The Correct Answer is D!
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A 62-year-old white man has had postprandial gastroesophageal reflux symptoms for over 10 years. Once or twice a week he feels heartburn after his evening meal. The symptoms resolve with a dose of oral antacid. He has no dysphagia, cough, weight loss, dyspnea, or exertional chest discomfort. He has hypertension and takes an angiotensin receptor blocker medication. Physical examination is notable for a body mass index of 34 with intra-abdominal distribution of fat.
Which of the following is the most appropriate next step in patient care?
- No further evaluation, continue antacids as needed
- No further evaluation, begin daily oral proton pump inhibitor
- Perform 24-hour ambulatory pH monitoring
- Perform upper GI endoscopy
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1. Source: "Comparative Analysis of Pre/Post Assessments of Live/Didactic Course Attendees when compared to Mico-Learning/Online Course Users., "Knowledge to Practice, 2017.