Slide 3 GI

Esophageal carcinoma is most commonly associated with which condition, and how can risk be reduced? A. H. pylori infection; antibiotics B. Barrett’s esophagus; indefinite proton pump inhibitor (PPI) therapy C. GERD; antacids only D. Gastritis; H2 blockers

B. Barrett’s esophagus; indefinite proton pump inhibitor (PPI) therapy

Severe GERD is defined as which of the following? A. Heartburn once per month B. Heartburn once per week C. Symptoms more than 2 times per week and/or erosive esophagitis D. Only nocturnal symptoms

C. Symptoms more than 2 times per week and/or erosive esophagitis

How is OTC GERD therapy typically used? A. Continuous daily therapy indefinitely B. 2-week therapy that can be repeated once every 4 months C. 1-day therapy only D. 6-month continuous therapy without breaks

B. 2-week therapy that can be repeated once every 4 months

How is prescription GERD therapy typically structured? A. 1–2 treatments total B. 4-week therapy only C. Usually 8–16 weeks of treatment D. Lifelong therapy without reassessment

C. Usually 8–16 weeks of treatment

Which maintenance therapy is used after 8 weeks of PPI therapy in patients with erosive esophagitis? A. H2 receptor antagonists (H2RAs) B. Antacids only C. PPIs D. Antibiotics

C. PPIs

Which maintenance therapy is used after 8 weeks of PPI therapy in patients WITHOUT erosive esophagitis? A. PPIs B. H2 receptor antagonists (H2RAs) C. Antibiotics D. Prokinetics only

B. H2 receptor antagonists (H2RAs)

Magnesium-containing antacids most commonly cause which side effect? A. Constipation B. Diarrhea C. Hypertension D. Dry mouth

B. Diarrhea

Aluminum-containing antacids most commonly cause which side effect? A. Diarrhea B. Constipation C. Hypoglycemia D. Rash

B. Constipation

Which antacid contains aluminum hydroxide and magnesium carbonate? A. Rolaids B. Gaviscon C. Alka-Seltzer D. Nexium

B. Gaviscon

Which antacid contains alginic acid? A. Maalox B. Mylanta C. Gaviscon D. Rolaids

C. Gaviscon

Which antacids contain simethicone? A. Maalox and Mylanta B. Rolaids and Gaviscon C. Alka-Seltzer only D. Nexium only

A. Maalox and Mylanta

Which antacid contains calcium carbonate and magnesium hydroxide? A. Rolaids B. Gaviscon C. Maalox D. Mylanta

A. Rolaids

Why should magnesium and aluminum-containing antacids be used cautiously? A. Liver impairment B. Renal impairment C. Cardiac disease D. Pulmonary disease

B. Renal impairment

What is a key concern with Alka-Seltzer? A. Contains calcium B. Contains aspirin and is not recommended in children or pregnancy C. Causes hypoglycemia D. Causes hypertension

B. Contains aspirin and is not recommended in children or pregnancy

What is tachyphylaxis? A. Allergy to medication B. Increased drug potency over time C. Tolerance to acid-suppressive effects (common with H2RAs) D. Drug-induced infection

C. Tolerance to acid-suppressive effects (common with H2RAs)

Which drug class is commonly associated with tachyphylaxis? A. PPIs B. H2 receptor antagonists C. Antacids D. Antibiotics

B. H2 receptor antagonists

Which PPI is available OTC at 15 mg and Rx at 30 mg? A. Omeprazole B. Lansoprazole (Prevacid) C. Esomeprazole (Nexium) D. Omeprazole/sodium bicarbonate (Zegerid)

B. Lansoprazole (Prevacid)

Which PPI is available OTC at 10 mg and 20 mg and Rx at 40 mg? A. Omeprazole B. Esomeprazole C. Lansoprazole D. Pantoprazole

A. Omeprazole

Which medication combines omeprazole with sodium bicarbonate? A. Omeprazole/sodium bicarbonate (Zegerid) B. Esomeprazole C. Lansoprazole D. Ranitidine

A. Omeprazole/sodium bicarbonate (Zegerid)

Which PPI is available OTC at 20 mg and Rx at 40 mg? A. Omeprazole B. Esomeprazole (Nexium) C. Lansoprazole D. Pantoprazole

B. Esomeprazole (Nexium)

Which adverse effects are associated with long-term PPI use? A. Hypertension and tachycardia B. C. difficile infection, pneumonia, and renal failure C. Hyperglycemia D. Liver failure

B. C. difficile infection, pneumonia, and renal failure

Which long-term adverse effects are associated with PPIs? A. Hyperkalemia, hyponatremia B. Hypomagnesemia, bone fractures, Vitamin B12 deficiency C. Anemia and leukocytosis D. Hypoglycemia and bradycardia

B. Hypomagnesemia, bone fractures, Vitamin B12 deficiency

What should be monitored in patients taking PPIs for more than 1 year? A. Liver enzymes B. Magnesium levels C. Blood glucose D. Platelet count

B. Magnesium levels

What is the general approach for partial responders to PPI therapy? A. Stop therapy immediately B. Optimize dosing → BID dosing → switch PPIs → endoscopy → vonoprazan C. Add antibiotics D. Switch to antacids only

B. Optimize dosing → BID dosing → switch PPIs → endoscopy → vonoprazan

What additional medications can be used in GERD patients with motor dysfunction? A. Anticoagulants B. Acid suppressors with promotility drugs like metoclopramide or baclofen C. Statins D. Diuretics

B. Acid suppressors with promotility drugs like metoclopramide or baclofen

How can infrequent nocturnal GERD be treated? A. Surgery only B. PPIs and PRN H2RAs C. Antibiotics D. Anticoagulants

B. PPIs and PRN H2RAs

How is frequent nocturnal GERD (>2 times/week) treated? A. Antacids only B. PPIs taken twice daily (BID) C. Antibiotics D. No treatment needed

B. PPIs taken twice daily (BID)

Which medication can be used for nocturnal GERD due to its formulation? A. Omeprazole/sodium bicarbonate (Zegerid) B. Lansoprazole C. Ranitidine D. Calcium carbonate

A. Omeprazole/sodium bicarbonate (Zegerid)

Which medication can decrease lower esophageal sphincter (LES) pressure and worsen GERD? A. PPIs B. Antacids C. Calcium channel blockers like amlodipine D. H2 blockers

C. Calcium channel blockers like amlodipine