Pharynx: manometry for achalasia: practice question

A ENT question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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ENT · Pharynx: manometry for achalasia

Sample item

A 40-year-old has progressive dysphagia to solids and liquids with regurgitation. Barium shows a dilated oesophagus with a beaked lower end. Which investigation confirms the motility disorder?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. High-resolution oesophageal manometry showing failure of lower sphincter relaxation

Achalasia is failure of the lower oesophageal sphincter to relax with loss of peristalsis, which manometry demonstrates. Endoscopy excludes a malignant pseudoachalasia. Treatment includes pneumatic dilatation, Heller myotomy or peroral endoscopic myotomy.

Option by option

  • A. Plain chest film

    A chest film cannot confirm the motility defect.

  • B. Laryngeal electromyography

    Laryngeal EMG assesses vocal cord neuromuscular function.

  • C. High-resolution oesophageal manometry showing failure of lower sphincter relaxation (correct)

    Correct. Manometry shows incomplete sphincter relaxation and absent peristalsis.

  • D. Pharyngeal pH study

    A pharyngeal pH study evaluates reflux.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this ENT question

What is the answer to this ENT question?

The best answer is C, High-resolution oesophageal manometry showing failure of lower sphincter relaxation. Achalasia is failure of the lower oesophageal sphincter to relax with loss of peristalsis, which manometry demonstrates.

Why is "Plain chest film" not the answer?

A chest film cannot confirm the motility defect.

Why is "Laryngeal electromyography" not the answer?

Laryngeal EMG assesses vocal cord neuromuscular function.

Why is "Pharyngeal pH study" not the answer?

A pharyngeal pH study evaluates reflux.

What concept does this question test?

It tests Pharynx: manometry for achalasia in ENT. Endoscopy excludes a malignant pseudoachalasia. Treatment includes pneumatic dilatation, Heller myotomy or peroral endoscopic myotomy.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Pharynx: manometry for achalasia?

Learn tuning fork results and audiogram patterns by sketching them. Then use the flashcards and the other ENT questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.