American Board of Internal Medicine (ABIM) Certification Practice Exam

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Prepare for the American Board of Internal Medicine Certification Exam. Utilize flashcards and multiple choice questions with hints and explanations to enhance your learning. Achieve success in your exam!

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What symptom is NOT considered an alarm feature in GERD that would necessitate endoscopy?

Hematemesis
Melena
Heartburn
Dysphagia

The correct answer is: Heartburn

Heartburn is a very common symptom experienced by patients with gastroesophageal reflux disease (GERD), but it is not classified as an alarm feature that would warrant endoscopy. Alarm features typically indicate potential complications or more serious underlying conditions. Hematemesis (vomiting blood), melena (dark, tarry stools indicating gastrointestinal bleeding), and dysphagia (difficulty swallowing) are recognized as alarm symptoms. These symptoms could suggest critical issues such as esophagitis, strictures, or malignancy, which require further investigation and management. Heartburn, while uncomfortable and possibly indicative of GERD, generally does not necessitate urgent endoscopic evaluation unless accompanied by those alarm features. Thus, heartburn is seen as a more routine symptom of GERD rather than a sign of severe underlying pathology.