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A 74-Year-Old Man Comes to the Office Due to Difficulty

question 232

Multiple Choice

A 74-year-old man comes to the office due to difficulty swallowing food. The symptoms began 4 months ago when the patient was eating steak and felt like a bite got stuck in the middle of his chest, which resolved after drinking a glass of water. Since then, he has had several similar episodes when eating bread or meat and has modified his diet to soft foods. He has no difficulty drinking liquids and has had no chest or abdominal pain, vomiting, melena, or weight loss. The patient has occasional nighttime heartburn, especially after eating spicy food, and takes antacids as needed. His other medical conditions include hypertension, for which he takes lisinopril. He does not use tobacco, alcohol, or illicit drugs. Family history is unremarkable. Vital signs are within normal limits. Physical examination shows normal dentition and oropharyngeal mucosa. Tonsils are normal. The lungs are clear on auscultation, and heart sounds are normal. The abdomen is soft and nontender with no organomegaly. The remainder of the physical examination shows no abnormalities. Which of the following is the best next step in management of this patient?

Definitions:

Increased Productivity

Refers to an enhancement in the efficiency of producing goods or services, often measured by the output per unit of input over a specific period.

Benefits Costs

The expenses associated with providing benefits to employees, such as health insurance, retirement contributions, and leave entitlements.

Corporate Giving Matching Fund

A philanthropic program where a corporation matches donations made by employees to eligible nonprofits, essentially doubling the charity's receipt.

Employee Assistance Program

A work-based intervention program designed to identify and assist employees in resolving personal problems that may adversely affect their job performance.