Multiple Choice Questions (MCQ)

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Category: Critical Care Medicine-Gastrointestinal, Nutrition and Genitourinary Disorders--->Esophagus
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Question 1# Print Question

A 65-year-old man with a history of reflux disease experiences chest discomfort after undergoing an upper endoscopy for surveillance. The patient is hemodynamically stable and a gastrografin esophagram confirms a small contained perforation in the mid esophagus with minimal contamination in the mediastinum.

The most appropriate initial therapy consists of:

A. Thoracotomy with primary repair and appropriate drainage
B. Esophagectomy with immediate reconstruction
C. Esophageal stent placement
D. Diversion cervical esophagostomy

Question 2# Print Question

A 70-year-old woman undergoes upper endoscopy, which reveals a distal esophageal mass. Biopsy of the mass confirms adenocarcinoma with invasion into the mucularis propria. Whole body PET scan shows the distal esophageal mass with no lymphadenopathy and no distal metastases.

Which statement regarding treatment with chemoradiation therapy is most correct for this patient?

A. Preoperative chemoradiation increases postoperative mortality
B. Preoperative chemoradiation before surgical resection improves survival compared to surgery alone
C. Preoperative radiation in addition to chemotherapy improves survival
D. Preoperative chemoradiation commonly results in esophageal perforation

Question 3# Print Question

A 60-year-old male with a history of coronary artery disease and Barrett disease completes a surveillance upper endoscopy. A 1-cm flat plaque is identified with pathology confirming low-grade dysplasia (LGD). Endoscopic ultrasound shows no lymphadenopathy and the tumor is confined to the mucosa.

What is an appropriate next step in treatment?

A. Photodynamic therapy
B. Neoadjuvant chemotherapy
C. Transhiatal esophagectomy
D. Repeat endoscopic surveillance with biopsy in 1 year

Question 4# Print Question

A 40-year-old man with a history of gastroesophageal reflux disease (GERD) undergoes esophageal sampling for Barrett esophagus (BE). An increase in the presence of which biomarker would indicate the presence of this condition?

A. Trefoil factor 1 (TFF1)
B. Fructose-bisphosphatase 1 (FBP1)
C. Forkhead box A3 (FOXA3)
D. Trefoil factor 3 (TFF3)
E. Flavin-containing monooxygenase 5 (FMO5)

Question 5# Print Question

A 60-year-old man with a history of heart failure with reduced ejection fraction (HFrEF), chronic obstructive pulmonary disease (COPD) requiring home oxygen, and GERD presents with dysphagia of solid and liquid foods, which has worsened over the last year. An esophagogastroduodenoscopy (EGD) is performed is performed, which reveals normal esophageal mucosa with negative biopsy results. High-resolution manometry reveals an integrated relaxation pressure of 20 mm Hg and a distal contractile integral (DCI <100 mm Hg/s/cm) of 100%. Esophagram demonstrates a dilated esophagus with poor emptying of barium.

Which of the following therapies would be the most appropriate for this patient? 

A. Nissen fundoplication
B. Botulinum toxin injection
C. Esophageal pneumatic dilation (PD)
D. Peroral endoscopic myotomy (POEM)

Category: Critical Care Medicine-Gastrointestinal, Nutrition and Genitourinary Disorders--->Esophagus
Page: 1 of 1