Histology: oesophageal epithelium: practice question

A Anatomy 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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Anatomy · Histology: oesophageal epithelium

Sample item

A 52-year-old man with 15 years of heartburn has salmon-coloured mucosa extending above the gastro-oesophageal junction at endoscopy. Which histological change is expected on biopsy of this segment?

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

The answer and the reasoning

A. Columnar epithelium with goblet cells replacing the stratified squamous lining

The normal oesophagus is lined by non-keratinised stratified squamous epithelium. Chronic acid reflux can cause intestinal metaplasia, in which columnar cells with goblet cells replace it (Barrett oesophagus), and this predisposes to adenocarcinoma. Metaplasia is a reversible replacement of one adult cell type by another that tolerates the stress better.

Option by option

  • A. Columnar epithelium with goblet cells replacing the stratified squamous lining (correct)

    Correct. Columnar epithelium with goblet cells is the intestinal-type metaplasia that defines Barrett oesophagus.

  • B. Transitional epithelium with large superficial umbrella cells

    Transitional epithelium lines the renal pelvis, ureter and bladder, not the oesophagus.

  • C. Simple cuboidal epithelium with a brush border

    A cuboidal lining with a brush border is characteristic of the proximal renal tubule.

  • D. Stratified squamous epithelium with a surface layer of keratin

    The oesophagus is normally non-keratinised, and a keratinised surface is seen in skin or in leukoplakia.

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.

More Anatomy questions

Questions about this Anatomy question

What is the answer to this Anatomy question?

The best answer is A, Columnar epithelium with goblet cells replacing the stratified squamous lining. The normal oesophagus is lined by non-keratinised stratified squamous epithelium.

Why is "Transitional epithelium with large superficial umbrella cells" not the answer?

Transitional epithelium lines the renal pelvis, ureter and bladder, not the oesophagus.

Why is "Simple cuboidal epithelium with a brush border" not the answer?

A cuboidal lining with a brush border is characteristic of the proximal renal tubule.

Why is "Stratified squamous epithelium with a surface layer of keratin" not the answer?

The oesophagus is normally non-keratinised, and a keratinised surface is seen in skin or in leukoplakia.

What concept does this question test?

It tests Histology: oesophageal epithelium in Anatomy. Chronic acid reflux can cause intestinal metaplasia, in which columnar cells with goblet cells replace it (Barrett oesophagus), and this predisposes to adenocarcinoma. Metaplasia is a reversible replacement of one adult cell type by another that tolerates the stress better.

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 Histology: oesophageal epithelium?

Learn every nerve by its route, its muscles and what a lesion looks like at the bedside. That one habit answers a large share of questions. Then use the flashcards and the other Anatomy 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.