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Retired NBME Step 2 CK Form 7 Answers

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submitted by โˆ—carolebaskin(109)
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That's a bird's beak deformity!

Nerve damage causes increased LES tone and decreased peristalsis

If they show you a picture of a barium swallow, it can only be a few things

  1. achalasia (bird's beak)
  2. Zenker (outpouching)
  3. volvulus/malrotation (corkscrew)
  4. stricture (symmetric narrowing)
  5. cancer (crazy, irregular stricture "hold up" prestricture dilatation; shouldering? whatever that means)
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submitted by โˆ—step_prep5(246)
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  • Previously healthy young woman with dysphagia to solids and liquids with upper endoscopy showing retained secretions in the esophagus with barium swallow showing โ€œbirdโ€™s beak signโ€, all of which is most consistent with achalasia
  • Key idea: Achalasia characterized by absence of esophageal peristalsis and impaired relaxation of lower esophageal sphincter

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