The paranoid patient constantly asks, ''Why are you asking me that? Do I have... ?'' When the interviewer asks the many questions in the review of systems, the patient responds, ''Who told you about that?'' Paranoid patients think there is some devious plan and that people are constantly talking about them. The patients' suspiciousness can sometimes be handled by the interviewer's saying, ''These are routine questions that I ask all my patients.'' Reassurance tends to be threatening to these patients and should not be used because it tends to produce more suspicion. The patient's delusion is beyond reason. The interviewer should therefore complete the questioning and not try to convince such patients about their false ideations. Avoidance of any anger by the interviewer is of paramount importance.
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Gastroesophageal reflux disease is the medical term for what we know as acid reflux. Acid reflux occurs when the stomach releases its liquid back into the esophagus, causing inflammation and damage to the esophageal lining. The regurgitated acid most often consists of a few compoundsbr acid, bile, and pepsin.