Oesophagus: practice question

A General Surgery 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.

Try it

General Surgery · Oesophagus

Sample item

A 35-year-old man has dysphagia to both solids and liquids since onset, regurgitation of undigested food at night and weight loss. A barium swallow shows a dilated oesophagus tapering to a smooth beak. Which test best confirms the diagnosis?

A24-hour oesophageal pH monitoringBCT of the chestCOesophageal manometryDUpper endoscopy alone

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

The answer and the reasoning

C. Oesophageal manometry

The history and barium appearance suggest achalasia cardia. Manometry confirms it by showing absent peristalsis with incomplete relaxation of the lower oesophageal sphincter. Endoscopy is still performed to exclude a tumour causing pseudoachalasia.

Option by option

A. 24-hour oesophageal pH monitoring
pH monitoring assesses reflux, which is not the primary problem in achalasia.
B. CT of the chest
CT can show a dilated oesophagus but cannot confirm the motor abnormality.
C. Oesophageal manometry (correct)
Correct. It demonstrates the underlying motility defect.
D. Upper endoscopy alone
Endoscopy alone may look normal, so it excludes malignancy but does not confirm achalasia.

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 Surgery question

What is the answer to this General Surgery question?

The best answer is C, Oesophageal manometry. The history and barium appearance suggest achalasia cardia.

Why is "24-hour oesophageal pH monitoring" not the answer?

pH monitoring assesses reflux, which is not the primary problem in achalasia.

Why is "CT of the chest" not the answer?

CT can show a dilated oesophagus but cannot confirm the motor abnormality.

Why is "Upper endoscopy alone" not the answer?

Endoscopy alone may look normal, so it excludes malignancy but does not confirm achalasia.

What concept does this question test?

It tests Oesophagus in General Surgery. Manometry confirms it by showing absent peristalsis with incomplete relaxation of the lower oesophageal sphincter. Endoscopy is still performed to exclude a tumour causing pseudoachalasia.

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 Oesophagus?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery 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.