GERD and Peptic Ulcer Disease USMLE Step 1 Practice Question
A 72-year-old man with a 3-year history of omeprazole use presents with halitosis, regurgitation of undigested food, and chronic nonproductive cough. His wife reports a gurgling sound in his neck during swallowing and nocturnal choking episodes. Vital signs show BP 138/82, HR 88, RR 16, temp 37.2°C, SpO2 98% on room air. Chest X-ray reveals no aspiration pneumonia. Upper endoscopy demonstrates a pharyngeal pouch without esophageal stricture. Which of the following is the most likely diagnosis?
Answer choices
- APeptic ulcer disease
- BZenker diverticulumCorrect answer
- CEsophageal varices
- DBoerhaave syndrome
- EAchalasia
- FEpiphrenic diverticulum
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