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The history of recurrent pyelonephritis + fever is also a giveaway that this was due to a bacterial infection.
This is the best explanation IMO
Also makes me feel like an absolute idiot
also per FA, misoprostol is used specifically for prevention of NSAID_induced peptic ulcers
I think the key to answering this question is to remember the specific side effects associated with misoprostol -> severe diarrhea. No other GERD medications in the answer choices have this side effect. Antiacids could also cause diarrhea (MgOH) but not in the answer choices
Actually one of the side effects of PPI use is diarrhea (and other GI issues). Not in FA but emphasized in AMBOSS and Sketchy. I got this Q wrong for that reason but I see now why Misoprostol is the better answer.