Abdominal and GI imaging: oesophageal carcinoma on barium: practice question

A Radiology 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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Radiology · Abdominal and GI imaging: oesophageal carcinoma on barium

Sample item

A 65-year-old smoker has progressive dysphagia to solids and weight loss. A barium swallow shows a short irregular stricture with abrupt, overhanging (shouldered) margins and mucosal destruction. What is the diagnosis?

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

The answer and the reasoning

D. Carcinoma of the oesophagus

An apple-core stricture with shouldered edges and an irregular mucosa is the classic barium appearance of oesophageal cancer. Peptic strictures taper smoothly, and achalasia gives a beak. Endoscopy with biopsy and CT staging follow.

Option by option

  • A. Oesophageal web

    A web is a thin membrane, not a long irregular stricture.

  • B. Achalasia cardia

    Achalasia shows a dilated oesophagus with a smooth beak.

  • C. Peptic stricture with smooth tapering

    A peptic stricture tapers smoothly with intact mucosa.

  • D. Carcinoma of the oesophagus (correct)

    Correct. Shouldering and an irregular apple-core stricture indicate carcinoma.

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 Radiology question

What is the answer to this Radiology question?

The best answer is D, Carcinoma of the oesophagus. An apple-core stricture with shouldered edges and an irregular mucosa is the classic barium appearance of oesophageal cancer.

Why is "Oesophageal web" not the answer?

A web is a thin membrane, not a long irregular stricture.

Why is "Achalasia cardia" not the answer?

Achalasia shows a dilated oesophagus with a smooth beak.

Why is "Peptic stricture with smooth tapering" not the answer?

A peptic stricture tapers smoothly with intact mucosa.

What concept does this question test?

It tests Abdominal and GI imaging: oesophageal carcinoma on barium in Radiology. Peptic strictures taper smoothly, and achalasia gives a beak. Endoscopy with biopsy and CT staging follow.

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 Abdominal and GI imaging: oesophageal carcinoma on barium?

Learn signs with the image, and the disease they point to. Then use the flashcards and the other Radiology 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.