RN Nursing · Gastroesophageal Reflux Disease · Practice question
Which of the following is an atypical respiratory symptom associated with gastroesophageal disease (GERD)?
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✓
Coughing.
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Hemoptysis.
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Shortness of breath.
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Rhinitis.
Answer & explanation
Correct: Coughing.
Coughing is a well-recognized atypical respiratory manifestation of gastroesophageal reflux disease (GERD). When gastric acid refluxes into the esophagus, it can trigger a vagally mediated reflex that stimulates the cough center, or micro-aspiration of acid into the airways can directly irritate bronchial mucosa and produce a chronic cough. This is considered an extraesophageal or atypical symptom because it does not arise from the typical heartburn pathway. The question asks which symptom is atypical — in this context it means which respiratory symptom is commonly associated with GERD, distinguishing it from typical symptoms like heartburn and regurgitation. Hemoptysis, the coughing up of blood, is not associated with GERD and instead signals conditions such as pulmonary tuberculosis, bronchiectasis, or malignancy. Shortness of breath can occasionally be associated with GERD-induced asthma but is a less direct and more variable extraesophageal feature, while rhinitis is considered a less commonly taught extraesophageal manifestation. Chronic cough as an atypical symptom of GERD is one of the most frequently tested associations, occurring in a significant proportion of patients with GERD-related respiratory complaints, making it the best answer here.
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