A 63-year-old man has 3 months of heartburn and progressive dysphagia to solids. He has lost 12 lb unintentionally. He has smoked for 40 years.

Question

A 63-year-old man has 3 months of heartburn and progressive dysphagia to solids. He has lost 12 lb unintentionally. He has smoked for 40 years. Abdominal examination is normal. Which of the following is the most appropriate next step in management?

Accepted Answer

Upper endoscopy

Answer

H pylori stool antigen alone

Answer

Reassurance and dietary changes

Answer

Barium swallow as cancer screening

Answer

Empiric antacid therapy for 1 year

GERD alarm symptoms — USMLE Step 3 MCQ

A 63-year-old man has 3 months of heartburn and progressive dysphagia to solids. He has lost 12 lb unintentionally. He has smoked for 40 years. Abdominal examination is normal. Which of the following is the most appropriate next step in management?