NBME Step 2 CK Form 7 Esophageal peristalsis: decreased;<br />Lower esophageal sphincter tone: increased (NBME Answers)

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Retired NBME Step 2 CK Form 7 Answers

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submitted by ∗carolebaskin(109)

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That's a bird's beak deformity!

Nerve damage causes increased LES tone and decreased peristalsis

If they show you a picture of a barium swallow, it can only be a few things

achalasia (bird's beak)
Zenker (outpouching)
volvulus/malrotation (corkscrew)
stricture (symmetric narrowing)
cancer (crazy, irregular stricture "hold up" prestricture dilatation; shouldering? whatever that means)

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submitted by ∗step_prep5(246)

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Previously healthy young woman with dysphagia to solids and liquids with upper endoscopy showing retained secretions in the esophagus with barium swallow showing “bird’s beak sign”, all of which is most consistent with achalasia
Key idea: Achalasia characterized by absence of esophageal peristalsis and impaired relaxation of lower esophageal sphincter

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