QuestionSBA
QuestionChoice
This is incorrect due to the red flag symptoms the patient is reporting. Whilst a Nissen fundoplication is a good surgical management option for GORD, this is usually offered after all Medical options have been exhausted and the patient is concerned with long-term side effects of medication.
10002563
c
Refer to surgery for a Nissen fundoplication
QuestionChoice
This is the most important step to take as this woman is over the age of 55, has dysphagia and has weight loss, a diagnosis of cancer is highly suspected, so an urgent referral is necessary.
10002561
a
Referral to Endoscopy under urgent 2-week-wait
QuestionChoice
This is incorrect as this patient has many red flag symptoms indicating a cancer diagnosis is likely.
10002562
b
Prescribe 20mg of Omeprazole once a day and review in 4-8 weeks
QuestionChoice
This is incorrect as the patient is displaying clear red flag symptoms that need urgent investigation. pH monitoring is useful in making an initial diagnosis of GORD.
10002565
e
24-hour pH monitoring
QuestionChoice
This is incorrect as this patient is presenting with many red flag symptoms indicative of a cancer diagnosis. Therefore, they must be referred to endoscopy as a matter of urgency.
10002564
d
Non-urgent referral to endoscopy
Concept
Chapter
2693
4051
Gastro-oesophageal reflux disease
Topic
136
Gastroenterology
13059
A 60-year-old female presents to her GP with a 3 month history of heartburn and progressively worsening dysphagia. She also notes she has lost some weight recently.

What is the most important step to take?
a