[MCQ] Diseases of the Esophagus- Part 2

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Diseases of the Esophagus- Part 2

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Congratulations - you have completed Diseases of the Esophagus- Part 2. You scored %%SCORE%% out of %%TOTAL%%. Your performance has been rated as %%RATING%%

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Question 1

Esophageal peristalsis is best studied in ?

A	Upright position
B	Recumbent position
C	Lateral position
D	Head down position

Question 1 Explanation:

Esophageal peristalsis is best studied in the recumbent position, because in the upright position barium passage occurs largely by gravity alone.

Question 2

Motility pattern of esophagus showing reduced amplitude of contractions in lower esophagus, peristaltic or simultaneous in onset with hypotension of LES is suggestive of ?

A	Scleroderma
B	Achalasia
C	Diffuse esophageal spasm
D	None of the above

Question 2 Explanation:

In scleroderma, thoracic esophagus shows reduced amplitude of contractions, which may be peristaltic or simultaneous in onset & hypotension of LES

Question 3

Motility pattern of esophagus showing reduced amplitude of contractions in lower esophagus, simultaneous in onset with hypertensive LES nonrelaxing on swallowing is suggestive of ?

A	Scleroderma
B	Achalasia
C	Diffuse esophageal spasm
D	None of the above

Question 3 Explanation:

In achalasia, lower part of esophagus shows contractions that are reduced in amplitude & simultaneous in onset. In contrast to scleroderma, LES in achalasia is hypertensive and fails to relax in response to a swallow

Question 4

Motility pattern of esophagus showing large amplitude, prolonged and repetitive contractions in lower esophagus, simultaneous in onset is suggestive of ?

A	Scleroderma
B	Achalasia
C	Diffuse esophageal spasm
D	Diffuse esophageal spasm

Question 4 Explanation:

In diffuse esophageal spasm, lower part of esophagus shows simultaneous-onset, large-amplitude, prolonged, repetitive contractions.

Question 5

Esophageal motility studies are helpful in the diagnosis of all except ?

A	Achalasia
B	Diffuse esophageal spasm
C	Scleroderma
D	Mechanical dysphagia

Question 5 Explanation:

Esophageal motility studies are helpful in the diagnosis of esophageal motor disorders (achalasia, spasm, and scleroderma) but are of little value in the differential diagnosis of mechanical dysphagia.

Question 6

Which is the most common type of hiatal hernia ?

A	Type I
B	Type II
C	Type III
D	Type IV

Question 6 Explanation:

Type I or sliding hiatal hernia comprising ~95% of hiatus hernias

Question 7

When colon herniate into the mediastinum, the type of hiatus hernia is ?

A	Type I
B	Type II
C	Type III
D	Type IV

Question 7 Explanation:

With type IV hiatal hernias, viscera other than stomach herniate into mediastinum, most commonly the colon.

Question 8

Intersection of squamous epithelium of tubular oesophagus & columnar epithelium of stomach is termed ?

A	W line
B	W line
C	Y line
D	Z line

Question 8 Explanation:

The intersection of squamous epithelium of the tubular oesophagus & columnar epithelium of stomach is termed Z line, because of jagged appearance of the interface.

Question 9

A lower esophageal mucosal ring is also called ?

A	A ring
B	B ring
C	C ring
D	D ring

Question 9 Explanation:

A lower esophageal mucosal ring, also called B ring, is a thin membranous narrowing at the squamocolumnar mucosal junction

Question 10

Location of ‘Schatzki ring’ is ?

A	Hypopharyngeal
B	Mid esophageal
C	Lower esophageal
D	Lower esophageal

Question 10 Explanation:

Schatzki ring is a lower esophageal mucosal ring. It is a thin, weblike constriction located at the squamo-columnar mucosal junction at or near the border of the LES. It may result from GERD or be congenital in origin

Question 11

Schatzki ring invariably produces dysphagia when the lumen diameter is ?

A	< 1.3 cm
B	< 2.3 cm
C	< 3.3 cm
D	< 4.3 cm

Question 11 Explanation:

Schatzki ring invariably produces dysphagia when the lumen diameter is <1.3 cm.

Question 12

“Steakhouse syndrome” best relates to ?

A	Mouth
B	Oesophagus
C	Stomach
D	Colon

Question 12 Explanation:

Schatzki ring is one of the most common causes of intermittent food impaction, also called “steakhouse syndrome” as meat is a typical instigator.

Question 13

Which of the following is false about Plummer-Vinson syndrome ?

A	Young women
B	Symptomatic proximal esophageal web
C	Iron-deficiency anemia
D	All of the above

Question 13 Explanation:

Symptomatic hypopharyngeal webs and iron-deficiency anemia in middle-aged women constitutes Plummer-Vinson syndrome.

Question 14

Which of the following is false about Zenker’s diverticula ?

A	Hypopharyngeal
B	False diverticula
C	Associated with distal obstruction
D	None of the above

Question 15

Which of the following is false about Zenker’s diverticulum ?

A	Hypopharyngeal
B	False diverticula
C	Associated with distal obstruction
D	None of the above

Question 16

Which of the following is false about Zenker’s diverticulum ?

A	Occurs below the Killian’s triangle
B	Causes halitosis & regurgitation of saliva & food
C	Nasogastric intubation may cause perforation
D	Symptomatic pt’s treated by cricopharyngeal myotomy

Question 16 Explanation:

Zenker’s diverticulum appears in natural zone of weakness in posterior hypopharyngeal wall (Killian’s triangle).

Question 17

Esophageal inlet patch best relates to ?

A	Esophageal atresia
B	Benign esophageal tumor
C	Heterotopic gastric mucosa
D	Zenker’s diverticula

Question 17 Explanation:

Heterotopic gastric mucosa, also known as an esophageal inlet patch, is an area of gastric type epithelium in proximal cervical esophagus. The inlet patch is due to incomplete replacement of embryonic columnar epithelium with squamous epithelium.

Question 18

Which of the following statements about achalasia is false ?

A	Motor disorder of esophageal smooth muscle
B	UES & LES relax normally with swallowing
C	Nonperistaltic contractions in esophageal body
D	Underlying abnormality is loss of intramural neurons

Question 18 Explanation:

With a swallow, pressure in sphincters falls and a contraction wave starts in pharynx and progresses down the esophagus. In achalasia, esophageal body loses peristaltic contractions & are replaced by simultaneous contractions with elevated resting pressure & LES does not relax normally in response to swallowing. Prominent degeneration of nerve cell bodies seen in achalasia.

Question 19

Which of the following statements about achalasia is false ?

A	Underlying abnormality is loss of intramural neurons
B	Inhibitory neurons containing substance P are predominantly involved
C	Inhibitory neurons containing VIP are involved
D	Presence of GE reflux goes against achalasia

Question 19 Explanation:

Inhibitory neurons containing VIP and nitric oxide synthase are predominantly involved

Question 20

Which of the following is not a feature of achalasia ?

A	Dysphagia
B	Gastroesophageal reflux
C	Chest pain
D	Regurgitation

Question 20 Explanation:

Dysphagia, chest pain, regurgitation and weight loss are the main symptoms of achalasia. Presence of gastroesophageal reflux goes against achalasia

Question 21

Chest x-ray in achalasia may show all except ?

A	Absence of the gastric air bubble
B	Tubular mediastinal mass beside the aorta
C	Air-fluid level in mediastinum in upright position
D	Atelectasis

Question 21 Explanation:

A chest x-ray shows absence of the gastric air bubble and sometimes a tubular mediastinal mass beside the aorta. An air-fluid level in the mediastinum in the upright position represents retained food in the esophagus. Barium swallow shows esophageal dilation, and in advanced cases the esophagus may become sigmoid. On fluoroscopy with barium swallow, normal peristalsis is lost in the lower two-thirds of the esophagus. The terminal part of the esophagus shows a persistent beaklike narrowing representing the nonrelaxing LES.

Question 22

In CCK test, paradoxical contraction of LES is found in ?

A	Achalasia
B	Gastric carcinoma
C	Scleroderma
D	Diffuse esophageal spasm

Question 22 Explanation:

In achalasia, Cholecystokinin (CCK) paradoxically causes contraction of LES (CCK test) because neurally transmitted inhibitory effect of CCK is absent & direct excitatory effect of CCK remains unopposed

Question 23

In achalasia, which is the treatment of choice ?

A	Pneumatic dilatation
B	Esophageal resection with gastric pull-up
C	Laparoscopic Heller myotomy of LES
D	Open surgical myotomy of LES

Question 23 Explanation:

Laparoscopic Heller myotomy is currently the procedure of choic

Question 24

Secondary achalasia may be caused by all except ?

A	Ulcerative colitis
B	Chagas’ disease
C	Eosinophilic gastroenteritis
D	Neurodegenerative disorders

Question 25

Which of the following is not a hypertensive motor disorder of esophagus ?

A	Diffuse esophageal spasm (DES)
B	Nutcracker esophagus
C	Hypercontracting LES
D	Hypertensive LES

Question 25 Explanation:

The hypertensive disorders of esophagus include nutcracker esophagus, hypercontracting LES and hypertensive LES. DES is characterized by nonperistaltic contractions.

Question 26

Esophageal contractions are normally peristaltic but hypertensive in ?

A	Nutcracker esophagus
B	Hypercontracting LES
C	Hypertensive LES
D	All of the above

Question 26 Explanation:

In nutcracker esophagus, esophageal contractions are normally peristaltic but hypertensive. In hypercontracting LES, normal sphincter relaxation is followed by hypertensive contraction. In hypertensive LES, basal LES pressure is elevated, but sphincter relaxation and contraction are normal

Question 27

“Corkscrew” esophagus is typical of ?

A	Diffuse esophageal spasm (DES)
B	Achalasia
C	Carcinoma esophagus
D	GERD

Question 28

Which of the following contributes to the development of gastroesophageal reflux disease (GERD) ?

A	Transient LES relaxations
B	LES hypotension
C	Anatomic distortion of esophagogastric junction
D	All of the above

Question 29

Which of the following may have a protective effect in GERD patients ?

A	Zollinger-Ellison syndrome
B	Chronic H. pylori gastritis
C	Hiatus hernia
D	Scleroderma

Question 29 Explanation:

Chronic H. pylori gastritis may have a protective effect in GERD by inducing atrophic gastritis with concomitant hypoacidity

Question 30

Which out of the following conditions has associations with GERD ?

A	Pulmonary fibrosis
B	Chronic sinusitis
C	Cardiac arrhythmias
D	All of the above

Question 30 Explanation:

Extraesophageal syndromes that have established association to GERD include chronic cough, laryngitis, asthma & dental erosions. Other conditions like pharyngitis, chronic bronchitis, pulmonary fibrosis, chronic sinusitis, cardiac arrhythmias, sleep apnea, and recurrent aspiration pneumonia have proposed associations with GERD.

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See all quizzes of Diseases of the Esophagus at here:

Diseases of the Esophagus- Part 1| Diseases of the Esophagus- Part 2| Diseases of the Esophagus- Part 3

1.Esophageal peristalsis is best studied in ?
A. Upright position
B. Recumbent position
C. Lateral position
D. Head down position

2. Motility pattern of esophagus showing reduced amplitude of
contractions in lower esophagus, peristaltic or simultaneous
in onset with hypotension of LES is suggestive of ?
A. Scleroderma
B. Achalasia
C. Diffuse esophageal spasm
D. None of the above

3. Motility pattern of esophagus showing reduced amplitude of
contractions in lower esophagus, simultaneous in onset with
hypertensive LES nonrelaxing on swallowing is suggestive of ?
A. Scleroderma
B. Achalasia
C. Diffuse esophageal spasm
D. None of the above

4. Motility pattern of esophagus showing large amplitude,
prolonged and repetitive contractions in lower esophagus,
simultaneous in onset is suggestive of ?
A. Scleroderma
B. Achalasia
C. Diffuse esophageal spasm
D. None of the above

5. Esophageal motility studies are helpful in the diagnosis of all
except ?
A. Achalasia
B. Diffuse esophageal spasm
C. Scleroderma
D. Mechanical dysphagia

6. Which is the most common type of hiatal hernia ?
A. Type I
B. Type II

C. Type III
D. Type IV

7. When colon herniate into the mediastinum, the type of hiatus
hernia is ?
A. Type I
B. Type II
C. Type III
D. Type IV

8. Intersection of squamous epithelium of tubular oesophagus
& columnar epithelium of stomach is termed ?
A. W line
B. X line
C. Y line
D. Z line

9. A lower esophageal mucosal ring is also called ?
A. A ring
B. B ring
C. C ring
D. D ring

10. Location of ‘Schatzki ring’ is ?
A. Hypopharyngeal
B. Mid esophageal
C. Lower esophageal
D. Any of the above

11. Schatzki ring invariably produces dysphagia when the lumen
diameter is ?
A. < 1.3 cm
B. < 2.3 cm
C. < 3.3 cm
D. < 4.3 cm

12. “Steakhouse syndrome” best relates to ?
A. Mouth
B. Oesophagus

C. Stomach
D. Colon

13. Which of the following is false about Plummer-Vinson syndrome ?
A. Young women
B. Symptomatic proximal esophageal web
C. Iron-deficiency anemia
D. All of the above

14. Which of the following is false about Zenker’s diverticula ?
A. Hypopharyngeal
B. False diverticula
C. Associated with distal obstruction
D. None of the above
15. Which of the following is false about Zenker’s diverticulum ?
A. Occurs below the Killian’s triangle
B. Causes halitosis & regurgitation of saliva & food
C. Nasogastric intubation may cause perforation
D. Symptomatic pt’s treated by cricopharyngeal myotomy

16. Esophageal inlet patch best relates to ?
A. Esophageal atresia
B. Benign esophageal tumor
C. Heterotopic gastric mucosa
D. Zenker’s diverticula

17. Which of the following statements about achalasia is false ?
A. Motor disorder of esophageal smooth muscle
B. UES & LES relax normally with swallowing
C. Nonperistaltic contractions in esophageal body
D. Underlying abnormality is loss of intramural neurons

18. Which of the following statements about achalasia is false ?
A. Underlying abnormality is loss of intramural neurons
B. Inhibitory neurons containing substance P are
predominantly involved
C. Inhibitory neurons containing VIP are involved

D. Presence of GE reflux goes against achalasia

19. Which of the following is not a feature of achalasia ?
A. Dysphagia
B. Gastroesophageal reflux
C. Chest pain
D. Regurgitation

20. Chest x-ray in achalasia may show all except ?
A. Absence of the gastric air bubble
B. Tubular mediastinal mass beside the aorta
C. Air-fluid level in mediastinum in upright position
D. Atelectasis

21. In CCK test, paradoxical contraction of LES is found in ?
A. Achalasia
B. Gastric carcinoma
C. Scleroderma
D. Diffuse esophageal spasm

22. In achalasia, which is the treatment of choice ?
A. Pneumatic dilatation
B. Esophageal resection with gastric pull-up
C. Laparoscopic Heller myotomy of LES
D. Open surgical myotomy of LES

23. Secondary achalasia may be caused by all except ?
A. Ulcerative colitis
B. Chagas’ disease
C. Eosinophilic gastroenteritis
D. Neurodegenerative disorders

24. Which of the following is not a hypertensive motor disorder of esophagus ?
A. Diffuse esophageal spasm (DES)
B. Nutcracker esophagus

C. Hypercontracting LES
D. Hypertensive LES

25. Esophageal contractions are normally peristaltic but hypertensive in ?
A. Nutcracker esophagus
B. Hypercontracting LES
C. Hypertensive LES
D. All of the above

26. “Corkscrew” esophagus is typical of ?
A. Diffuse esophageal spasm (DES)
B. Achalasia
C. Carcinoma esophagus
D. GERD

27. Which of the following contributes to the development of
gastroesophageal reflux disease (GERD) ?
A. Transient LES relaxations
B. LES hypotension
C. Anatomic distortion of esophagogastric junction
D. All of the above
28. Which of the following may have a protective effect in GERD patients ?
A. Zollinger-Ellison syndrome
B. Chronic H. pylori gastritis
C. Hiatus hernia
D. Scleroderma

29. Which out of the following conditions has associations with GERD ?
A. Pulmonary fibrosis
B. Chronic sinusitis
C. Cardiac arrhythmias
D. All of the above

Diseases of the Esophagus

[MCQ] Diseases of the Esophagus- Part 2

I. Start the exam by click the “Start” button

Diseases of the Esophagus- Part 2

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[MCQ] Diseases of the Esophagus- Part 1

[MCQ] Diseases of the Esophagus- Part 3

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