A 54 year-old man complains of frequent by Dr. Laurence Bailen @Tufts

Question 1 / 32: A 54 year-old man complains of frequent heartburn. He reports a burning sensation in his chest within an hour of eating a large meal. He notes a similar sensation when he is in a supine position, particularly at bedtime. He denies any dysphagia or odynophagia.

Which of the following is the most likely mechanism resulting in the patient’s symptoms?

Absent peristalsis in the esophageal body

Transient relaxations of the LES (lower esophageal sphincter) without peristalsis

Multiple, simultaneous peristaltic contractions

High amplitude peristaltic contractions in the esophageal body

High LES pressure with failure of the LES to relax with swallowing

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Explanation:

Pathophysiology of gastro-esophageal reflux. Manometric finding felt to be most responsible for reflux is transient relaxation of the LES. Answers 1 and 5 are findings seen in achalasia. Answers 3 and 4 are findings observed in esophageal spasm.

Assessment Home Page

https://www.jobilize.com/gastrointestinal-pathophysiology-mcq-assessment-by-dr-laurence-bailen

Gastrointestinal Pathophysiology Self-Assessment

Author:

Dr.Laurence BailenProfessor

Tufts University School of Medicine

USA

Access: Public

Attribution: Laurence Scott Bailen, Tamsin Knox, Paul Abourjaily, Fredric D. Gordon,Marshall Kaplan,Andrew G. Plaut. PPY 222 Gastrointestinal Pathophysiology, Spring 2007. (Tufts University OpenCourseWare), http://ocw.tufts.edu/Course/47 (Accessed 3 May, 2014). License: Creative Commons BY-NC-SA

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