GI imaging: achalasia: 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 · GI imaging: achalasia

Sample item

A barium swallow in a young adult with dysphagia for solids and liquids shows a dilated oesophagus tapering smoothly to a narrow segment at the gastro-oesophageal junction. What is this sign?

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

The answer and the reasoning

B. Bird's beak sign of achalasia

Achalasia results from failure of relaxation of the lower oesophageal sphincter with loss of peristalsis, giving a dilated oesophagus with a smooth tapered end like a bird's beak. The corkscrew oesophagus appears in diffuse oesophageal spasm. The rat-tail sign suggests malignancy.

Option by option

  • A. Cobblestone sign

    Cobblestone sign is seen in Crohn disease.

  • B. Bird's beak sign of achalasia (correct)

    Correct. Smooth tapered narrowing at the GE junction is the bird's beak.

  • C. Corkscrew oesophagus

    Corkscrew oesophagus indicates diffuse spasm.

  • D. Rat-tail sign of carcinoma

    The rat-tail sign suggests a malignant stricture, usually with shouldering.

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 Radiology questions

Questions about this Radiology question

What is the answer to this Radiology question?

The best answer is B, Bird's beak sign of achalasia. Achalasia results from failure of relaxation of the lower oesophageal sphincter with loss of peristalsis, giving a dilated oesophagus with a smooth tapered end like a bird's beak.

Why is "Cobblestone sign" not the answer?

Cobblestone sign is seen in Crohn disease.

Why is "Corkscrew oesophagus" not the answer?

Corkscrew oesophagus indicates diffuse spasm.

Why is "Rat-tail sign of carcinoma" not the answer?

The rat-tail sign suggests a malignant stricture, usually with shouldering.

What concept does this question test?

It tests GI imaging: achalasia in Radiology. The corkscrew oesophagus appears in diffuse oesophageal spasm. The rat-tail sign suggests malignancy.

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 GI imaging: achalasia?

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.