Gastroenterology and hepatology: Plummer-Vinson syndrome: 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: Plummer-Vinson syndrome

Sample item

A 45-year-old woman has fatigue, glossitis, koilonychia and difficulty swallowing solids. Haemoglobin is 8.5 g/dL with microcytic indices. A barium swallow shows a thin shelf-like filling defect in the cervical oesophagus. Which malignancy is she at increased risk of?

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

The answer and the reasoning

A. Squamous carcinoma of the hypopharynx or upper oesophagus

Iron deficiency anaemia, dysphagia and a postcricoid oesophageal web make up Plummer-Vinson (Paterson-Kelly) syndrome. Iron replacement often relieves the dysphagia, and dilatation treats persistent webs. The condition predisposes to squamous cell carcinoma of the hypopharynx and oesophagus.

Option by option

  • A. Squamous carcinoma of the hypopharynx or upper oesophagus (correct)

    Correct. Postcricoid web with iron deficiency carries a risk of upper squamous carcinoma.

  • B. Adenocarcinoma of the lower oesophagus

    Lower oesophageal adenocarcinoma arises in Barrett oesophagus from reflux.

  • C. Carcinoma of the gallbladder

    Gallbladder carcinoma is linked to gallstones and a porcelain gallbladder.

  • D. Gastric MALT lymphoma

    MALT lymphoma of the stomach is linked to Helicobacter pylori infection.

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 General Medicine question

What is the answer to this General Medicine question?

The best answer is A, Squamous carcinoma of the hypopharynx or upper oesophagus. Iron deficiency anaemia, dysphagia and a postcricoid oesophageal web make up Plummer-Vinson (Paterson-Kelly) syndrome.

Why is "Adenocarcinoma of the lower oesophagus" not the answer?

Lower oesophageal adenocarcinoma arises in Barrett oesophagus from reflux.

Why is "Carcinoma of the gallbladder" not the answer?

Gallbladder carcinoma is linked to gallstones and a porcelain gallbladder.

Why is "Gastric MALT lymphoma" not the answer?

MALT lymphoma of the stomach is linked to Helicobacter pylori infection.

What concept does this question test?

It tests Gastroenterology and hepatology: Plummer-Vinson syndrome in General Medicine. Iron replacement often relieves the dysphagia, and dilatation treats persistent webs. The condition predisposes to squamous cell carcinoma of the hypopharynx and oesophagus.

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: Plummer-Vinson syndrome?

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.