Pharynx and tonsils: cervical osteophyte dysphagia: 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 and tonsils: cervical osteophyte dysphagia

Sample item

An elderly man has slowly progressive dysphagia for solids and a sensation of a lump. A lateral cervical spine radiograph shows large flowing bony outgrowths along the anterior surface of C4 to C6. What is the most likely cause of the dysphagia?

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

The answer and the reasoning

A. Mechanical compression of the pharynx by anterior vertebral bony spurs

Large anterior cervical osteophytes, as in degenerative disease or diffuse idiopathic skeletal hyperostosis, can narrow and tether the hypopharynx and upper oesophagus. Dysphagia is mainly for solids, and surgical excision is considered when symptoms are severe.

Option by option

  • A. Mechanical compression of the pharynx by anterior vertebral bony spurs (correct)

    Correct. Anterior bony spurs push into the pharynx and impede the bolus.

  • B. Hypopharyngeal mucosal protrusion above the cricopharyngeus

    A pharyngeal pouch is a mucosal herniation that causes regurgitation and gurgling.

  • C. Cricopharyngeal muscle failing to relax

    Cricopharyngeal dysfunction is a muscular problem and is not explained by bony outgrowths.

  • D. Post-cricoid web with iron deficiency

    A post-cricoid web occurs with iron deficiency and typically affects middle-aged women.

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 A, Mechanical compression of the pharynx by anterior vertebral bony spurs. Large anterior cervical osteophytes, as in degenerative disease or diffuse idiopathic skeletal hyperostosis, can narrow and tether the hypopharynx and upper oesophagus.

Why is "Hypopharyngeal mucosal protrusion above the cricopharyngeus" not the answer?

A pharyngeal pouch is a mucosal herniation that causes regurgitation and gurgling.

Why is "Cricopharyngeal muscle failing to relax" not the answer?

Cricopharyngeal dysfunction is a muscular problem and is not explained by bony outgrowths.

Why is "Post-cricoid web with iron deficiency" not the answer?

A post-cricoid web occurs with iron deficiency and typically affects middle-aged women.

What concept does this question test?

It tests Pharynx and tonsils: cervical osteophyte dysphagia in ENT. Dysphagia is mainly for solids, and surgical excision is considered when symptoms are severe.

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 and tonsils: cervical osteophyte dysphagia?

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.