A 59-year-old man has 4 months of heartburn and regurgitation. He now reports progressive dysphagia to solids and 5-kg weight loss. He smoked for 35

Question

A 59-year-old man has 4 months of heartburn and regurgitation. He now reports progressive dysphagia to solids and 5-kg weight loss. He smoked for 35 years. Which of the following is the most appropriate next step in management?

Accepted Answer

Upper endoscopy

Answer

Helicobacter pylori breath test as definitive evaluation

Answer

Empiric antacid therapy for 1 year

Answer

Esophageal manometry as the initial test

Answer

Reassurance and dietary advice alone

GERD alarm features — USMLE Step 3 MCQ

A 59-year-old man has 4 months of heartburn and regurgitation. He now reports progressive dysphagia to solids and 5-kg weight loss. He smoked for 35 years. Which of the following is the most appropriate next step in management?