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Clinical Review Quiz

Laryngopharyngeal Reflux

Peter C. Belafsky, MD, PhD, MPH, and Catherine J. Rees, MD

Dr. Belafsky is director and assistant professor, and Dr. Rees is a fellow in laryngology/bronchoesophagology; both are at the Center for Voice and Swallowing, Department of Otolaryngology/Head and Neck Surgery, University of California at Davis Medical Center, Sacramento, CA.

The questions below are based on the article
“Identifying and Managing Laryngopharyngeal Reflux”.

Choose the single best answer for each question.

1. All of the following are common symptoms of laryngopharyngeal reflux (LPR) EXCEPT:
  1. Excessive throat mucus
  2. Globus pharyngeus
  3. Heartburn
  4. Intermittent dysphonia
  5. Throat-clearing
Click here to compare your answer.

2. Appropriate work-up of globus pharyngeus should always include which of the following?

  1. Cervical ultrasound
  2. Dual probe pH testing
  3. Laryngoscopy
  4. Neck computed tomography
  5. Reassurance only
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3. Dysphonia attributable to LPR is:

  1. Not fluctuating
  2. Not usually improved with antireflux therapy
  3. Usually intermittent
  4. Usually progressive
  5. None of the above
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4. Which of the following statements regarding ambulatory pH monitoring for LPR is true?

  1. Ambulatory pH testing plays no role in LPR diagnosis
  2. A pharyngeal probe is used to diagnose LPR
  3. Distal pH testing is sufficient for diagnosing LPR
  4. Patients should not eat during ambulatory pH testing
  5. Proximal esophageal testing is sufficient for diagnosing LPR
Click here to compare your answer .

5. Which of the following statements regarding the treatment of LPR is true?

  1. Lifestyle modifications are not effective
  2. Treatments used for gastroesophageal reflux disease (GERD) are equally effective for LPR
  3. Twice-daily proton pump inhibitor (PPI) therapy should be given for significantly symptomatic LPR
  4. Ranitidine is the gold standard treatment for LPR
  5. Failure to respond to a 14-day trial of once-daily PPI therapy effectively rules out LPR
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6. Which of the following statements regarding LPR is true?

  1. Treatment of LPR should be initiated prior to performing laryngoscopy in patients with globus
  2. LPR is common among patients with voice disorders
  3. LPR always presents concomitantly with GERD
  4. Erosive esophagitis is common in patients with LPR
  5. LPR is diagnosed primarily on the basis of laryngeal erythema
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7. Which of the following is not a recommended lifestyle modification for reflux (GERD and LPR)?

  1. Do not lie down within 3 hours of eating
  2. Eat small, frequent meals
  3. Elevate head of bed
  4. Move the evening meal to just before bedtime
  5. Weight loss
Click here to compare your answer.

8. Which antireflux treatment creates a physical barrier to reflux?

  1. Antacids
  2. Liquid alginate
  3. Metoclopramide
  4. Omeprazole
  5. Ranitidine
Click here to compare your answer.


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