Chest Pain and bitter taste at night!
NBME form 7 block 2
A 72 year old woman comes to the physician because of an 8-month history of burning chest pain & a bitter taste in her mouth; both symptoms occur at night when she lies down. The pain does not radiate & is not associated with shortness of breath. Physical examination shows no abnormalities. Which of the following is most likely to be associated with her symptoms?
(choice C is incorrect according to NBME)
a) atrophic gastritis
b) H.pylori infection
c) impaired relaxation of the lower esophageal sphincter
d) metaplasia of the esophageal epithelium
e) spasm of the esophageal smooth muscle
What do you guys think about the best choice...!!!!!!!