The following are multiple choice questions (with answers) about medical knowledge.   **Question:** A 63-year-old man presents to the ambulatory medical clinic with symptoms of dysphagia and ‘heartburn’, which he states have become more troublesome over the past year. His past medical history is significant for hypertension and GERD. He takes lisinopril for hypertension and has failed multiple different therapies for his GERD. On physical exam, he is somewhat tender to palpation over his upper abdomen. Barium swallow demonstrates a subdiaphragmatic gastroesophageal junction, with herniation of the gastric fundus into the left hemithorax. Given the following options, what is the most appropriate next step in the management of this patient’s underlying condition?   (A) Lifestyle modification   (B) Combined antacid therapy   (C) Continue on Omeprazole   (D) Surgical gastropexy
['(D) Surgical gastropexy <> answer', 'The following are multiple choice questions (with answers) about medical knowledge. <> instruction', '(A) Lifestyle modification \n (B) Combined antacid therapy \n (C) Continue on Omeprazole \n (D) Surgical gastropexy <> possible answers', '  A 63-year-old man presents to the ambulatory medical clinic with symptoms of dysphagia and ‘heartburn’, which he states have become more troublesome over the past year. His past medical history is significant for hypertension and GERD. He takes lisinopril for hypertension and has failed multiple different therapies for his GERD. On physical exam, he is somewhat tender to palpation over his upper abdomen. Barium swallow demonstrates a subdiaphragmatic gastroesophageal junction, with herniation of the gastric fundus into the left hemithorax. Given the following options, what is the most appropriate next step in the management of this patient’s underlying condition? <> context@']