GERD and Peptic Ulcer Disease USMLE Step 1 Practice Question
A 58-year-old obese man with a 10-year history of GERD presents with worsening dysphagia and 8-kg unintended weight loss over 3 months. He takes omeprazole daily but remains symptomatic. Vital signs: BP 128/82, HR 92, RR 16, Temp 37°C, SpO2 98%. Upper endoscopy reveals a distal esophageal mass within an area of intestinal metaplasia. Biopsy shows adenocarcinoma. No dyspnea or hematemesis noted. Which diagnosis best explains these findings?
Answer choices
- AZenker diverticulum
- BEsophageal squamous cell carcinoma
- CEsophageal adenocarcinomaCorrect answer
- DEsophageal candidiasis
- EDiffuse esophageal spasm
- FAchalasia with secondary malignant transformation
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