Gastro-oesophageal reflux disease — MCCQE Part 1 MCQ

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EasyChest PainGastro-oesophageal reflux diseaseMCCQE Part 1

A 42-year-old woman has post-prandial burning retrosternal discomfort, sour regurgitation and nocturnal cough that improve with antacid; there is no exertional component. Which of the following is the most likely diagnosis?

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Correct answer: E — Gastro-oesophageal reflux disease

Gastro-oesophageal reflux disease is the single best answer because the age, timing, examination findings and investigations in the vignette fit Gastro-oesophageal reflux disease better than the alternatives. The most tempting distractor is less appropriate because it either treats a neighbouring presentation, delays a time-critical intervention, or ignores a key discriminator in the stem. The remaining options are suboptimal because they would miss the diagnosis, use an investigation or treatment in the wrong sequence, or fail to address safety and follow-up. Canadian practice should be anchored to Canadian Association of Gastroenterology GERD guidance, with attention to acuity, safety-netting and local provincial pathways.

Reference: Canadian Association of Gastroenterology GERD guidance