Pharynx and tonsils: dysphagia lusoria: 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: dysphagia lusoria

Sample item

A 30-year-old woman has intermittent dysphagia more marked for solids. A barium swallow shows an oblique extrinsic indentation on the posterior wall of the oesophagus at about the fourth thoracic level. Which structure is responsible?

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

The answer and the reasoning

D. Aberrant right subclavian artery

An aberrant right subclavian artery arises from the left side of the aortic arch and passes behind the oesophagus, causing a posterior oblique indentation and dysphagia lusoria. Pulmonary artery sling and an enlarged left atrium indent the oesophagus anteriorly.

Option by option

  • A. Enlarged left atrium

    An enlarged left atrium indents the oesophagus anteriorly at a lower level.

  • B. Retrosternal goitre

    A retrosternal goitre displaces the trachea and oesophagus at the thoracic inlet and does not produce an oblique posterior indentation.

  • C. Pulmonary artery sling

    A pulmonary artery sling passes between the trachea and oesophagus, indenting the oesophagus anteriorly, and presents in infancy.

  • D. Aberrant right subclavian artery (correct)

    Correct. An aberrant right subclavian artery crosses behind the oesophagus and indents its posterior wall obliquely.

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 D, Aberrant right subclavian artery. An aberrant right subclavian artery arises from the left side of the aortic arch and passes behind the oesophagus, causing a posterior oblique indentation and dysphagia lusoria.

Why is "Enlarged left atrium" not the answer?

An enlarged left atrium indents the oesophagus anteriorly at a lower level.

Why is "Retrosternal goitre" not the answer?

A retrosternal goitre displaces the trachea and oesophagus at the thoracic inlet and does not produce an oblique posterior indentation.

Why is "Pulmonary artery sling" not the answer?

A pulmonary artery sling passes between the trachea and oesophagus, indenting the oesophagus anteriorly, and presents in infancy.

What concept does this question test?

It tests Pharynx and tonsils: dysphagia lusoria in ENT. Pulmonary artery sling and an enlarged left atrium indent the oesophagus anteriorly.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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: dysphagia lusoria?

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.