1. A 32-year-old woman presents to your clinic with a six-month history of upper abdominal discomfort, bloating, and nausea after meals. She denies weight loss, vomiting, or bleeding. Her physical exam is unremarkable. Which of the following is the most appropriate next step in her management?

• Upper endoscopy
• H. pylori stool antigen test
• Empiric therapy with a proton pump inhibitor (PPI)
• Abdominal CT scan

2. A 55-year-old man with a history of hypertension presents with persistent dyspepsia for eight months, including postprandial fullness, early satiety, and epigastric discomfort. He reports occasional dark stools. Which of the following is the most appropriate initial investigation?

• Upper endoscopy
• Abdominal ultrasound
• Fecal immunohistochemical test (FIT)
• H. pylori urea breath test

3. A 42-year-old woman with a recent diagnosis of functional dyspepsia has been on PPI therapy for four weeks, with mild symptom improvement. Which of the following is the most appropriate next step in her management?

• Increase the PPI dose
• Switch to an H2-receptor antagonist
• Add a prokinetic medication
• Refer for upper endoscopy

4. A 62-year-old man presents with new-onset dyspepsia along with unintentional weight loss and fatigue. His exam reveals mild epigastric tenderness, but no palpable masses. What investigation is the highest priority?

• Upper endoscopy
• Abdominal CT scan
• Serum gastrin level
• Fecal occult blood test

5. You are reviewing the results of an upper endoscopy performed on a 48-year-old woman with refractory dyspepsia. The report describes normal-appearing gastric and duodenal mucosa. Which of the following is the most likely diagnosis?

• Gastroesophageal reflux disease (GERD)
• Celiac disease
• Functional dyspepsia
• Peptic ulcer disease