ABSITE - ESOPHAGUS – QUESTIONS WITH
CORRECT ANSWERS 2025
AN75-year-
oldNmaleNpresentsNtoNtheNclinicNwithNaNfeelingNofNfullnessNinNhisNthroatNandNtroubleNswallowing.NHeNcomp
lainsNofNaNworseningNcoughNandNmoreNrecently,NbadNbreathNtoNtheNpointNheNavoidsNgoingNoutNinNpublic.N
WhatNisNtheNmostNappropriateNfirstNdiagnosticNtest?
A.NPlainNchestNx-ray
B.NBariumNesophagram
C.NUpperNendoscopy
D.NManometry
E.NCTNofNtheNchestN-NCORRECTNANSWERN-BariumNesophagram
Correct.
ThisNpatientNpresentsNwithNclassicNsymptomsNofNZenker'sNdiverticulum,NwhichNisNmostNcommonlyNfoundNi
nNelderlyNpatientsNandNisNbelievedNtoNbeNtheNresultNofNlossNofNtissueNelasticityNandNmuscleNtoneNassociate
dNwithNaging.NItNisNfoundNherniatingNintoNKillian'sNtriangle,NlocatedNatNtheNjunctionNofNtheNhypopharynxNan
dNtheNesophagus.NTheNmostNappropriateNfirstNdiagnosticNtestNwouldNbeNaNbariumNesophagram,Nespecially
NlateralNviewsNsinceNitNisNusuallyNfoundNposteriorlyNalongsideNtheNesophagus.NUpperNendoscopyNandNman
ometryNareNnotNnecessaryNinNdiagnosingNZenker's.
AN50-year-
oldNmaleNpresentsNtoNtheNERNwithNchestNpainN6NhoursNafterNundergoingNpneumaticNdilationNforNachalasia.
NANwater-solubleNcontrastNUGINdemonstratesNaNsmallNwell-
containedNperforation.NTheNdistalNesophagusNappearsNpatent.NTheNpatientNisNhemodynamicallyNstable.NW
hatNisNtheNnextNbestNstepNinNmanagement?
A.NObserveNandNattemptNPONtrial.
B.NAdmit,NkeepNNPONandNstartNbroad-spectrumNantibiotics.
C.NPlacementNofNaNCT-guidedNmediastinalNdrain
D.NImmediateNoperativeNdebridement
E.NDischargeNpatientNwithNcloseNfollow-up.N-NCORRECTNANSWERN-Admit,NkeepNNPONandNstartNbroad-
spectrumNantibiotics.
Correct.
MostNiatrogenicNesophagealNperforationsNsecondaryNtoNpneumaticNdilationNareNsmallNandNwell-
contained.NTheNpatientNshouldNbeNinitiallyNconsideredNforNnon-
operativeNmanagementNwithNantibioticsNandNcloseNmonitoringNbasedNonNtheNaforementionedNUGINfindin
,gsNifNtheNdistalNobstructionNhasNbeenNresolvedNandNtheNpatientNremainsNhemodynamicallyNstable.NDevelo
pmentNofNconcerningNsignsNmayNultimatelyNwarrantNinterventionNsuchNasNCT-
guidedNdrainageNorNoperativeNmanagement.NAttemptingNPONtrialNorNdischargeNwouldNbeNinappropriateNa
ndNprematureNatNthisNtime.
AN35-year-
oldNmaleNpresentsNtoNtheNERNcomplainingNofNchestNpain.NHeNwentNoutNtoNdinnerN2NnightsNagoNandNrapidly
NdevelopedNabdominalNcramps,NemesisNandNdiarrhea;Nhowever,NheNdidNnotNnoticeNbloodNinNhisNvomitNorN
stools.NThisNmorningNheNwokeNupNwithNacuteNonsetNofN10/10NchestNpainNandNdescribedNfeelingNlighthead
edNandNdizzy.NHeNdeniesNanyNrecentNalcoholNuse.NCurrentNvitalNsignsNare:NHRN120Nbpm,NBPN100/68NmmHg
,NRN24/minNandNTN101.6°F.NWhichNtestNisNmostNlikelyNtoNidentifyNtheNdiagnosis?
A.NEKG
B.NFlatNplateNandNuprightNofNtheNabdomen
C.NEsophagram
D.NStoolNpathogens
E.NUreaNbreathNtestN-NCORRECTNANSWERN-Esophagram
Correct.
TheNcorrectNdiagnosisNisNspontaneousNesophagealNperforation,NorNBoerhaaveNsyndrome.NTheNstemNidenti
fiesNaNrecentNepisodeNofNfoodNpoisoningNwithNsignificantNemesis.NAlthoughNthisNpatientNdoesn'tNdrink,Nalc
oholismNandNbingeNdrinkingNwithNemesisNisNanotherNredNflagNforNesophagealNspontaneousNperforation.NC
ontrastNesophagramNisNtheNtestNmostNlikelyNtoNidentifyNtheNdiagnosis.NCTNscan,NalthoughNnotNlisted,NisNals
oNhelpful.NEKGNwouldNbeNhelpfulNtoNidentifyNaNcardiacNetiologyNsuchNasNMI,NbutNinNourNpatientNwouldNlikel
yNjustNshowNsinusNtachycardia.NAbdominalNseriesNwouldNhelpNdiagnoseNbowelNobstructionNorNpneumoper
itoneumNfromNaNhollowNviscusNperforation.NStoolNpathogenNmayNbeNpositiveNgivenNrecentNgastroenteritis;
Nhowever,NthisNisNnotNtheNcauseNofNdelayedNsepsis.NUreaNbreathNtestNisNusedNtoNdiagnoseNH.NpyloriNrelated
NtoNpepticNulcerNdisease.
AN45-year-
oldNmaleNpresentsNtoNtheNERNcomplainingNofNnauseaNandNvomiting.NHeNsmellsNofNalcoholNandNnotesNaNcha
ngeNinNemesisNfromNbiliousNtoNbloodyNacutelyNthisNevening.NUponNfurtherNquestioning,NheNadmitsNtoNbing
eNdrinkingNoftenNtoNtheNpointNofNvomiting.NHisNcurrentNvitalsNare:NHRN110Nbpm,NBPN120/74NmmHg,NRN22/
minNandNTN99.3°F.NWhatNisNtheNlikelyNcauseNofNhisNsymptoms?
A.NPepticNulcerNdisease
B.NEsophagealNvarices
C.NEsophagealNperforation
D.NEsophagealNcancer
, E.NMallory-WeissNsyndromeN-NCORRECTNANSWERN-Mallory-WeissNsyndrome
Correct.
TheNpatientNhasNMallory-
WeissNsyndrome.NFromNhisNhistory,NheNappearsNtoNbeNanNalcoholicNonNaNrecentNbinge.NAlthoughNtheNdiffer
entialNforNupperNGINbleedingNandNemesisNisNbroad,NbiliousNemesisNwhichNacutelyNchangesNtoNbloodyNemes
isNisNhighlyNsuggestiveNofNaNMallory-
WeissNtear,NwhichNoccursNatNtheNjunctionNofNtheNesophagusNandNgastricNcardia.NCancerNisNlikelyNtoNhaveNaN
moreNindolentNobstructiveNpresentation.NPerforationNoftenNpresentsNwithNtachycardia,NleukocytosisNandNf
ever.
AN42-year-
oldNotherwiseNhealthyNfemaleNwasNnotedNtoNhaveNpersistentNUGINbleedingNfollowingNanNepisodeNofNsever
eNvomiting.NEndoscopicNevaluationNnotesNaNmucosalNtearNinNtheNgastricNcardia.NMultipleNendoscopicNatte
mptsNfailNtoNcontrolNtheNbleeding.NTheNpatientNisNnowNhemodynamicallyNunstable.NWhatNisNtheNnextNstepN
inNmanagement?
A.NOctreotide
B.NContinuousNprotonNpumpNinhibitor
C.NRepeatNattemptNatNendoscopicNelectrocoagulation
D.NAngiographicNembolization
E.NOversewingNlacerationNthroughNanNanteriorNgastrostomyN-NCORRECTNANSWERN-
OversewingNlacerationNthroughNanNanteriorNgastrostomy
Correct.
Mallory-
WeissNtearsNareNoftenNcausedNbyNforcefulNretchingNorNcoughing.NSimilarNtoNotherNsourcesNofNUGINbleeding
,NinitialNtreatmentNtypicallyNconsistsNofNnon-
operativeNmedicalNmanagementNandNendoscopicNmaneuvers.NHowever,NinNcasesNofNpersistentNbleedingNa
ndNconcurrentNhemodynamicNinstability,NoperativeNinterventionNisNwarranted.NTheNmucosalNtearNisNtypica
llyNlocatedNinNtheNgastricNcardiaNandNcanNbeNaccessedNthroughNanNanteriorNgastrostomy.NContinuedNmedic
alNtherapyNwouldNnotNbeNappropriateNatNthisNtime.NAngiographicNembolizationNcanNbeNutilizedNinNcasesNw
henNpatientsNareNnotNsuitableNorNunwillingNtoNundergoNsurgery.
AN1-year-
oldNchildNpresentsNtoNtheNemergencyNroomNafterNhavingNswallowedNaNpenny.NAtNwhichNlevelNofNtheNesoph
agusNisNtheNcoinNmostNlikelyNtoNbecomeNlodged?
A.NCervicalNesophagus
B.NMidNesophagus
CORRECT ANSWERS 2025
AN75-year-
oldNmaleNpresentsNtoNtheNclinicNwithNaNfeelingNofNfullnessNinNhisNthroatNandNtroubleNswallowing.NHeNcomp
lainsNofNaNworseningNcoughNandNmoreNrecently,NbadNbreathNtoNtheNpointNheNavoidsNgoingNoutNinNpublic.N
WhatNisNtheNmostNappropriateNfirstNdiagnosticNtest?
A.NPlainNchestNx-ray
B.NBariumNesophagram
C.NUpperNendoscopy
D.NManometry
E.NCTNofNtheNchestN-NCORRECTNANSWERN-BariumNesophagram
Correct.
ThisNpatientNpresentsNwithNclassicNsymptomsNofNZenker'sNdiverticulum,NwhichNisNmostNcommonlyNfoundNi
nNelderlyNpatientsNandNisNbelievedNtoNbeNtheNresultNofNlossNofNtissueNelasticityNandNmuscleNtoneNassociate
dNwithNaging.NItNisNfoundNherniatingNintoNKillian'sNtriangle,NlocatedNatNtheNjunctionNofNtheNhypopharynxNan
dNtheNesophagus.NTheNmostNappropriateNfirstNdiagnosticNtestNwouldNbeNaNbariumNesophagram,Nespecially
NlateralNviewsNsinceNitNisNusuallyNfoundNposteriorlyNalongsideNtheNesophagus.NUpperNendoscopyNandNman
ometryNareNnotNnecessaryNinNdiagnosingNZenker's.
AN50-year-
oldNmaleNpresentsNtoNtheNERNwithNchestNpainN6NhoursNafterNundergoingNpneumaticNdilationNforNachalasia.
NANwater-solubleNcontrastNUGINdemonstratesNaNsmallNwell-
containedNperforation.NTheNdistalNesophagusNappearsNpatent.NTheNpatientNisNhemodynamicallyNstable.NW
hatNisNtheNnextNbestNstepNinNmanagement?
A.NObserveNandNattemptNPONtrial.
B.NAdmit,NkeepNNPONandNstartNbroad-spectrumNantibiotics.
C.NPlacementNofNaNCT-guidedNmediastinalNdrain
D.NImmediateNoperativeNdebridement
E.NDischargeNpatientNwithNcloseNfollow-up.N-NCORRECTNANSWERN-Admit,NkeepNNPONandNstartNbroad-
spectrumNantibiotics.
Correct.
MostNiatrogenicNesophagealNperforationsNsecondaryNtoNpneumaticNdilationNareNsmallNandNwell-
contained.NTheNpatientNshouldNbeNinitiallyNconsideredNforNnon-
operativeNmanagementNwithNantibioticsNandNcloseNmonitoringNbasedNonNtheNaforementionedNUGINfindin
,gsNifNtheNdistalNobstructionNhasNbeenNresolvedNandNtheNpatientNremainsNhemodynamicallyNstable.NDevelo
pmentNofNconcerningNsignsNmayNultimatelyNwarrantNinterventionNsuchNasNCT-
guidedNdrainageNorNoperativeNmanagement.NAttemptingNPONtrialNorNdischargeNwouldNbeNinappropriateNa
ndNprematureNatNthisNtime.
AN35-year-
oldNmaleNpresentsNtoNtheNERNcomplainingNofNchestNpain.NHeNwentNoutNtoNdinnerN2NnightsNagoNandNrapidly
NdevelopedNabdominalNcramps,NemesisNandNdiarrhea;Nhowever,NheNdidNnotNnoticeNbloodNinNhisNvomitNorN
stools.NThisNmorningNheNwokeNupNwithNacuteNonsetNofN10/10NchestNpainNandNdescribedNfeelingNlighthead
edNandNdizzy.NHeNdeniesNanyNrecentNalcoholNuse.NCurrentNvitalNsignsNare:NHRN120Nbpm,NBPN100/68NmmHg
,NRN24/minNandNTN101.6°F.NWhichNtestNisNmostNlikelyNtoNidentifyNtheNdiagnosis?
A.NEKG
B.NFlatNplateNandNuprightNofNtheNabdomen
C.NEsophagram
D.NStoolNpathogens
E.NUreaNbreathNtestN-NCORRECTNANSWERN-Esophagram
Correct.
TheNcorrectNdiagnosisNisNspontaneousNesophagealNperforation,NorNBoerhaaveNsyndrome.NTheNstemNidenti
fiesNaNrecentNepisodeNofNfoodNpoisoningNwithNsignificantNemesis.NAlthoughNthisNpatientNdoesn'tNdrink,Nalc
oholismNandNbingeNdrinkingNwithNemesisNisNanotherNredNflagNforNesophagealNspontaneousNperforation.NC
ontrastNesophagramNisNtheNtestNmostNlikelyNtoNidentifyNtheNdiagnosis.NCTNscan,NalthoughNnotNlisted,NisNals
oNhelpful.NEKGNwouldNbeNhelpfulNtoNidentifyNaNcardiacNetiologyNsuchNasNMI,NbutNinNourNpatientNwouldNlikel
yNjustNshowNsinusNtachycardia.NAbdominalNseriesNwouldNhelpNdiagnoseNbowelNobstructionNorNpneumoper
itoneumNfromNaNhollowNviscusNperforation.NStoolNpathogenNmayNbeNpositiveNgivenNrecentNgastroenteritis;
Nhowever,NthisNisNnotNtheNcauseNofNdelayedNsepsis.NUreaNbreathNtestNisNusedNtoNdiagnoseNH.NpyloriNrelated
NtoNpepticNulcerNdisease.
AN45-year-
oldNmaleNpresentsNtoNtheNERNcomplainingNofNnauseaNandNvomiting.NHeNsmellsNofNalcoholNandNnotesNaNcha
ngeNinNemesisNfromNbiliousNtoNbloodyNacutelyNthisNevening.NUponNfurtherNquestioning,NheNadmitsNtoNbing
eNdrinkingNoftenNtoNtheNpointNofNvomiting.NHisNcurrentNvitalsNare:NHRN110Nbpm,NBPN120/74NmmHg,NRN22/
minNandNTN99.3°F.NWhatNisNtheNlikelyNcauseNofNhisNsymptoms?
A.NPepticNulcerNdisease
B.NEsophagealNvarices
C.NEsophagealNperforation
D.NEsophagealNcancer
, E.NMallory-WeissNsyndromeN-NCORRECTNANSWERN-Mallory-WeissNsyndrome
Correct.
TheNpatientNhasNMallory-
WeissNsyndrome.NFromNhisNhistory,NheNappearsNtoNbeNanNalcoholicNonNaNrecentNbinge.NAlthoughNtheNdiffer
entialNforNupperNGINbleedingNandNemesisNisNbroad,NbiliousNemesisNwhichNacutelyNchangesNtoNbloodyNemes
isNisNhighlyNsuggestiveNofNaNMallory-
WeissNtear,NwhichNoccursNatNtheNjunctionNofNtheNesophagusNandNgastricNcardia.NCancerNisNlikelyNtoNhaveNaN
moreNindolentNobstructiveNpresentation.NPerforationNoftenNpresentsNwithNtachycardia,NleukocytosisNandNf
ever.
AN42-year-
oldNotherwiseNhealthyNfemaleNwasNnotedNtoNhaveNpersistentNUGINbleedingNfollowingNanNepisodeNofNsever
eNvomiting.NEndoscopicNevaluationNnotesNaNmucosalNtearNinNtheNgastricNcardia.NMultipleNendoscopicNatte
mptsNfailNtoNcontrolNtheNbleeding.NTheNpatientNisNnowNhemodynamicallyNunstable.NWhatNisNtheNnextNstepN
inNmanagement?
A.NOctreotide
B.NContinuousNprotonNpumpNinhibitor
C.NRepeatNattemptNatNendoscopicNelectrocoagulation
D.NAngiographicNembolization
E.NOversewingNlacerationNthroughNanNanteriorNgastrostomyN-NCORRECTNANSWERN-
OversewingNlacerationNthroughNanNanteriorNgastrostomy
Correct.
Mallory-
WeissNtearsNareNoftenNcausedNbyNforcefulNretchingNorNcoughing.NSimilarNtoNotherNsourcesNofNUGINbleeding
,NinitialNtreatmentNtypicallyNconsistsNofNnon-
operativeNmedicalNmanagementNandNendoscopicNmaneuvers.NHowever,NinNcasesNofNpersistentNbleedingNa
ndNconcurrentNhemodynamicNinstability,NoperativeNinterventionNisNwarranted.NTheNmucosalNtearNisNtypica
llyNlocatedNinNtheNgastricNcardiaNandNcanNbeNaccessedNthroughNanNanteriorNgastrostomy.NContinuedNmedic
alNtherapyNwouldNnotNbeNappropriateNatNthisNtime.NAngiographicNembolizationNcanNbeNutilizedNinNcasesNw
henNpatientsNareNnotNsuitableNorNunwillingNtoNundergoNsurgery.
AN1-year-
oldNchildNpresentsNtoNtheNemergencyNroomNafterNhavingNswallowedNaNpenny.NAtNwhichNlevelNofNtheNesoph
agusNisNtheNcoinNmostNlikelyNtoNbecomeNlodged?
A.NCervicalNesophagus
B.NMidNesophagus
