Gastroenterology and hepatology: Schatzki ring: practice question

A General Medicine 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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General Medicine · Gastroenterology and hepatology: Schatzki ring

Sample item

A 55-year-old man has intermittent dysphagia only for solids, especially bread and meat, with occasional food sticking that clears with water. He has no weight loss. Barium swallow shows a thin, smooth circumferential ring in the lower oesophagus above a small hiatal hernia. Where is this ring located?

AIn the gastric cardia below the diaphragmBJust below the cricopharyngeus in the post-cricoid regionCAt the squamocolumnar junction of the lower oesophagusDAt the level of the aortic arch indentation

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

The answer and the reasoning

C. At the squamocolumnar junction of the lower oesophagus

A Schatzki ring is a thin mucosal ring at the squamocolumnar junction (the B ring), often with a hiatal hernia. It causes intermittent solid-food dysphagia, sometimes called steakhouse syndrome. Dilatation gives relief.

Option by option

A. In the gastric cardia below the diaphragm
The gastric cardia lies below the junction, and a ring there would not be seen above the hiatal hernia.
B. Just below the cricopharyngeus in the post-cricoid region
A post-cricoid web is the lesion of Plummer-Vinson syndrome, with iron deficiency anaemia.
C. At the squamocolumnar junction of the lower oesophagus (correct)
Correct. A lower oesophageal mucosal ring sits at the squamocolumnar junction.
D. At the level of the aortic arch indentation
Indentation at the aortic arch is a normal extrinsic impression and does not cause a ring.

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.

Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is C, At the squamocolumnar junction of the lower oesophagus. A Schatzki ring is a thin mucosal ring at the squamocolumnar junction (the B ring), often with a hiatal hernia.

Why is "In the gastric cardia below the diaphragm" not the answer?

The gastric cardia lies below the junction, and a ring there would not be seen above the hiatal hernia.

Why is "Just below the cricopharyngeus in the post-cricoid region" not the answer?

A post-cricoid web is the lesion of Plummer-Vinson syndrome, with iron deficiency anaemia.

Why is "At the level of the aortic arch indentation" not the answer?

Indentation at the aortic arch is a normal extrinsic impression and does not cause a ring.

What concept does this question test?

It tests Gastroenterology and hepatology: Schatzki ring in General Medicine. It causes intermittent solid-food dysphagia, sometimes called steakhouse syndrome. Dilatation gives relief.

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 Gastroenterology and hepatology: Schatzki ring?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine 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.