1. Which of the following is the primary pathophysiological mechanism behind Gastroesophageal Reflux Disease (GERD)?
2. Achalasia is primarily caused by the degeneration of ganglion cells in which of the following locations?
3. A 45-year-old patient presents with classic heartburn and regurgitation. Proton pump inhibitors (PPIs) have provided only partial relief. What is considered the gold standard for diagnosing GERD in this scenario?
4. Barrett’s esophagus, a complication of chronic GERD, is characterized by the metaplastic replacement of the normal esophageal epithelium with what type of cells?
5. A patient with progressive dysphagia to both solids and liquids undergoes a barium swallow. Which of the following findings is most characteristic of achalasia?
6. Which of the following is considered an atypical or extra-esophageal symptom of GERD?
7. What are the classic findings on high-resolution esophageal manometry that confirm a diagnosis of achalasia?
8. A 55-year-old patient reports intermittent, non-cardiac chest pain and dysphagia. A barium swallow reveals a “corkscrew” or “rosary bead” esophagus. This finding is most suggestive of:
9. Nutcracker esophagus (hypertensive peristalsis) is diagnosed based on which specific finding?
10. A patient with known systemic sclerosis (scleroderma) presents with severe heartburn and dysphagia. Manometry is performed. Which set of findings would be most expected?
11. What is the first-line pharmacological treatment for moderate to severe GERD?
12. Which of the following treatments for achalasia directly addresses the underlying pathophysiology by disrupting the muscle fibers of the lower esophageal sphincter?
13. Long-term use of proton pump inhibitors (PPIs) has been associated with an increased risk of which of the following conditions?
14. Esophageal manometry is most useful for evaluating which of the following clinical problems?
15. A 70-year-old male presents with a 3-month history of rapid-onset dysphagia and significant weight loss. Manometry and barium swallow suggest achalasia. What underlying condition must be ruled out?
16. Which of the following substances is known to decrease lower esophageal sphincter (LES) pressure, potentially worsening GERD?
17. Per-oral endoscopic myotomy (POEM) is a modern, less invasive alternative to which surgical procedure for achalasia?
18. A young male presents with dysphagia and food impaction. Endoscopy reveals linear furrows and white exudates. What histological finding would confirm Eosinophilic Esophagitis (EoE)?
19. “Jackhammer esophagus” is another term for which esophageal motility disorder?
20. Chagas disease, caused by *Trypanosoma cruzi*, can lead to a condition clinically indistinguishable from primary achalasia. What is the mechanism?
21. Which of the following lifestyle modifications is most strongly recommended for a patient with nocturnal GERD symptoms?
22. How do H2-receptor antagonists like cimetidine and ranitidine reduce gastric acid?
23. Which of the following is considered an “alarm feature” in a patient with GERD symptoms, warranting an urgent upper GI endoscopy?
24. The manometric criterion for Diffuse Esophageal Spasm (DES) is the presence of premature contractions (rapid conduction velocity) in what percentage of swallows?
25. What is the primary goal of a Nissen fundoplication surgery for severe GERD?
