A 53-Year-Old Man with Nocturnal Cough Undergoes an Upper Endoscopy

question 130

Multiple Choice

A 53-year-old man with nocturnal cough undergoes an upper endoscopy with esophageal biopsy.  Light microscopy of the tissue specimen shows elongation of the lamina propria papillae with several eosinophils and neutrophils scattered within the squamous epithelium.  The patient takes metformin and enalapril for diabetes mellitus and hypertension, respectively.  He is started on pantoprazole, and after 2 weeks his cough symptoms resolve.  Which of the following was the most likely cause of his symptoms?

• A)Absent esophageal peristaltic movements
• B)Allergen-mediated esophageal disease
• C)Gastroesophageal junction incompetence
• D)Mucosal disruption from fungal infection
• E)Mucosal disruption from viral infection
• F)Pill-induced esophageal mucosa damage

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Definitions:

Fractures

Breaks or cracks in rocks along which there is no movement of the sides.

Photovoltaic Panels

Devices that convert sunlight directly into electricity through the photovoltaic effect.

Biomass Energy

energy produced from organic materials, such as plant and animal waste, used as fuel.

Ethanol

A type of alcohol that is produced when corn, sugarcane, and other plant material is soaked in ammonia, fermented, and distilled.