Week 2
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Quiz 2 Context:
A 39-year-old otherwise healthy man presents for a second opinion on chest discomfort. He relates a history of retrosternal discomfort, typically at night or in the early morning. He also complains of a persistent, nonproductive cough. In the past he has had heartburn or regurgitation with some meals. A recent electrocardiogram (EKG), chest X-ray, and stress test were completely normal. The patient wishes to avoid chronic medications unless a definite, treatable abnormality is discovered. An upper endoscopy is performed and shown above.
Sorry, that is not the most likely answer. Try Again.
a. Excellent!
This upper endoscopy reveals changes diagnostic of erosive esophagitis. These changes may be seen in patients suffering from gastroesophageal reflux disease, or GERD, which may present with symptoms identical to those described by the patient in this week's case.
You have correctly identified this week's Image of the Week. Now test your knowledge about other aspects of acid peptic disorders. Do you know .....
...the percentage of the population that reports suffering from symptoms of heartburn or acid regurgitation on a weekly basis?
....the healing rates for erosive esophagitis when treated with Histamine H2 receptor antagonist? And, when treated with proton pump inhibitors?
....what the American College of Gastroenterology recommendations are for surveillance for patients with Barrett's esophagus found to have no dysplasia? And, for those found to have low-grade dysplasia?
The answers to these questions and a concise review of the pathogenesis, diagnosis, and treatment of acid peptic disorders, can be found here within the Cleveland Clinic Disease Management Project.
This EGD is most consistent with which of the following?
- Erosive esophagitis
- Gastric ulcer
- Mass lesion suspicious for carcinoma
- Normal healthy tissue
- Esophageal varices
