esophageal sphincter
d) Gastric emptying mechanisms
e) None of the above

8. Which of the following is a cause of esophagitis?

a) Candidal infection
b) GERD
c) Drugs as steroids-NSAIDs-bisphosphonates
d) Eosinophilic infiltration of mucosa
e) All of the above

9. Which of the following about esophageal stricture is TRUE?

a) It can occur as a complication of non-erosive esophagitis
b) It's about 1-2cm in length
c) Dilatation is a useless solution
d) It's more common in proximal esophagus
e) None of the above

10.Which of the following is FALSE regarding GERD complications?

a) Erosive esophagitis is responsible for 30% of GERD symptoms
b) Barrett's esophagus is a cuboidal metaplasia of esophagus
c) Barrett's esophagus is caused by Acidic damage of the lining of
esophagus causing chronic esophagitis.
d) Esophageal stricture can result from Barrett's esophagitis in 30%
of cases
e) None of the above
11. Which of these ISN'T a typical symptom of GERD?
a) Heartburn
b) Water brash
c) Regurgitation
d) Cough
e) None of the above

12. All of the following are Atypical symptoms of GERD EXCEPT:

a) Hoarseness
b) Pharyngitis
c) Dental erosions
d) Allergic asthma
e) Dental erosions

13. Regarding GERD ,which is FALSE?

a) Can be monitored by 24hr PH level
b) Vomiting is Atypical symptom of the disease
c) Typical symptoms can be aggravated by particular body position
d) Atypical symptoms can manifest alone
e) All are true

14. Which of the following drugs is NOT used to treat GERD?

a) Famotidine
b) Antacids
c) Pantoprazole
d) Metoclopromide
e) None of the above

15. Concerning lifestyle modifications to treat GERD which one is

FALSE?
a) Weight gain
b) Decrease fatty foods
c) Prevent alcohol consumption & smoking.
d) CCB, CCP Stoppage (NB: calcium channel blocker/ contraceptive pills ☺)
e) None of the above
16. Which of the following is not indication for surgery in GERD?
a) Failed medical management
b) GERD complications
c) Small hiatal hernia
d) Atypical symptoms with reflux in 24hr- PH monitoring

NOTE that in this lecture:

30% of population  with aphthous ulcers

30% of Barrett's esophagitis  develop stricture esophagus
30% of patients  erosive esophagitis is Responsible for GERD
symptoms.

1. a 5. a 9. b 13. b
2. b 6. e 10. b 14. e
3. b 7. c 11. d 15. a
4. e 8. e 12. d 16. c

OE