A 29-Year-Old Man Comes to the Office Due to Difficulty

question 38

Multiple Choice

A 29-year-old man comes to the office due to difficulty swallowing for the past 2 years.  Pork, chicken, and steak occasionally "get stuck" in his mid-chest seconds after he swallows.  These episodes occur intermittently but with increasing frequency.  Drinking water usually alleviates the symptoms, but the patient occasionally induces vomiting to eject the food.  He has no trouble swallowing water, broth, or gelatin.  The patient has no pain, cough, or nasal regurgitation after swallowing.  He frequently plays football and takes ibuprofen to relieve aches and pains.  He has seasonal allergies and takes antihistamines during the spring.  Temperature is 37.3 C (99.1 F) , blood pressure is 125/78 mm Hg, pulse is 76/min, and respirations are 12/min.  BMI is 28 kg/m².  Heart and lung sounds are unremarkable.  The abdomen is soft, nontender, and nondistended.  Which of the following is the most likely explanation for this patient's symptoms?

• A)Achalasia
• B)Eosinophilic esophagitis
• C)Esophageal cancer
• D)Herpes esophagitis
• E)Myasthenia gravis
• F)Pill esophagitis

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Definitions:

Guarantee

A promise or assurance, typically in writing, that certain conditions will be fulfilled, especially that a product will meet certain quality and performance standards.

Requirement of Writing

A legal principle that certain contracts or agreements must be in written form to be legally valid.

Third-Party Agreement

A legally binding contract that involves a party outside of the two primary entities involved in a transaction or agreement.

Restricting Competition

Practices or agreements that limit free competition in the marketplace, often scrutinized under antitrust or competition laws.