GERD and Peptic Ulcer Disease USMLE Step 1 Practice Question
A 45-year-old man presents with progressive dysphagia to solids and liquids, nocturnal regurgitation, and 8-kg weight loss over 3 months. He denies heartburn. Vital signs: BP 128/82, HR 92, RR 16, temp 37°C, SpO2 98%. Chest X-ray shows a dilated esophagus with air-fluid level. Esophageal manometry reveals increased lower esophageal sphincter tone with incomplete relaxation and absent peristalsis. Which of the following is the most likely diagnosis?
Answer choices
- AAchalasiaCorrect answer
- BGERD
- CEsophageal adenocarcinoma
- DDiffuse esophageal spasm
- EScleroderma esophagus
- FChagas disease with megaesophagus
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