DYSPHAGIA

Question 1

75 yo M presents with dysphagia that
started with solids and progressed to
liquids. He is an alcoholic and a heavy
smoker. He has had an unintentional
weight loss of 7 kg over the past four
months.

Answer 1

Esophageal cancer CBC
Achalasia CXR
Esophagitis Endoscopy with biopsy
Systemic sclerosis Barium swallow
Esophageal stricture CT—chest
Amyotrophic lateral sclerosis

Question 2

45 yo F presents with dysphagia for two
weeks together with fatigue and a craving
for ice and clay.

Answer 2

Plummer-Vinson syndrome CBC
Esophageal cancer Serum iron, ferritin, TIBC
Esophagitis Barium swallow
Achalasia Endoscopy
Systemic sclerosis
Mitral valve stenosis

Question 3

48 yo F presents with dysphagia for both
solid and liquid foods that has slowly
progressed in severity over the past year.
It is associated with regurgitation of
undigested food, especially at night.

Answer 3

Achalasia CXR
Plummer-Vinson syndrome Endoscopy
Esophageal cancer Barium swallow
Esophagitis Esophageal manometry
Systemic sclerosis
Mitral valve stenosis
Esophageal stricture
Zenker’s diverticulum

Question 4

38 yo M presents with dysphagia and pain
on swallowing solids more than liquids.
Exam reveals oral thrush.

Answer 4

Esophagitis (CMV, HSV, pillinduced) CBC
Systemic sclerosis Endoscopy
GERD Barium swallow
Esophageal stricture HIV antibody
Zenker’s diverticulum CD4 count