Gerd, Hernias, And Hiatal Hernia Quiz

Explanation
A weakened area of the diaphragm where a portion of the stomach and lower esophagus protrude into the thoracic cavity is called a hiatal hernia. In this condition, the stomach pushes up through the diaphragm into the chest cavity, causing symptoms such as heartburn, chest pain, and difficulty swallowing. Hiatal hernias are often caused by weakened muscles and tissues in the diaphragm, and they can be exacerbated by factors such as obesity, pregnancy, and aging. Treatment options for hiatal hernias include lifestyle changes, medications, and in some cases, surgery.

Explanation
Obesity can cause GERD because excess weight can put pressure on the stomach and cause stomach acid to flow back into the esophagus. Pregnancy can also cause GERD due to hormonal changes and the pressure of the growing uterus on the stomach. Increased gastric volume can contribute to GERD as it increases the amount of stomach acid that can flow back into the esophagus. Smoking and the consumption of nicotine, caffeine, chocolate, alcohol, peppermint, and spearmint can irritate the esophagus and weaken the lower esophageal sphincter, leading to GERD. Fatty foods, beta-blockers, calcium channel blockers, Valium, heavy lifting, and relaxation of the lower esophageal sphincter can also contribute to GERD.

Explanation
Weakened abdominal muscles can cause a hernia because when the muscles are weak, they are unable to provide enough support to the abdominal wall, allowing organs or tissues to protrude through. Increased abdominal pressure can also cause a hernia as it puts extra strain on the abdominal muscles, making them more likely to become weakened or torn.

Explanation
Increase in discomfort when sitting upright is not a symptom of GERD. GERD, or gastroesophageal reflux disease, is a condition where stomach acid flows back into the esophagus, causing symptoms such as heartburn, regurgitation, chest pain, and difficulty swallowing. The other symptoms listed, wheezing at night, hoarse voice, and bad taste in the mouth in the morning, are all commonly associated with GERD. However, an increase in discomfort when sitting upright is not typically seen in GERD and may be indicative of other conditions.

Explanation
The correct answer is "None of the above." This means that all of the medications listed (Zantac, Tagmet, Prilosec, and Protonix) are appropriate treatments for GERD.

Explanation
The Valsalva Maneuver is not an appropriate intervention for a hernia because it involves forcefully exhaling while keeping the mouth and nose closed, which can increase abdominal pressure. This increased pressure can potentially worsen the hernia or cause it to become incarcerated or strangulated. Therefore, it is not recommended as a treatment option for hernias.

Explanation
A reducible hernia is a hernia that can be pushed back into the abdominal cavity, either on its own or with the help of gentle pressure. Surgery is usually required to fully repair a hernia. Therefore, the statement that a reducible hernia can be made smaller by means other than surgery is false.

Explanation
If a hernia's blood supply has been reduced to the protruding bowel and it results in ischemia, obstruction, necrosis of tissues, and perforation, it is not called an irreducible hernia. An irreducible hernia refers to a hernia that cannot be pushed back into place or reduced manually. However, the given statement describes complications that can occur in a hernia, but it does not specify whether the hernia is reducible or irreducible. Therefore, the correct answer is False.

Explanation
Patients with GERD often complain of pain in the substernal area. This is because GERD, or gastroesophageal reflux disease, is a condition where stomach acid flows back into the esophagus, causing irritation and discomfort. The substernal area refers to the region just below the sternum or breastbone, which is where the esophagus is located. Therefore, pain in this area is a common symptom of GERD.

Explanation
Achalasia is a disorder of the esophagus that affects the ability of the esophagus to move food toward the stomach. It is characterized by the inability of the lower esophageal sphincter to relax and allow food to pass into the stomach. This can lead to symptoms such as dysphagia, or difficulty swallowing. Therefore, achalasia is the correct answer as it fits the description provided in the question.

Explanation
Nissen fundoplication is a surgical procedure in which the fundus of the stomach is wrapped completely around the esophagus to prevent movement into the thoracic cavity. This procedure is commonly performed to treat gastroesophageal reflux disease (GERD) and hiatal hernias. By wrapping the upper part of the stomach around the lower esophagus, it creates a valve mechanism that prevents stomach acid and contents from flowing back into the esophagus, thus reducing symptoms such as heartburn and regurgitation.

Explanation
Hill repair is a procedure in which the fundus of the stomach is wrapped halfway around the esophagus to prevent movement up into the thoracic cavity.