Posttest

1. There are currently four approved PPIs available commercially

True
False

2. A PPI is most effective when given at bedtime

True
False

3. A PPI is indicated for all of the following except:

Peptic Ulcer Disease
Zollinger-Ellison Syndrome
H. Pylori treatment
Gastroparesis

4. A patient comes into the office in follow-up after treatment for H.pylori. Part of the treatment regimen included a PPI BID for 14 days. She has no concerning symptoms, denies any reflux symptoms, and she asks you for a refill for the PPI. What is the correct answer you would then say regarding PPI therapy indications for this scenario?

“Continue the PPI once daily forever because you had H.pylori.
“Continue the PPI for an additional three months.”
“You have completed the course of therapy, and you will never need a PPI again.”
“Your therapy course is completed, and I recommend stopping the PPI. If you start having reflux symptoms, I would like to see you again and discuss appropriate evaluation and therapy options.”

5. A 56-year-old obese male presents to your office to establish care. He tells you that many years ago he was diagnosed with Barrett’s esophagus, and he is not taking a PPI. According to current guidelines, he does not need to take a PPI because he is asymptomatic.

True
False

6. Research has shown that there is an inconclusive relationship between PPI therapy and Clostridium difficile infection (CDI)

True
False

7. Individuals who have just started PPI therapy are more at risk for fractures than those who have been on therapy a year or longer.

True
False

8. A 34-year-old male presents to the office for routine follow-up. He was started on omeprazole 20 mg daily approximately 6 months ago due to symptomatic GERD. He has changed his diet to avoid reflux triggers, lost 10 pounds after joining a gym and regularly exercising, and he asks you if he needs to continue taking this dosage. What would be an indication for deprescribing in this scenario?

Symptom resolution and therapy has extended beyond best practices
Risks outweigh the benefits
He was not prescribed PPI with appropriate indication
He is young and shouldn’t need a PPI.

9. You discuss with this patient a possible tapering technique, and one method for deprescribing is by tapering his dosage by 50% each week.

True
False

10. An 84-year-old female presents with a history of heart disease. She has documented esophagitis on a recent endoscopy, and she has symptoms of reflux without a PPI. She was prescribed Plavix many years ago, and you are trying to find a cost-effective PPI to prescribe. As omeprazole is over-the-counter and usually covered well with insurances, you decide to prescribe this for her. Is this an appropriate combination for your patient?