A 43-Year-Old Man Is Evaluated for Retrosternal Discomfort and Dysphagia

question 341

Multiple Choice

A 43-year-old man is evaluated for retrosternal discomfort and dysphagia for the past several months.  He smokes a pack of cigarettes daily and drinks alcohol on weekends.  His BMI is 32.8 kg/m².  Physical examination is unremarkable.  Esophageal manometry is performed; after a single swallow of 5 mL of water, the tracings appear as shown in the image below. Which of the following is the most likely diagnosis in this patient?

• A)Achalasia
• B)Cricopharyngeal dysfunction
• C)Diffuse esophageal spasm
• D)Esophageal stricture
• E)Systemic sclerosis

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Definitions:

Gain-sharing

A performance-based compensation strategy where employees receive bonuses based on the improvement of company metrics.

Productivity Increases

The improvement in the efficiency of production processes, leading to more output from the same amount of inputs.

Measurable Cost Reductions

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Employee Assistance

Programs and services provided by employers to help employees deal with personal problems that might adversely impact their work performance, health, and well-being.